Which are more risk at sudden cardiac death(SCD); sedentary people or active people?
in general population
in specific high risk population, such as people with DM & hypertension, family history in SCD
other conditions
Mahalul Azam,
Your question is not easily answered. Since the primary cause of sudden cardiac death is related to coronary artery disease (CAD), one might assume sedentary lifestyle. But a sedentary lifestyle does not usually result in demand ischemia because the baseline myocardial oxygen demand is low. Therefore, one might then opine that then an active lifestyle would be at a greater risk although with an active lifestyle is associated with cardiac health.
My answer would then be males with a baseline CAD that is undiagnosed nor treated who increase their myocardial oxygen consumption at irregular intervals.
https://doi.org/10.1161/01.CIR.98.21.2334
Very good question, most study have found protective association between regular physical activity and sudden cardiac death particularly for moderate levels of exertion. But vigorous exertion is also known as a risk factors of SCD. You can find exellent comment throught this link.
sorry i have forgotten to send the link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4929621/
Dear Dr. Azam,
Your question is not too easy to answer by one comprehensive answer. Indeed, the most important and consequently more definitive condition is what underlying cardiac disorders in a patient? The spectrum of cardiac abnormalities attributable to SCD is very wide and differ between various age groups. Congenital heart disease, severe heart rhythm and conduction disorders, coronary artery anomalies are more frequently registered in children and adolescents. In young persons hyperthrophic cardiomyopaty and myocarditis are leading causes of SCD in which exercises are contraindicated. In middle age and still greater in elderly patients the leading cause of ventricular tachyarrhythmias and, accordingly, SCD is coronary artery disease. Therefore, for its effective prevention the active mood of life is quite reasonable. There are a lot of information concerning this question.
In your question the paradigm of duality incorporated. Physical activity has both beneficial and adverse effects on SCD risk. Most studies, but not all,have found inverse associations between increasing regular physical activity and SCD or sudden cardiac arrest. Results are most consistent for moderate levels of exertion, where the majority of studies have documented favorable associations. Despite the long-term benefits of exercise, it is also well known that SCD occurs with a higher-than-average frequency during or shortly after vigorous exertion.Case-control and case-crossover studies performed among men have demonstrated that vigorous exertion can trigger cardiac arrest and SCD. Regular vigorous exertion diminishes the magnitude of this excess risk; however, the risk remains significantly elevated even in the most habitually active men. The magnitude of the risk associated with exertion appears to be lower among women where exertion-related SCD is much less common.
Sedentary lifestyle is associated with increased cardiovascular mortality. Patient with established cardiovascular disease .modest exercise might have some beneficial effect .But vigorous exercise in these groups is associated with increased cardiovascular mortality andSCD. So active lifestyle might have some beneficial effect provided unacustomed vigorous exercise to be avoided.
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