The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index; 3 of the 11 sources its claims cite were checked for support.
Triggering of Sudden Death from Cardiac Causes by Vigorous Exertion
Open accessAbstract
BACKGROUND: Retrospective and cross-sectional data suggest that vigorous exertion can trigger cardiac arrest or sudden death and that habitual exercise may diminish this risk. However, the role of physical activity in precipitating or preventing sudden death has not been assessed prospectively in a large number of subjects. METHODS: We used a prospective, nested case-crossover design within the Physicians' Health Study to compare the risk of sudden death during and up to 30 minutes after an episode of vigorous exertion with that during periods of lighter exertion or none. We then evaluated whether habitual vigorous exercise modified the risk of sudden death that was associated with vigorous exertion. In addition, the relation of vigorous exercise to the overall risk of sudden death and nonsudden death from coronary heart disease was assessed. RESULTS: During 12 years of follow-up, 122 sudden deaths were confirmed among the 21,481 male physicians who were initially free of self-reported cardiovascular disease and who provided information on their habitual level of exercise at base line. The relative risk of-sudden death during and up to 30 minutes after vigorous exertion was 16.9 (95 percent confidence interval, 10.5 to 27.0; P<0.001). However, the absolute risk of sudden death during any particular episode of vigorous exertion was extremely low (1 sudden death per 1.51 million episodes of exertion). Habitual vigorous exercise attenuated the relative risk of sudden death that was associated with an episode of vigorous exertion (P value for trend=0.006). The base-line level of exercise was not associated with the overall risk of subsequent sudden death. CONCLUSIONS: These prospective data from a study of U.S. male physicians suggest that habitual vigorous exercise diminishes the risk of sudden death during vigorous exertion.
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Claims the paper makes
16 Own result · 6 Own method · 5 No full text of the sources · 5 Own interpretation · 2 Supported so far · 2 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The relative risk of sudden death during and up to 30 minutes after vigorous exertion was 16.9 (95 percent confidence interval, 10.5 to 27.0; P<0.001).”
- Also stated in: § RESULTS · plain
“the relative risk of sudden death during the one-hour period associated with vigorous exertion (Fig. 1), as compared with other time points, was significantly elevated at 16.9 (95 percent confidence interval, 10.5 to 27.0; P<0.001).”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Each episode of exertion was associated with 60 minutes of exposure time.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Men who rarely engaged in vigorous exercise (less than once a week) had a relative risk of sudden death of 74.1 in the period during and 30 minutes after exertion.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > T ABLE 1. C HARACTERISTICS OF THE S UBJECTS W HO D IED S UDDENLY AND T HOSE W
plaincorrelationaln = 122- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Each episode of exertion was associated with 60 minutes of exposure time.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The relative risk associated with an acute episode of vigorous exertion was not significantly modified by the time of death.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Effect of Time of Death
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In comparison, men who exercised at least five times per week had a much lower risk (relative risk, 10.9); however, this risk was still significantly higher than that during periods of lighter exertion or none.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > T ABLE 1. C HARACTERISTICS OF THE S UBJECTS W HO D IED S UDDENLY AND T HOSE W
plaincorrelationaln = 122- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Each episode of exertion was associated with 60 minutes of exposure time.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In contrast, the risk of nonsudden death from coronary heart disease was lower among the men who participated in vigorous exercise than among those who did not.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Overall Risk Associated with Vigorous Exercise at Base Line
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In comparison, men who exercised at least five times per week had a much lower risk (relative risk, 10.9); however, this risk was still significantly higher than that during periods of lighter exertion or none.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > T ABLE 1. C HARACTERISTICS OF THE S UBJECTS W HO D IED S UDDENLY AND T HOSE W
plaincorrelationaln = 122- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Each episode of exertion was associated with 60 minutes of exposure time.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Habitual vigorous exercise attenuated the relative risk of sudden death that was associated with an episode of vigorous exertion (P value for trend= 0.006).”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Each episode of exertion was associated with 60 minutes of exposure time.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“it was 14.6 (95 percent confidence interval, 9.10 to 23.4) when the duration was estimated to be 40 minutes.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Sensitivity Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Each episode of exertion was associated with 60 minutes of exposure time.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The base-line level of exercise was not associated with the overall risk of subsequent sudden death.”
- Also stated in: § Overall Risk Associated with Vigorous Exercise at Base Line · plain
“The base-line level of vigorous exercise was not significantly associated with the risk of subsequent sudden death, either before or after potential confounders had been controlled for.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Overall Risk Associated with Vigorous Exercise at Base Line · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When the usual duration of vigorous exercise was estimated to be 20 minutes, the relative risk of sudden death in the 60-minute hazard period was 20.4 (95 percent confidence interval, 12.7 to 32.7)”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Sensitivity Analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Each episode of exertion was associated with 60 minutes of exposure time.
- It may state two separate claims as one. 5
- Probably not a substantial claim. 6
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“These results are similar to those reported for nonfatal myocardial infarction 17,25 and corroborate those previously reported in a population-based, retrospective casecontrol study of victims of cardiac arrest.11”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > T ABLE 3. R ELATIVE R ISK OF S UDDEN D EATH A SSOCIATED WITH AN E PISODE OF V IGOROUS E XERTION , A CCORDING TO THE TIME OF DEATH.
What the sources say
- Supportedcites [17] source
The source reports findings on myocardial infarction after heavy exertion, including a higher risk in the hour after exertion and a lower relative risk among people who exercised regularly (Results, p. 1). It therefore supports the comparison with nonfatal myocardial infarction. The cardiac-arrest study is cited separately as reference 11 and is not attributed to this source. (LLM, conf=0.93)
- Supportedcites [25] source
This source supports the nonfatal-myocardial-infarction portion of the sentence, to which its citation is attached. The Study Population (p. 2) identifies patients with documented nonfatal myocardial infarctions, and the Discussion (p. 4) reports increased risk during strenuous physical activity or within an hour afterward. The cardiac-arrest study is attached to a different citation and is not attributed to this source. (LLM, conf=0.91)
- Not checked — no full text of the sourcecites [11] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Each episode of exertion was associated with 60 minutes of exposure time.
- Supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Moderate physical activity is associated with a markedly reduced risk of coronary events 32,36 and cardiac arrest, 37 and therefore it might also protect against sudden death.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > T ABLE 3. R ELATIVE R ISK OF S UDDEN D EATH A SSOCIATED WITH AN E PISODE OF V IGOROUS E XERTION , A CCORDING TO THE TIME OF DEATH.
What the sources say
- Supportedcites [32] source
The Discussion reports that brisk walking, a moderate-intensity activity, was associated with a 30–40% lower risk of coronary events among women. In the citing sentence, the cardiac-arrest claim has a separate citation (37), so it is not attributed to this source. (LLM, conf=0.92)
- Not checked — no full text of the sourcecites [36] source
- Not checked — no full text of the sourcecites [37] source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In addition, the relative risk associated with vigorous exertion remained significantly elevated at times other than the circadian peak in sudden death, except for the period from midnight to 6 a.m., when exposure to exertion was low.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Effect of Time of Death
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“although the number is still quite small, the 23 sudden deaths that were associated with vigorous exertion in this study make up one of the largest series to date.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > T ABLE 3. R ELATIVE R ISK OF S UDDEN D EATH A SSOCIATED WITH AN E PISODE OF V IGOROUS E XERTION , A CCORDING TO THE TIME OF DEATH.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“To identify sudden deaths, medical records and reports from the next of kin for all subjects who had died from cardiac causes were reviewed again by two cardiologists, and agreement was reached on whether the death was sudden.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Definitions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The casecrossover study design permits the assessment of change in the risk of an event during a brief”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Study Design
What the sources say
- Not checked — no full text of the sourcecites [13] Maclure M, 1991, Am J Epidemiol source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Third, the rarity of exertion-related sudden death limits the statistical power of the study and tends to produce unstable estimates of risk.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > T ABLE 3. R ELATIVE R ISK OF S UDDEN D EATH A SSOCIATED WITH AN E PISODE OF V IGOROUS E XERTION , A CCORDING TO THE TIME OF DEATH.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“the relative risks of sudden death and nonsudden death from coronary heart disease for the base population of 21,481 men were computed with use of Cox proportional-hazards models 23 with simultaneous control for potential confounders.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Overall Risk of Sudden and Nonsudden Death from Cardiac Causes
What the sources say
- Not checked — no full text of the sourcecites [23] Cox DR, 1972, J R Stat Soc [B] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“An end-points committee of physicians confirmed all events by review of medical records.”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Definitions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“However, habitual vigorous exertion increases basal vagal tone, resulting in increased cardiac electrical stability and in protection against ventricular fibrillation.27”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > T ABLE 3. R ELATIVE R ISK OF S UDDEN D EATH A SSOCIATED WITH AN E PISODE OF V IGOROUS E XERTION , A CCORDING TO THE TIME OF DEATH.
What the sources say
- Not checked — no full text of the sourcecites [27] Hull SS, 1994, Circulation source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The authors state this as an assumption.
Each episode of exertion was associated with 60 minutes of exposure time.
“We therefore assumed that each episode of exertion was associated with 60 minutes of exposure time.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In addition, there is considerable evidence that exercise is safe for most people and has many associated health and fitness benefits; exercise-related cardiovascular events are often preceded by warning signs/symptoms; and the cardiovascular risks associated with exercise lessen as individuals become more physically active/fit.”
From Updating ACSM's Recommendations for Exercise Preparticipation Health Screening (2015) · cites this paper as [1]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Retrospective and prospective data suggest that vigorous-intensity physical activity transiently increases the risk of nonfatal AMI and SCD approximately sixfold (31) to 17-fold (1) as compared with resting behavior.”
From Updating ACSM's Recommendations for Exercise Preparticipation Health Screening (2015) · cites this paper as [1]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Nonetheless, some evidence suggests that diabetes mellitus and renal disease may be associated with exercise-related SCD and AMI (1,31), and specific recommendations for individuals with these comorbid conditions are incorporated into the new procedures.”
From Updating ACSM's Recommendations for Exercise Preparticipation Health Screening (2015) · cites this paper as [1]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In the Physician's Health Study, exercise substantially increased the relative risk of sudden cardiac death, 91”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [91]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Moreover, in virtually all studies, habitual physical activity was inversely related to the likelihood of SCD and/or AMI occurring during or immediately after vigorous-intensity exercise (1,12,31,39).”
From Updating ACSM's Recommendations for Exercise Preparticipation Health Screening (2015) · cites this paper as [1]
The cited source says what the claim attributes to it.
In the citing paper
“It is well established that the transient risks of SCD and AMI are substantially higher during acute vigorous physical exertion as compared with those during rest (1,31).”
From Updating ACSM's Recommendations for Exercise Preparticipation Health Screening (2015) · cites this paper as [1]
The cited source says what the claim attributes to it.
In the citing paper
“In the Physician's Health Study, although sudden cardiac death increased during exercise, habitual vigorous exercise reduced the risk of sudden cardiac death during exercise 7-fold.91”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [91]
The cited source says what the claim attributes to it.
In the citing paper
“One factor known to decrease exercise-related sudden cardiac death is habitual exercise.”
From Managing with pacemakers and implantable cardioverter defibrillators (2013) · cites this paper as [91]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > Abstract
“the absolute risk of sudden death during any particular episode of vigorous exertion was extremely low (1 sudden death per 1.51 million episodes of exertion).”
§ TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXER TION TRIGGERING OF SUDDEN DEATH FROM CARDIAC CAUSES BY VIGOROUS EXERTION > RESULTS
“The risk of sudden death associated with an episode of vigorous exertion was 1 per 1.42 million episodes or person-hours at risk.Alternatively, the risk of sudden death during periods of lighter exertion or none was 1 death per 23 million person-hours.From these data, the unadjusted difference in risk associated with exposure to vigorous exertion can be estimated at 1 excess sudden death per 1.51 million episodes of vigorous exertion.”
Citations
Cites
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Regression Models and Life-Tables
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Research works printed but not linked: 2
- Rothman KJ, Greenland S. Modern epidemiology. 2nd ed. Philadelphia: Lippincott–Raven, 1998:253-79.
- Chae CU, 1997, Circulation, 96, I
Cited by
Sorted by citations
Zeppenfeld, K., Tfelt‐Hansen, J., Riva, M., Winkel, B. G., Behr, E. R., Blom, N. A., Charron, P., Corrado, D., Dagres, N., de Chillou, C., et al. (2022) · European Heart Journal · doi:10.1093/eurheartj/ehac262 · Cited by 3,432
Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., CHAITMAN, B. R., FROMER, M. A., Gregoratos, G., Klein, G. J., Myerburg, R. J., Quiñones, M. A., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.07.010 · Cited by 1,975
2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease
Pelliccia, A., Sharma, S., Gati, S., Bäck, M., Börjesson, M., Caselli, S., Collet, J.-P., Corrado, D., Drezner, J. A., Halle, M., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehaa605 · Cited by 1,958
Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., Chaitman, B., Fromer, M., Gregoratos, G., Klein, G., Moss, A. J., Myerburg, R. J., et al. (2006) · Circulation · doi:10.1161/circulationaha.106.178233 · Cited by 1,080
Thompson (2007) · doi:10.1161/circulationaha.107.181485 · Cited by 1,000
“among young individuals and adults with both occult and diagnosed heart disease (5,7,25,29).”
BackgroundSelf-citationEvidence-Based Guidelines for Cardiovascular Disease Prevention in Women
Mosca, L. J., Appel, L. J., Benjamin, E. J., Berra, K. A., Chandra‐Strobos, N., Fabunmi, R. P., Grady, D. G., Haan, C. K., Hayes, S. N., Judelson, D. R., et al. (2004) · Circulation · doi:10.1161/01.cir.0000114834.85476.81 · Cited by 918
European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances
Lott, C., Truhlář, A., Alfonzo, A. V. M., Barelli, A., Salvado, V. G., Hinkelbein, J., Nolan, J. P., Paal, P., Perkins, G. D., Thies, K., et al. (2021) · Resuscitation · doi:10.1016/j.resuscitation.2021.02.011 · Cited by 839
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“Habitual vigorous exercise attenuates risk (76,77).”
BackgroundEpidemiology of Sudden Cardiac Death: Clinical and Research Implications
Chugh, S. S., Reinier, K., Teodorescu, C., Evanado, A., Kehr, E. L., Samara, M. A., Mariani, R., Gunson, K., & Jui, J. (2008) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2008.06.003 · Cited by 732
“An analysis from the Physicians Health Study reported no significant differences in total cholesterol or LDL using a case-control analysis.”
BackgroundThe Spectrum of Epidemiology Underlying Sudden Cardiac Death
Hayashi, M., Shimizu, W., & Albert, C. M. (2015) · Circulation Research · doi:10.1161/circresaha.116.304521 · Cited by 741
“Case–control and case-crossover analyses have demonstrated that vigorous exertion can trigger cardiac arrest(116) and SCD,(119,121) and this risk seems to be greater in men versus women.(119,121) Habitual exercise lowers this transient excess risk of SCD; however for men, the risk remains significantly elevated even a…”
Self-citationUpdating ACSM's Recommendations for Exercise Preparticipation Health Screening
RIEBE, D., FRANKLIN, B. A., THOMPSON, P. D., GARBER, C. E., WHITFIELD, G. P., MAGAL, M., & PESCATELLO, L. S. (2015) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000664 · Cited by 688
“Less is known about the risks of SCD and AMI during light- to moderate-intensity exercise, but they are assumed to be substantially lower (44).”
BackgroundInfluentialPhysical Activity for Health: What Kind? How Much? How Intense? On Top of What?
Powell, K. E., Paluch, A. E., & Blair, S. N. (2011) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031210-101151 · Cited by 685
Epidemiology and Genetics of Sudden Cardiac Death
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Self-citationMaron, B. J., Chaitman, B. R., Ackerman, M. J., Bayés de Luna, A., Corrado, D., Crosson, J. E., Deal, B. J., Driscoll, D. J., Estes, N. A. M., Araújo, C. G. S., et al. (2004) · Circulation · doi:10.1161/01.cir.0000128363.85581.e1 · Cited by 591
Cardiac arrest during long-distance running races
Kim, J. H., Malhotra, R., Chiampas, G., d'Hemecourt, P., Troyanos, C., Cianca, J., Smith, R. N., Wang, T. J., Roberts, W. O., Thompson, P. D., et al. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1106468 · Cited by 597
“Ventricular fibrillation or ventricular tachycardia 6 (26) 7 (88) 0.”
Assessment of Autonomic Function in Cardiovascular Disease
Lahiri, M. K., Kannankeril, P. J., & Goldberger, J. J. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.01.038 · Cited by 571
“The risk of cardiac arrest and sudden death is substantially increased during and immediately after vigorous activity (99,100).”
Sports-Related Sudden Death in the General Population
Marijon, É., Tafflet, M., Celermajer, D. S., Dumas, F., Perier, M., Mustafić, H., Toussaint, J., Desnos, M., Rieu, M., Bénameur, N., et al. (2011) · Circulation · doi:10.1161/circulationaha.110.008979 · Cited by 556
“lthough regular physical activity benefits cardiovascular health,(1) sport, particularly when practiced vigorously, has been shown to increase the risk of dying suddenly during or shortly after exercise.(2,3) The devastating consequences of unexpected sports-related sudden death (SD) and the recent availability of pub…”
BackgroundRognmo, Ø., Moholdt, T., Bakken, H., Hole, T., Mølstad, P., Myhr, N. E., Grimsmo, J., & Wisløff, U. (2012) · Circulation · doi:10.1161/circulationaha.112.123117 · Cited by 511
Mohlenkamp, S., Lehmann, N., Breuckmann, F., Brocker-Preuss, M., Nassenstein, K., Halle, M., Budde, T., Mann, K., Barkhausen, J., Heusch, G., et al. (2008) · European Heart Journal · doi:10.1093/eurheartj/ehn163 · Cited by 487
Autonomic Tone as a Cardiovascular Risk Factor: The Dangers of Chronic Fight or Flight
Curtis, B. M., & O’Keefe, J. H. (2002) · Mayo Clinic Proceedings · doi:10.4065/77.1.45 · Cited by 460
Exercise acts as a drug; the pharmacological benefits of exercise
Vina, J., Sanchis‐Gomar, F., Martinez‐Bello, V, & Gomez‐Cabrera, M. (2012) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.2012.01970.x · Cited by 443
Updated Cardiovascular Prevention Guideline of the Brazilian Society of Cardiology - 2019
Précoma, D. B., de Oliveira, G. M. M., Simão, A. F. L., Dutra, Ó. P., Coelho-Filho, O. R., Izar, M. C. D. O., Póvoa, R., Giuliano, I. D. C. B., Filho, A. C. D. A., Machado, C. A., et al. (2019) · Arquivos Brasileiros de Cardiologia · doi:10.5935/abc.20190204 · Cited by 507
Prospective Study of Sudden Cardiac Death Among Women in the United States
Albert, C. M., Chae, C. U., Grodstein, F., Rose, L. M., Rexrode, K. M., Ruskin, J. N., Stampfer, M. J., & Manson, J. E. (2003) · Circulation · doi:10.1161/01.cir.0000065223.21530.11 · Cited by 429
Self-citationDose of Jogging and Long-Term Mortality
Schnohr, P., O’Keefe, J. H., Marott, J. L., Lange, P., & Jensen, G. B. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.11.023 · Cited by 416
Gelsolin superfamily proteins: key regulators of cellular functions
Silacci, P., Mazzolai, L., Gauci, C. G., Stergiopulos, N., Yin, H. L., & Hayoz, D. (2004) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-004-4225-6 · Cited by 426
Franklin, B. A., Thompson, P. D., Al-Zaiti, S. S., Albert, C. M., Hivert, M.-F., Levine, B. D., Lobelo, F., Madan, K., Sharrief, A. Z., Eijsvogels, T. M. H., et al. (2020) · Circulation · doi:10.1161/cir.0000000000000749 · Cited by 410
Self-citationRelationship of Walking to Mortality Among US Adults With Diabetes
Gregg, E. W., Gerzoff, R. B., Caspersen, C. J., Williamson, D. F., & Narayan, K. M. V. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.12.1440 · Cited by 412
Panteleimon Ekkekakis, A., Hall, E. E., & Petruzzello, S. J. (2005) · Journal of Sports Sciences · doi:10.1080/02640410400021492 · Cited by 398
“On the other hand, physical activity of excessive intensity entails risk, leading to an increased incidence of sudden cardiac death (e.g. Albert et al., 2000; Cadroy et al., 2002), musculoskeletal injuries (e.g. Hootman et al., 2001) and suppression of immune function (e.g. Nieman, 1997).”
BackgroundMethodGebel, K., Ding, D., Chey, T., Stamatakis, E., Brown, W. J., & Bauman, A. E. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.0541 · Cited by 344
Emotional and physical precipitants of ventricular arrhythmia
Lampert, R., Joska, T., Burg, M. M., Batsford, W. P., McPherson, C. A., & Jain, D. (2002) · Circulation · doi:10.1161/01.cir.0000031733.51374.c1 · Cited by 347
Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women
Mosca, L. J., Appel, L. J., Benjamin, E. J., Berra, K. A., Chandra‐Strobos, N., Fabunmi, R. P., Grady, D. G., Haan, C. K., Hayes, S. N., Judelson, D. R., et al. (2004) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/01.atv.0000114834.85476.81 · Cited by 342
Autonomic Nervous System Dysfunction
Goldberger, J. J., Arora, R., Buckley, U., & Shivkumar, K. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.12.064 · Cited by 375
“The role of exercise and other conditions associated with sympathoexcitation as a major precipitant for MI (169,170) and ventricular arrhythmias and/or sudden cardiac death (171,172), and the proven usefulness of beta-adrenergic blockers to improve survival after MI and in heart failure with reduced ejection fraction…”
BackgroundMarijon, É., Narayanan, K., Smith, K. L., Barra, S., Basso, C., Blom, M. T., Crotti, L., d’Ávila, A., Deo, R., Dumas, F., et al. (2023) · The Lancet · doi:10.1016/s0140-6736(23)00875-9 · Cited by 336
Self-citationClinical neurocardiology defining the value of neuroscience-based cardiovascular therapeutics
Shivkumar, K., Ajijola, O. A., Anand, I., Armour, J. A., Chen, P., Esler, M., De Ferrari, G. M., Fishbein, M. C., Goldberger, J. J., Harper, R. M., et al. (2016) · The Journal of Physiology · doi:10.1113/jp271870 · Cited by 308
“While the roles for sympathetic activation as a trigger for life-threatening ventricular arrhythmias (Albert et al. 2000, 2003; Lampert et al. 2002), and for parasympathetic activation’s protective effect (Vanoli et al. 1991; Ng, 2014) are well established, none of the heart rate-based parameters…”
BackgroundEijsvogels, T. M. H., Molossi, S. M., Lee, D.-C., Emery, M. S., & Thompson, P. D. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.11.034 · Cited by 314
“9%) of which were exercise related, occurred in a study of 21,481 male physicians (45).”
BackgroundVanhees, L., Geladas, N. D., Hansen, D., Kouidi, E. J., Niebauer, J., Reiner, Ž., Cornelissen, V., Adamopoulos, S., Prescott, E., & Börjesson, M. (2011) · European Journal of Preventive Cardiology · doi:10.1177/1741826711430926 · Cited by 326
Assessment of parasympathetic reactivation after exercise
Goldberger, J. J., Le, F. K., Lahiri, M., Kannankeril, P. J., Ng, J., & Kadish, A. H. (2006) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.01118.2005 · Cited by 296
Physical Activity and Mortality in Patients With Stable Coronary Heart Disease
Stewart, R., Held, C., Hadziosmanovic, N., Armstrong, P. W., Cannon, C. P., Granger, C. B., Hagström, E., Hochman, J. S., Köenig, W., Lonn, E., et al. (2017) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.08.017 · Cited by 310
“Vigorous exercise may increase CV risk by triggering MI (28) or sudden death (29), and this risk could be greater in patients with stable CHD.”
BackgroundThe short-term mortality consequences of income receipt
Evans, W. N., & Moore, T. (2011) · Journal of Public Economics · doi:10.1016/j.jpubeco.2011.05.010 · Cited by 292
“…1 Triggers for heart attacks include getting out of bed (Elliott, 2001), returning to work on Mondays (Witte et al., 2005), shoveling snow (Heppell et al. 1991), the Christmas season (Phillips et al., 2004) and physical exertion (Albert et al. 2000).”
BackgroundInfluentialBreuckmann, F., Möhlenkamp, S., Naßenstein, K., Lehmann, N., Ladd, S. C., Schmermund, A., Sievers, B., Schlosser, T. W., Jöckel, K., Heusch, G., et al. (2009) · Radiology · doi:10.1148/radiol.2511081118 · Cited by 290
Lampert, R., Olshansky, B., Heidbuchel, H., Lawless, C., Saarel, E., Ackerman, M., Calkins, H., Estes, N. A. M., Link, M. S., Maron, B. J., et al. (2013) · Circulation · doi:10.1161/circulationaha.112.000447 · Cited by 286
Physical Activity, Health Benefits, and Mortality Risk
Kokkinos, P. F. (2012) · ISRN Cardiology · doi:10.5402/2012/718789 · Cited by 321
“5 to 30 times higher when compared to those who engage even moderate levels of physical activity (twice weekly) [152–154].”
BackgroundExercise Dose in Clinical Practice
Wasfy, M. M., & Baggish, A. L. (2016) · Circulation · doi:10.1161/circulationaha.116.018093 · Cited by 292
Triggering of Acute Cardiovascular Disease and Potential Preventive Strategies
Tofler, G. H., & Muller, J. E. (2006) · Circulation · doi:10.1161/circulationaha.105.596189 · Cited by 270
Mont, L., Pelliccia, A., Sharma, S., Biffi, A., Börjesson, M., Brugada, J., Carré, F., Guasch, E., Heidbüchel, H., Gerche, A. L., et al. (2016) · European Journal of Preventive Cardiology · doi:10.1177/2047487316676042 · Cited by 268
Sudden cardiac death in athletes: the Lausanne Recommendations
Bille, K., Figueiras, D., Schamasch, P., KAPPENBERGER, L. J., Brenner, J. I., Meijboom, F. J., & Meijboom, E. J. (2006) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/01.hjr.0000238397.50341.4a · Cited by 254
Lin, J. S., O’Connor, E., Whitlock, E. P., & Beil, T. L. (2010) · Annals of Internal Medicine · doi:10.7326/0003-4819-153-11-201012070-00007 · Cited by 256
“42 million person-hours of exercise (126).”
Chugh, S. S., Reinier, K., Singh, T., Uy‐Evanado, A., Socoteanu, C., Peters, D., Mariani, R., Gunson, K., & Jui, J. (2009) · Circulation · doi:10.1161/circulationaha.108.797035 · Cited by 236
Billman, G. E. (2009) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00534.2009 · Cited by 237
Association of Short-term Ambient Air Pollution Concentrations and Ventricular Arrhythmias
Rich, D. Q., Schwartz, J. D., Mittleman, M. A., Link, M. S., Luttmann‐Gibson, H., Catalano, P. J., Speizer, F. E., & Dockery, D. W. (2005) · American Journal of Epidemiology · doi:10.1093/aje/kwi143 · Cited by 232
Self-citationHigh Intensity Interval Training for Maximizing Health Outcomes
Karlsen, T., Aamot, I., Haykowsky, M. J., & Rognmo, Ø. (2017) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2017.03.006 · Cited by 256
Risk of sports: do we need a pre-participation screening for competitive and leisure athletes?
Corrado, D., Schmied, C. M., Basso, C., Börjesson, M., Schiavon, M., Pelliccia, A., Vanhees, L., & Thiene, G. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehq482 · Cited by 240
Maron, B. J., de Araújo, C. G. S., Thompson, P. D., Fletcher, G. F., de Luna, A. B., Fleg, J. L., Pelliccia, A., Balady, G. J., Furlanello, F., Camp, S. P. V., et al. (2001) · Circulation · doi:10.1161/01.cir.103.2.327 · Cited by 227
Börjesson, M., Urhausen, A. P., Kouidi, E. J., Dugmore, D., Sharma, S., Halle, M., Heidbüchel, H., Björnstad, H. H., Gielen, S., Mezzani, A., et al. (2010) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/hjr.0b013e32833bo969 · Cited by 238
“This step incorporating further risk stratification/evaluation should be performed by a qualified physician, thereby concentrating the physician’s efforts towards the group of individuals with a higher risk of events during PA.”
BackgroundInfluential72-h Kinetics of High-Sensitive Troponin T and Inflammatory Markers after Marathon
Scherr, J., Braun, S., Schuster, T., HARTMANN, C., MOEHLENKAMP, S., Wolfarth, B., Preßler, A., & Halle, M. (2011) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31821b12eb · Cited by 229
Are There Deleterious Cardiac Effects of Acute and Chronic Endurance Exercise?
Eijsvogels, T. M. H., Fernández, A. B., & Thompson, P. D. (2015) · Physiological Reviews · doi:10.1152/physrev.00029.2014 · Cited by 236
Exercise and cardiovascular risk in patients with hypertension
Sharman, J. E., La Gerche, A., & Coombes, J. S. (2015) · American Journal of Hypertension · doi:10.1093/ajh/hpu191 · Cited by 224
Mont, L., Pelliccia, A., Sharma, S., Biffi, A., Börjesson, M., Brugada, J., Carré, F., Guasch, E., Heidbüchel, H., Gerche, A. L., et al. (2016) · EP Europace · doi:10.1093/europace/euw243 · Cited by 226
“Whilst intense exercise is an established trigger of coronary events, regular exercise training attenuates this risk.(159)”
BackgroundPaffenbarger, R. S., Blair, S. N., & Lee, I.-M. M. (2001) · International Journal of Epidemiology · doi:10.1093/ije/30.5.1184 · Cited by 234
Self-citationSudden Cardiac Arrest During Sports Activity in Middle Age
Marijon, É., Uy‐Evanado, A., Reinier, K., Teodorescu, C., Narayanan, K., Jouven, X., Gunson, K., Jui, J., & Chugh, S. S. (2015) · Circulation · doi:10.1161/circulationaha.114.011988 · Cited by 217
“4) during vigorous activity among men enrolled in the Physicians’ Health Study.(20,21) Similar sex differences have also been reported in smaller retrospective studies in Finland and in the United States.”
BackgroundMethodResultInfluentialPhysical inactivity: associated diseases and disorders.
Knight, J. A. (2012) · PubMed · Cited by 208
Effects of acute exercise on flow-mediated dilatation in healthy humans
Dawson, E. A., GREEN, D. J., Cable, N. T., & Thijssen, D. H. J. (2013) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00450.2013 · Cited by 207
Dahabreh, I. J. (2011) · JAMA · doi:10.1001/jama.2011.336 · Cited by 199
“One study was nested within the Physicians’ Health Study and enrolled 122 male patients.(37) The other study was nested within the Nurses’ Health Study and enrolled 288 female patients.”
Physical, Psychological and Chemical Triggers of Acute Cardiovascular Events
Mittleman, M. A., & Mostofsky, E. (2011) · Circulation · doi:10.1161/circulationaha.110.968776 · Cited by 210
Self-citationPhysical Exertion, Exercise, and Sudden Cardiac Death in Women
Whang, W., Manson, J. E., Hu, F. B., Chae, C. U., Rexrode, K. M., Willett, W. C., Stampfer, M. J., & Albert, C. M. (2006) · JAMA · doi:10.1001/jama.295.12.1399 · Cited by 192
“Despite all of the known benefits of exercise, there are also well-documented associations between acute episodes of exertion and sudden cardiac death.(9-15) Although exertion-related sudden cardiac deaths are relatively rare compared with other health outcomes, these deaths commonly occur in an unexpected fashion amo…”
BackgroundMethodSelf-citationEXERCISE AND AUTONOMIC FUNCTION IN HEALTH AND CARDIOVASCULAR DISEASE
Rosenwinkel, E. T., Bloomfield, D. M., Arwady, M. A., & Goldsmith, R. L. (2001) · Cardiology Clinics · doi:10.1016/s0733-8651(05)70223-x · Cited by 194
Aerobic exercise conditioning: a nonpharmacological antiarrhythmic intervention
Billman, G. E. (2002) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00874.2001 · Cited by 185
“In a similar manner, a large prospective study of male physicians (2) found that, although the incidence of sudden death significantly increased during or shortly after exercise, the “absolute risk of sudden death during any particular episode of rigorous exertion was extremely low (1 sudden death per 1.”
ResultExercise Prescription and Proscription for Patients With Coronary Artery Disease
Thompson, P. D. (2005) · Circulation · doi:10.1161/circulationaha.104.502591 · Cited by 176
Behavioral and Emotional Triggers of Acute Coronary Syndromes: A Systematic Review and Critique
Strike, P. C., & Steptoe, A. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000155663.93160.d2 · Cited by 180
“An analysis was carried out of deaths in the Physician’s Health Study using case–crossover comparisons with habitual exercise levels measured previously by questionnaire (28).”
MethodDrezner, J. A., Toresdahl, B. G., Rao, A. L., Huszti, E., & Harmon, K. G. (2013) · British Journal of Sports Medicine · doi:10.1136/bjsports-2013-092786 · Cited by 188
Maron, B. J. (2000) · New England Journal of Medicine · doi:10.1056/nejm200011093431911 · Cited by 182
I Diretriz Brasileira de Prevenção Cardiovascular
Simão, A., Précoma, D., Andrade, J., Filho, H. C., Saraiva, J., Oliveira, G., Murro, A., Campos, A., Alessi, A., Avezum, Á., et al. (2013) · Arquivos Brasileiros de Cardiologia · doi:10.5935/abc.2013s012 · Cited by 186
Zipes, D. P., Link, M. S., Ackerman, M. J., Kovacs, R. J., Myerburg, R. J., & Estes, N. A. M. (2015) · Circulation · doi:10.1161/cir.0000000000000245 · Cited by 172
“There may be as yet unrecognized implications for higher risk of SCD associated with intense exercise in subjects in the general population who do not exercise regularly.(21) This observation should be considered in deconditioned athletes who immediately begin a very intense conditioning program.”
BackgroundRich, D. Q., Mittleman, M. A., Link, M. S., Schwartz, J. D., Luttmann‐Gibson, H., Catalano, P. J., Speizer, F. E., Gold, D. R., & Dockery, D. W. (2005) · Environmental Health Perspectives · doi:10.1289/ehp.8371 · Cited by 167
“These methods have been used previously to study triggers of acute cardiovascular events (Albert et al. 2000; D’Ippoliti et al. 2003; Hallqvist et al. 2000; Mittleman et al. 1995; Peters et al. 2000a; Rich et al. 2005).”
MethodSelf-citationRisk Stratification for Arrhythmic Sudden Cardiac Death
Goldberger, J. J., Buxton, A. E., CAIN, M. E., Costantini, O., Exner, D. V., Knight, B. P., Lloyd‐Jones, D. M., Kadish, A. H., Lee, B. K., Moss, A. J., et al. (2011) · Circulation · doi:10.1161/circulationaha.110.959734 · Cited by 167
Lampert, R., Chung, E. H., Ackerman, M. J., Arroyo, A. R., Darden, D., Deo, R., Dolan, J., Etheridge, S. P., Gray, B. R., Harmon, K. G., et al. (2024) · Heart Rhythm · doi:10.1016/j.hrthm.2024.05.018 · Cited by 167
Mourot, L., Bouhaddi, M., Tordi, N., Rouillon, J. D., & Regnard, J. (2004) · European Journal of Applied Physiology · doi:10.1007/s00421-004-1119-0 · Cited by 177
“However, the risk of sudden death is increased during and immediately after exercise (Albert et al. 2000), possibly related to acute changes in autonomic tone (Curtis and O’Keefe 2002).”
BackgroundCardiac Arrest and Sudden Cardiac Death
Myerburg, R. J., & Castellanos, A. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-0398-6.00041-x · Cited by 166
Extreme sacrifice: sudden cardiac death in the US Fire Service
Smith, D. L., Barr, D. A., & Kales, S. N. (2013) · Extreme Physiology & Medicine · doi:10.1186/2046-7648-2-6 · Cited by 180
“Heavy physical exertion [52-54] or strenuous work [55] can trigger the onset of acute CVD events, particularly in sedentary individuals.”
BackgroundCardiovascular Strain of Firefighting and the Risk of Sudden Cardiac Events
Smith, D. L., DeBlois, J. P., Kales, S. N., & Horn, G. P. (2016) · Exercise and Sport Sciences Reviews · doi:10.1249/jes.0000000000000081 · Cited by 159
“Classic studies have temporally linked heavy physical exertion/ strenuous work (such as running or snow shoveling) to the onset of acute cardiovascular events, with the risk being concentrated among individuals who are unaccustomed to such levels of exertion (1,12).”
BackgroundBaggish, A. L., Battle, R. W., Beaver, T. A., Border, W. L., Douglas, P. S., Kramer, C. M., Martinez, M. W., Mercandetti, J., Phelan, D. M. J., Singh, T. K., et al. (2020) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2020.02.009 · Cited by 157
“However, vigorous physical activity, particularly in CAwith underlying cardiovascular disease (CVD), transiently increases the risk of adverse events, including sudden cardiac death (SCD).(5,6) The true incidence of SCD in CA 35 years or younger is unknown, with estimates ranging from 0.”
BackgroundSafety of Sports for Athletes With Implantable Cardioverter-Defibrillators
Lampert, R. J., Olshansky, B., Heidbüchel, H., Lawless, C. E., Saarel, E. V., Ackerman, M. J., Calkins, H. G., Estes, N. A. M., Link, M. S., Maron, B. J., et al. (2017) · Circulation · doi:10.1161/circulationaha.117.027828 · Cited by 156
Kuriachan, V. P., Sumner, G., & Mitchell, L. B. (2015) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2015.01.002 · Cited by 166
“51 million sessions in the Physicians Health Study of 21,481 men followed for 12 years(4).”
BackgroundHair cortisol and the risk for acute myocardial infarction in adult men
Pereg, D., Gow, R., Mosseri, M., Lishner, M., Rieder, M., Uum, S. V. V., & Koren, G. (2011) · Stress · doi:10.3109/10253890.2010.511352 · Cited by 161
“The association between acute stress and cardiovascular morbidity and mortality is well established (Mittleman et al. 1993, 1995; Leor et al. 1996; Albert et al. 2000; Strike et al. 2006; Brotman et al. 2007; Chida and Steptoe 2010).”
BackgroundKop, W. J., Krantz, D. S., Nearing, B. D., Gottdiener, J. S., Quigley, J. F., O’Callahan, M., DelNegro, A. A., Friehling, T. D., Karasik, P., Suchday, S., et al. (2004) · Circulation · doi:10.1161/01.cir.0000124726.72615.60 · Cited by 153
Cardiac autonomic modulation during recovery from acute endurance versus resistance exercise
Heffernan, K. S., Kelly, E. E., Collier, S. R., & Fernhall, B. (2006) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/01.hjr.0000197470.74070.46 · Cited by 149
Risgaard, B., Winkel, B. G., Jabbari, R., Glinge, C., Hansen, O. I., Thomsen, J. L., Ottesen, G. L., Haunsø, S., Holst, A. G., & Tfelt‐Hansen, J. (2014) · Heart Rhythm · doi:10.1016/j.hrthm.2014.05.026 · Cited by 145
Physical Activity, Obesity and Cardiovascular Diseases
Lakka, T. A., & Bouchard, C. (2005) · Handbook of experimental pharmacology · doi:10.1007/3-540-27661-0_4 · Cited by 141
Biological Influence of Physical Exercise on Hemostasis
Lippi, G., & Maffulli, N. (2009) · Seminars in Thrombosis and Hemostasis · doi:10.1055/s-0029-1222605 · Cited by 139
“9), but offers protection against this risk in trained subjects.(32) Therefore, although growing evidence indicates that benefit of physical activity may result to some extent from effects on hemostasis and inflammation, the increased burden of cardiovascular complications and sudden death occurring during and immedia…”
BackgroundSudden Cardiac Death in the Older Athlete
Chugh, S. S., & Weiss, J. B. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.10.064 · Cited by 141
Effect of marathon running on inflammatory and hemostatic markers
Siegel, A. J., Stec, J. J., Lipinska, I., Cott, E. M. V., Lewandrowski, K. B., Ridker, P. M., & Tofler, G. H. (2001) · The American Journal of Cardiology · doi:10.1016/s0002-9149(01)01909-9 · Cited by 139
Circumstances of death in adult congenital heart disease
Zomer, A. C., Vaartjes, I. C. H., Uiterwaal, C. S. P. M., van der Velde, E. T., van den Merkhof, L. F. M., Baur, L. H. B., Ansink, T. J. M., Cozijnsen, L., Pieper, P. G., Meijboom, F. J., et al. (2010) · International Journal of Cardiology · doi:10.1016/j.ijcard.2010.09.015 · Cited by 140
“Heavy physical exercise as trigger for sudden death (SD) in adults with CHD has been suggested, but is not as well reported as for coronary artery disease, (isolated) coronary artery anomalies, and hypertrophic cardiomyopathy [19–23].”
BackgroundEvidence for an exercise induced increase of TNF ‐α and IL ‐6 in marathon runners
Bernecker, C., Scherr, J., Schinner, S., Braun, S., Scherbaum, W. A., & Halle, M. (2011) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/j.1600-0838.2011.01372.x · Cited by 151
“However, prolonged strenuous exercise such as marathon running may trigger acute myocardial infarction and sudden cardiac death (Maron et al., 1996; Albert et al., 2000).”
BackgroundBigler, E. D. (2004) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617704105146 · Cited by 135
Triggers of Subarachnoid Hemorrhage
Anderson, C. S., Mhurchú, C. N., Scott, D., Bennett, D., Jamrozik, K. D., & Hankey, G. J. (2003) · Stroke · doi:10.1161/01.str.0000077015.90334.a7 · Cited by 129
Incidence of sudden cardiac arrest in high school student athletes on school campus
Toresdahl, B. G., Rao, A. L., Harmon, K. G., & Drezner, J. A. (2014) · Heart Rhythm · doi:10.1016/j.hrthm.2014.04.017 · Cited by 128
Exercise Guidelines in Pregnancy
Zavorsky, G. S., & Longo, L. D. (2011) · Sports Medicine · doi:10.2165/11583930-000000000-00000 · Cited by 130
Williams, P. T., & Thompson, P. D. (2014) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2014.05.006 · Cited by 126
Sudden Cardiac Death in the Athlete
Link, M. S., & Estes, N. A. M. (2012) · Circulation · doi:10.1161/circulationaha.111.023861 · Cited by 122
Effect of Sildenafil on Cardiac Performance in Patients With Heart Failure
Hirata, K., Adji, A. I., Vlachopoulos, C. V., & O’Rourke, M. F. (2005) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.06.091 · Cited by 122
Metadata
- Authors
- Albert, C. M., Mittleman, M. A., Chae, C. U., Lee, I.-M., Hennekens, C. H., & Manson, J. E.
- Affiliations
- Brigham and Women's Hospital (US)
- Beth Israel Deaconess Medical Center (US)
- University of Miami (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2000-11-09
- Volume
- 343
- Issue
- 19
- Pages
- 1355-1361
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2319521698
- Cited by
- 1,020
- References
- 44
- Citations by year
- 2026: 8 · 2025: 27 · 2024: 32 · 2023: 36 · 2022: 42 · 2021: 37 · 2020: 45 · 2019: 41 · 2018: 47 · 2017: 61 · 2016: 51 · 2015: 78 · 2014: 43 · 2013: 43 · 2012: 41
- FWCI
- 14.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (HL-34595, R01HL034595, K08HL003783)
- National Cancer Institute (R01CA040360, CA 40360)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- sudden cardiac death, physical activity, habitual exercise, cardiac arrest, coronary heart disease mortality, male physicians, exercise intensity, risk factor control
- MeSH terms
- Adult, Aged, Aged, 80 and over, Coronary Disease, Physical Exertion, Humans, Male, Middle Aged, Prospective Studies, Risk, Risk Factors, Exercise, Proportional Hazards Models, Case-Control Studies, Death, Sudden, Cardiac
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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