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
Regression Models and Life-Tables
Cox, D. R. (1972) · Journal of the Royal Statistical Society Series B: Statistical Methodology · doi:10.1111/j.2517-6161.1972.tb00899.x · Cited by 39,793
Regression Models and Life-Tables
Cox, D. R. (1992) · Springer Series in Statistics · doi:10.1007/978-1-4612-4380-9_37 · Cited by 26,297
The Case-Crossover Design: A Method for Studying Transient Effects on the Risk of Acute Events
Maclure, M. (1991) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115853 · Cited by 2,327
Final Report on the Aspirin Component of the Ongoing Physicians' Health Study
Steering Committee of the Physicians' Health Study Research Group (1989) · New England Journal of Medicine · doi:10.1056/nejm198907203210301 · Cited by 2,267
Paffenbarger, R. S., Hyde, R. T., Wing, A. L., Lee, I.-M., Jung, D. L., & Kampert, J. B. (1993) · New England Journal of Medicine · doi:10.1056/nejm199302253280804 · Cited by 1,972
Self-citationBlair, S. N. (1996) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1996.03540030039029 · Cited by 1,819
Mittleman, M. A., Maclure, M., Tofler, G. H., Sherwood, J. B., Goldberg, R. J., & Muller, J. E. (1993) · New England Journal of Medicine · doi:10.1056/nejm199312023292301 · Cited by 1,431
Self-citationA meta-analysis of physical activity in the prevention of coronary heart disease.
BERLIN, J. A., & COLDITZ, G. A. (1990) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115704 · Cited by 1,382
Circadian variation in the frequency of sudden cardiac death.
Muller, J. E., Ludmer, P. L., Willich, S. N., Tofler, G. H., Aylmer, G., Klangos, I., & Stone, P. H. (1987) · Circulation · doi:10.1161/01.cir.75.1.131 · Cited by 1,083
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
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Boon, N. A. (2005) · The Journal of the Royal College of Physicians of Edinburgh · doi:10.1177/1478271520053504003 · Cited by 1
La pratica sportiva in portatori di pacemaker e defibrillatori
Lamberti, F. (2011) · Springer eBooks · doi:10.1007/978-88-470-2352-9_25
Risk Factors for Sudden Death in the General Population
Jouven, X., & Ducimetière, P. (2001) · Cardiac Electrophysiology Review · doi:10.1023/a:1013215630871
The effect of beta blockers on heart rate response during the Chester Step Test
Gilchrest, J. (2011) · ChesterRep (University of Chester)
Sagiv, M. S. (2012) · Springer eBooks · doi:10.1007/978-1-4471-2888-5_9
Sports Practice in Individuals with Cardiac Pacemakers and Implantable Cardioverter-Defibrillators
Lamberti, F. (2012) · Springer eBooks · doi:10.1007/978-88-470-2775-6_27
Endurance Sport Practice and Arrhythmias
Guasch, E., & Mont, L. (2009) · Springer eBooks · doi:10.1007/978-1-84882-927-5_5
Panhuyzen-Goedkoop, N. M., & Smeets, J. L. R. M. (2008) · Radboud Repository (Radboud University)
High-intensity aerobic exercise and cardiovascular health
Rognmo, Ø. (2008) · NORA - Norwegian Open Research Archives
Efectos del entrenamiento concurrente, polarizado y tradicional, sobre la condición física saludable
Varela-Sanz, A. (2014) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
Condición física en la adolescencia
Porcel, F. B. O. (2011)
Goodman, J. M., Thomas, S. G., & Burr, J. F. (2013) · Europe PMC (PubMed Central)
Preventing Sudden Cardiac Death during Marathons with Pre-Race Aspirin
Siegel, A. J. (2015) · World Journal of Cardiovascular Diseases · doi:10.4236/wjcd.2015.58024
Effects of exercise on thrombosis and hemostasis
Ikarugi, H., & Yamamoto, J. (2008) · Japanese Journal of Thrombosis and Hemostasis · doi:10.2491/jjsth.19.48
What should the clinician tell patients with mild hypertension about physical activity?
Cornelissen, V., & Fagard, R. (2007) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-007-0039-z · Cited by 1
Putting the 2008 Physical Activity Guidelines Into Practice to Prevent Cardiovascular Disease
Lee, I.-M. M. (2010) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-010-0105-9
Self-citationWüstenfeld, J. C., Scherr, J., & Wolfarth, B. (2014) · Sports Orthopaedics and Traumatology · doi:10.1016/j.orthtr.2014.09.011
Irles, D., Canu, P., Popoff, S., et al. (2014) · Archives des Maladies du Coeur et des Vaisseaux - Pratique · doi:10.1016/s1261-694x(14)70589-9
Kardiale Zwischenfälle im Sport
Löllgen, H., Gerke, R., & Löllgen, R. (2009) · Sport- und Präventivmedizin · doi:10.1007/s12534-009-0044-8
Chronic physical exercise: Beneficial effects overcome risks when correctly prescribed
Lucini, D., & Pagani, M. (2011) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2011.08.026
Hilberg, T. (2005) · Journal of Laboratory Medicine · doi:10.1515/jlm.2005.051
Muerte súbita en jóvenes deportistas
González‐Gross, M., & Montero, F. J. C. (2009) · FMC - Formación Médica Continuada en Atención Primaria · doi:10.1016/s1134-2072(09)70470-0
Hoppe, U. C. (2008) · Springer eBooks · doi:10.1007/978-3-540-79011-2_3
Electrophysiologic Study of Exhaustive Exercise
Bigi, B., & Aslani, A. (2010) · International Cardivascular Research Journal
Novel Predictors of Sudden Cardiac Death
Chugh, S. S., Havmöller, R., Teodorescu, C., Huertas‐Vázquez, A., Uy‐Evanado, A., & Reinier, K. (2013) · Springer eBooks · doi:10.1007/978-1-4471-4978-1_19
Corrado, D., Crosson, J. E., Deal, B. J., Driscoll, D. J. O., Maron, B. J., CHAITMAN, B. R., & Ackerman, M. J. (2007)
Oxidative Stress and Heart Rate Variability Following an Accute Bout of CrossFit
Kliszczewicz, B. M. (2014)
Evaluation of the Young Patient Resuscitated from Ventricular Fibrillation
Subbiah, R. N., Leong‐Sit, P., Gula, L. J., Skanes, A. C., White, J. A., Yee, R. K., Klein, G. J., & Krahn, A. D. (2011) · Cardiac Electrophysiology Clinics · doi:10.1016/j.ccep.2011.08.005
Zipes, D. P., Buxton, A. E., Gregoratos, G., Moss, A. J., Myerburg, R. J., Priori, S. G., Quiñones, M. A., von Roden, M., & Silka, M. J. (2006)
Two Cases of Acute Myocardial Infarction Occurring in Healthy Adults during a Marathon Race
Lee, B., Ahn, P., Min, H. J., et al. (2013) · Korean Journal of Medicine · doi:10.3904/kjm.2013.85.4.411
Echocardiography in sports cardiology: LV remodeling in athletes' heart — Questions to be answered
Zdravkovic, M. D., Vujusić-Tesic, B., Krotin, M., Nedeljković, I., Mazic, S. D., Stepanović, J., Tesic, M., & Ostojić, M. (2011) · Interventional Medicine and Applied Science · doi:10.1556/imas.3.2011.3.9
Cardiovascular Risk: Exercise Good Judgment
McInnis, K. J. (2008) · American Journal of Lifestyle Medicine · doi:10.1177/1559827608317641
Cardiac Effects of Prolonged Exercise
Sahlén, A. (2009) · Figshare
Sudden cardiac death athletes: a systematic
Ferreira, M., Silva, P. R. S., de Abreu, L. C., et al. (2010)
Parker, C. F., & Desmond, S. M. (2006)
Baskurt, K., Yalçın, Ö., Erman, A., Muratlı, S., & Bor-Küçükatay, M. (2015)
volunteerstendency in healthy sedentary male Strenuous but not moderate exercise increases the
Rivière, D., Pillard, F., Sakaríassen, K. S., Thalamas, C., Seiler, C. A., Senden, J., Solberg, E. E., Börjesson, M., Assanelli, D., Carré, F., et al. (2015)
Disease Exercise Prescription and Proscription for Patients With Coronary Artery
Thompson, P. D. (2006)
Title of Document: EMPIRICAL ESSAYS ON DISABILITY INSURANCE, EMPLOYMENT, INCOME AND HEALTH
Moore, T., & Kearney, M. S. (2012)
Physical Exertion as a Risk Factor for Ventricular Arrhythmia: A Prospective Cohort Study
Chahal, H. S. (2015) · Scholarship@Western (Western University)
Das Herz beim Seniorensportler: Benefit und Risiken.
Trachsel, L. D., & Wilhelm, M. (2014) · doi:10.7892/boris.64466
Vigorous Exertion May Trigger Sudden Death
Brett, A. (2000) · Journal watch · doi:10.1056/jw200011170000001
The Effects of a Delay Following Warm-up on the Heart Rate Response to Sudden Strenuous Exercise
Lesser, I., & Hodges, A. N. H. (2015) · Journal of Advances in Medicine and Medical Research · doi:10.9734/bjmmr/2015/17374
Cipolletta, L. (2015) · Springer eBooks · doi:10.1007/978-3-319-19926-9_27
da Silva, R. R., Talvani, A., Bahia, M. T., & Preto, O. (2010)
Salvador, J. J. G. (2015) · Archivos de medicina del deporte: revista de la Federación Española de Medicina del Deporte y de la Confederación Iberoamericana de Medicina del Deporte
Ejercicio, piedra angular de la Prevención Cardiovascular
Cámera, M. I., & Colonna, L. A. (2008)
Eichner, E. R. (2008) · Current Sports Medicine Reports · doi:10.1097/01.csmr.0000313386.72907.e7
Sudden vigorous exercise associated with increased risk of death
Lyford, J. (2000) · Current Controlled Trials in Cardiovascular Medicine · doi:10.1186/cvm-2001-72062
The cardiovascular impact of intense eccentric isokinetic exercise versus aerobic treadmill running
Goff, C. M. L., Kaux, J., Laurent, T., Vannuscorps, J., Seidel, L., de la Cruz, C. R., Forthomme, B., Bury, T., Chapelle, J.-P., Cavalier, E., et al. (2016) · Isokinetics and Exercise Science · doi:10.3233/ies-160618
Regular Exercise Lowers Risk of Sudden Death After Exertion
Bohan, J. S. (2000) · Journal watch · doi:10.1056/em200012060000001
Pushing the body's limits. Medical emergencies associated with endurance athletics.
Vining, D. K., & Gaieski, D. F. (2007) · PubMed · doi:10.1016/s0197-2510(07)72261-1
Meinertz, T., Rösen, P., Ziegler, D., Schömig, A., & Tschöpe, D. (2005) · Steinkopff eBooks · doi:10.1007/3-7985-1531-x_18
Kiningham, R. B., Master-Hunter, T., & Kumagai, A. K. (2008) · Elsevier eBooks · doi:10.1016/b978-141603000-3.10021-8
Driving, flying, and sport after a coronary event
Jelinek, M. V. (2011) · Elsevier eBooks · doi:10.1016/b978-0-7295-3927-2.10094-6
Chiuve, S. E., Albert, C. M., & Conen, D. (2012) · Elsevier eBooks · doi:10.1016/b978-0-12-384978-6.00068-6
Self-citationGil, C., de Araújo, S., Lúcia, C., de Castro, B., & Franca, J. F. (2008)
Screening for Cardiovascular Disease in the Older Athlete
Börjesson, M. (2016) · doi:10.1002/9781119046899.ch41
Fletcher, G., & Rea, T. D. (2008) · Elsevier eBooks · doi:10.1016/b978-012373960-5.00006-x
Morte subita no exercicie e no esporte
de Oliveira, M. A. B., & Leitão, M. B. (2005) · Revista Brasileira de Medicina do Esporte
Sitges, M., & Brugada, J. (2016) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2016.12.048
Olson, K. A. (2015) · Elsevier eBooks · doi:10.1016/b978-0-323-26306-1.00003-4
Risques cardiovasculaires de l′activité physique chez des gens apparemment en bonne santé
Goodman, J. M., Thomas, S. G., & Burr, J. F. (2013) · Canadian Family Physician
The Effect of Tilt Angle on Autonomic Nerve Modulation during Post-exercise in Healthy Men
정혜영, & 김맹규 (2016) · Korean Journal of Sport Science · doi:10.24985/kjss.2016.27.3.470
Condición física en la adolescencia: Physical fitness in adolescence
Porcel, F. B. O. (2008) · Dialnet (Universidad de la Rioja)
OBSOLETE: Managing Cardiovascular Disease in Sport and Athletes
Baggish, A. L. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.99713-7
Sudden Cardiac Death (SCD) -A Raising Concern of Modern Cardiology
Sakib, M. A. M., Khan, M. A. I., Chowdhury, M. A. M., Moniruzzaman, M., & Islam, M. S. (2017) · KYAMC Journal · doi:10.3329/kyamcj.v7i1.33765
The epidemiology of sudden cardiac death in Western Australia
Feng, J. (2016) · UWA Profiles and Research Repository (University of Western Australia) · doi:10.4225/23/599298dd29127
Brown, W. J., Pavey, T., Peeters, G. M. E. E., & Bauman, A. E. (2014) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000262
Awot, S. L. (2017) · University of Nairobi Research Archive (University of Nairobi)
OBSOLETE: Sudden Cardiac Death
Mitchell, L. B. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.99775-7
Franke, W. D. (2013) · ACSMʼs Health & Fitness Journal · doi:10.1249/fit.0b013e318296db01
Chapman, M. C. (2018) · The Mathematics Enthusiast
Non-invasive cardiac imaging of coronary artery anomalies
Christoph, G. (2018) · doi:10.26481/dis.20180223cg
Blain, G. M., Ducrocq, G. P., Peraldi, M., et al. (2018) · Computing in cardiology · doi:10.22489/cinc.2018.299
Giudice, A. S. D., Sene, I. G. G., de Moraes, J. G. R., Martelli, A., & Delbim, L. R. (2018) · Ensaios e Ciência C Biológicas Agrárias e da Saúde · doi:10.17921/1415-6938.2018v22n1p53-57
Galanti, G., Tosi, B., & Modesti, P. A. (2018) · Updates in hypertension and cardiovascular protection · doi:10.1007/978-3-319-93148-7_23
Cardiac disease and dysfunction
Buckley, J., & Doherty, P. (2008) · Elsevier eBooks · doi:10.1016/b978-0-443-10343-8.00003-2
Sports Medicine and Cardiac Rehabilitation for Coronary and Peripheral Artery Disease Patients
Thomas, G. S., & Ellestad, M. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780190225483.003.0026
Syncope in the young athlete: Assessment of prognosis in subjects with hypertrophic cardiomyopathy
Magalhães-Ribeiro, C., & Freitas, J. P. (2016) · Revista Portuguesa de Cardiologia (English Edition) · doi:10.1016/j.repce.2016.04.004
Maleki, M., & Hosseini, Z. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-51149-0.00016-x
Stress Testing of Athletes and Those in High-Risk Occupations
Wann, L. S. (2018) · Oxford University Press eBooks · doi:10.1093/med/9780190225483.003.0025
Franklin, B. A., & Kokkinos, P. F. (2019) · Springer eBooks · doi:10.1007/978-3-030-04816-7_7
Healthy Aging and Exercise: Preventing Disease and Disability
Wu, Y., Panza, G. A., Taylor, B. A., & Pescatello, L. S. (2019) · Springer eBooks · doi:10.1007/978-3-030-06200-2_20
Avaliação em saúde antes da prática de exercícios físicos
Rosa, C. D., & Profice, C. C. (2019) · Conexões · doi:10.20396/conex.v17i0.8649550
Chronic Fatigue Stress and Sudden Death
Zhu, H., Han, G., & Li, S. (2019) · IntechOpen eBooks · doi:10.5772/intechopen.88649
Cunha, R. M. (2013) · Revista Brasileira de Fisiologia do Exercício · doi:10.33233/rbfe.v12i4.3335
Mabbett, A. (2017) · Physiology News · doi:10.36866/pn.108.16
Beta-blockers as Antiarrhythmic Agents
Buzea, A., Dan, A. R., & Dan, G. (2020) · Springer eBooks · doi:10.1007/978-3-030-34893-9_4
Exercise in Specific Diseases: Pacemakers and Implantable Cardioverter Defibrillators
Narayanan, K., & Marijon, É. (2020) · Springer eBooks · doi:10.1007/978-3-030-35374-2_50
Exercise in Specific Diseases: Coronary Artery Disease
Börjesson, M., Niebauer, J., & Dellborg, M. (2020) · Springer eBooks · doi:10.1007/978-3-030-35374-2_44
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
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