Can you still get heart disease if you are fit?

We’re often told that regular exercise is great for our health – particularly preventing major diseases such as cardiovascular disease (CVD). But does that mean if you’re fit and active, you don’t need to worry about getting heart disease?

Bottom line: while exercise is certainly helpful, nobody is off the hook completely, says Dr Sundip Patel, consultant cardiologist at London Bridge Hospital.

“The simple answer to the question is – and I’m afraid I’ve been seeing it more in recent years – heart disease is no longer a disease of the middle-aged, unfit and overweight, it is now a disease of the young, fit and healthy too, so we must keep a very open mind,” says Dr Patel.

There aren’t always obvious warning signs
Dr Patel says it’s not all that uncommon to see patients in their 30s and 40s who, to all intents and purposes, are fit and active with healthy lifestyles – and “their only vice was family history”.

Read: Coronary heart disease is the biggest killer of women worldwide

These seemingly healthy patients may present with “silent heart disease” (meaning there weren’t obvious symptoms, or symptoms were very minor and easily missed) or heart attacks that strike seemingly with little warning. Plus, some people only find out they have high cholesterol or high blood pressure, for example, during a routine test – and these are major factors in developing future problems such as stroke and heart attack.

Family history is key
One in six Australians self-report as living with CVD, accounting for more than four million Australians or 16.6 per cent of the population.

The prevalence of CVD has been decreasing over time (declining approximately 80 per cent since the 1980s), due to research into risk factors, medications and interventions. Regardless, it’s still one of the most prevalent diseases in Australia.

There are lots of factors involved and genetics and lifestyle factors are both important – but Dr Patel says being aware of your family history is vital. This means you can get things checked out as a matter of routine or ‘just in case’, rather than waiting for problems to present.

“Obviously, if you have symptoms – classic symptoms being discomfort, tightness and heaviness of the chest, breathlessness, fluttering and palpitations, having a funny turn and feeling as if you’re faint and lightheaded – all that would trigger a cardiac review,” he says. “But otherwise, is there a family history? It’s the family history that can tell us a lot about whether there will be an adverse outcome.”

Spotting things like high blood pressure and cholesterol early means steps can be taken to treat and manage them. Problems within the heart and blood vessels may be picked up and treated early sometimes too, preventing things getting worse.

Read: Follow these 13 rules for a healthy heart

Is it still worth doing exercise then?
“Absolutely yes,” says Dr Patel. This isn’t about saying there is no point bothering with being fit and keeping up a healthy lifestyle – there is very clear and strong evidence that it’s worthwhile. It’s just about remembering it’s only part of the picture.

Being fit doesn’t offset other major risk factors
Can getting plenty of exercise offset other environmental and lifestyle risk factors, such as smoking, a poor diet and air pollution? “The brutal answer is no, you can’t offset one against the other,” says Dr Patel. “Undoubtedly exercise does show benefits for heart health, but interestingly it does not have a major impact on cholesterol. But it will help your blood sugar and the risk of diabetes. Exercise will help your lung function and your heart rate.”

And no, regular workouts won’t undo the damage of smoking: “We know that smoking is one of the most potent contributors to heart disease,” notes Dr Patel.

Read: WHO guidelines on physical activity

‘Looking’ fit and healthy doesn’t mean you are
Weight often crops up in discussions around disease risk and heart health. It can be a useful indicator and obesity is generally associated with increased disease risk. But Dr Patel stresses that when it comes to cardiovascular disease, the outside doesn’t always match the inside: “A healthy diet is important, but not all overweight people have heart disease and high cholesterol and health problems, and not all of those who seem slim and fit on the surface have healthy hearts and circulation.”

Do you consider yourself fit? How much exercise do you get in a typical week? Share your thoughts in the comments section below.

– With PA

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Written by Abi Jackson



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