Leisure-Time Physical Activity and the Risk of Primary Cardiac Arrest

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Abstract
WHETHER REGULAR exercise is associated with an overall reduction in the risk of coronary heart disease, including sudden cardiac death, is no longer a source of controversy.1-5 However, less understood is the exercise intensity required to achieve the cardiac benefit of regular exercise. In early epidemiological studies,1,2,6-8 vigorous exercise was associated with a decreased risk of sudden cardiac death, while nonvigorous exercise was not. More recently, modest levels of energy expended in leisure-time physical activities (LTPAs) were found to be associated with a decreased risk of sudden cardiac death among middle-aged men participating in the Multiple Risk Factor Intervention Trial.3 While only total LTPA was considered, the activities reported by the men in the cohort were mostly low- and moderate-intensity LTPA. Because during acute bouts of high-intensity activity the risks of both sudden cardiac death and myocardial infarction are transiently increased,9-11 whether regular participation in moderate-intensity activity confers overall protection from sudden cardiac death is an important question from the clinical and public health perspective.