Leisure-time physical activity and the risk of primary cardiac arrest

Background: Because the risks of sudden cardiac death and myocardial infarction are transiently increased during acute bouts of high-intensity activity, it is an important question from the public health perspective whether regular participation in moderate-intensity activity confers overall protection from sudden cardiac death. Participants and Methods: We used data from a population-based case-control study to assess the associations of regular high-intensity and moderate-intensity leisure-time physical activity with primary cardiac arrest. Cases were patients with primary cardiac arrest, aged 25 to 74 years, attended by paramedics between 1988 and 1994 in King County, Washington (n = 333). Controls were randomly identified from the same community (n = 503), matched for age and sex. All case patients and controls were free of prior clinical heart disease, major comorbidity, and self-reported poor health. Spouses of case patients and controls were interviewed to assess participation in 15 high-intensity and 6 moderate-intensity physical activities during the prior year. Results: Compared with subjects who performed none of the activities, the odds ratio for primary cardiac arrest from matched analyses was 0.34 (95% confidence interval, 0.13-0.89) among subjects who performed only gardening activities for more than 60 minutes per week; 0.27 (95% confidence interval, 0.11-0.67) among subjects who walked for exercise for more than 60 minutes per week; and 0.34 (95% confidence interval, 0.16-0.75) among subjects who engaged in any high-intensity activities, after adjustment for age, smoking, education, diabetes, hypertension, and health status. Conclusions: The results suggest that regular participation in moderate-intensity activities, such as walking and gardening, are associated with a reduced risk of PCA and support current exercise recommendations.