The advice for people who are at higher risk of having a heart event is pretty straightforward. If you have high cholesterol, are overweight or obese or have high blood pressure—among other risk factors—you should eat less animal fat, eat more plants, and exercise to keep the heart muscle strong. In fact, rehabilitation programs for people who have had heart problems revolve around this advice.
Studies show that people who watch their diet and exercise are less likely to have a heart attack. But if they do have a heart event, how well do they fare—and how much of a difference do these changes really make?
Dr. Michael Blaha and his colleagues from the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease has some good news on that. In a study published in Mayo Clinic Proceedings, they found that people who had better fitness before their first heart attack are more likely to survive the attack than those with lower fitness.
The researchers studied the electronic health records of more than 2,000 men and women who took a treadmill test as a way to measure how fit they were. The people with the highest fitness scores were 40% less likely to die after their first heart attack than those with lower fitness scores. And a third of the people with the lowest fitness died within a year of their first heart attack.
“The thinking here is that if you are more fit at baseline, you are more willing to withstand lots of insults and have a good outcome if you do have a heart attack,” says Blaha. “It’s quite a remarkable effect.”
The findings are especially relevant since so many people have at least some risk factors for heart disease, he says. These results suggest that making changes to address them can be important in helping more people to remain healthy even if they do have a heart attack. “Most of my patients come to me because they are concerned about their risk of having a heart attack,” says Blaha. “They have a family history of heart problems, or high cholesterol, or smoked in the past, and they want to know what they can do. Now we know that if they get their risk factors under control and increase their fitness level that they are more likely to survive a heart attack if they have one.”