Heart Attacks: Sudden or Gradual Occurrence? Signs of Trouble in the Heart emerge 12 Years Prior to a Stroke - Neglected Warning, Preventive Measures
In a groundbreaking discovery, the CARDIA study, a long-term research project, has unveiled an early warning sign for heart disease that can be traced back up to 12 years before symptoms appear [1][3][4]. The study focuses on the decline in moderate-to-vigorous physical activity (MVPA), a crucial factor in maintaining heart health.
According to the research, individuals who eventually develop cardiovascular disease (CVD) experience a steeper decline in MVPA, with this decline accelerating sharply in the two years immediately prior to diagnosis [1][3][4]. After the event, their activity levels remain persistently lower compared to those who do not develop CVD [1][3][4].
The decline in MVPA is not just a sign of aging but also an early warning signal for impending heart disease [1][3][4]. Those with declining MVPA are at increased risk for coronary heart disease, stroke, and heart failure [1][3][4].
Key early warning signs for heart problems identified by the CARDIA study and related research include:
- Gradual decline in physical activity capacity, especially in moderate-to-vigorous intensity activities such as brisk walking, cycling, or swimming [1][2][3].
- Fatigue, breathlessness, and declining exercise tolerance are red flags that often precede heart disease but are frequently mistaken as normal aging [2]. Recognizing these symptoms early presents a window for preventive intervention [2].
The study also found subgroup differences, with Black women showing the lowest MVPA throughout adulthood and the highest risk of low MVPA after a CVD event [3][5], underscoring the need for targeted strategies in vulnerable populations.
To combat this trend, public health guidelines recommend 150 minutes of moderate activity or 75 minutes of vigorous exercise weekly, which can be broken into daily short sessions [6]. Simple activity checks, such as timed walks or questions about effort levels during exercise, can help spot worrying trends early [7].
Adding movement to daily life, such as walking to work or taking stairs, can also contribute to physical activity [7]. Overcoming barriers like childcare or unsafe neighborhoods is important for maintaining a healthy exercise routine [8].
The study suggests that doctors should look for trends in stamina, not only one low activity report, and ask patients about their energy and exercise over years [9]. Tracking tools, such as wearable devices, phone apps, simple logs, or repeated walk tests, can help spot worrying trends early [7]. Basic heart tests, including measuring blood pressure, waist size, cholesterol, and blood sugar levels, also play a crucial role in monitoring heart health [10].
In summary, the CARDIA study demonstrates that a decline in moderate-to-vigorous physical activity beginning more than a decade before heart disease diagnosis is a critical early indicator of cardiovascular risk. Symptoms like decreasing exercise tolerance and fatigue serve as important early warning signs warranting proactive screening and intervention to prevent progression to clinical heart disease. By understanding and addressing this warning sign, individuals can take steps to reduce their risk of heart disease and live healthier lives.
References: [1] D. E. Ford et al., "Physical Activity, Cardiovascular Disease, and All-Cause Mortality in the Coronary Artery Risk Development in Young Adults (CARDIA) Study," Circulation, vol. 126, no. 15, pp. 1607–1614, 2012. [2] R. J. O'Keefe et al., "Exercise as Medicine: Prescription for Health Promotion and Disease Prevention," Mayo Clinic Proceedings, vol. 84, no. 1, pp. 98–100, 2009. [3] J. L. Belle et al., "Physical Activity and Cardiovascular Health in the CARDIA Study: The Role of Race, Gender, and Age," Journal of the American Heart Association, vol. 6, no. 1, p. e005452, 2017. [4] D. E. Ford et al., "Physical Activity, Cardiovascular Disease, and All-Cause Mortality in the Coronary Artery Risk Development in Young Adults (CARDIA) Study: 30-Year Follow-Up," Journal of the American College of Cardiology, vol. 72, no. 14, pp. 1478–1488, 2018. [5] J. L. Belle et al., "Physical Activity and Cardiovascular Health in the CARDIA Study: The Role of Race, Gender, and Age," Journal of the American Heart Association, vol. 6, no. 1, p. e005452, 2017. [6] U.S. Department of Health and Human Services, "Physical Activity Guidelines for Americans," 2nd ed., 2018. [7] American Heart Association, "Physical Activity," 2021. [8] A. M. Sallis et al., "Environmental and Policy Approaches to Promote Physical Activity: The Role of Community Design," Annual Review of Public Health, vol. 39, pp. 143–159, 2018. [9] D. E. Ford et al., "Physical Activity, Cardiovascular Disease, and All-Cause Mortality in the Coronary Artery Risk Development in Young Adults (CARDIA) Study: 30-Year Follow-Up," Journal of the American College of Cardiology, vol. 72, no. 14, pp. 1478–1488, 2018. [10] American Heart Association, "Know Your Numbers," 2021.
- Regularly engaging in moderate-to-vigorous health and wellness activities such as sports can promote good cardiovascular health and potentially reduce the risk of chronic diseases.
- Mental-health conditions, like stress and anxiety, may affect one's motivation and ability to engage in fitness and exercise, which can impact cardiovascular health.
- The CARDIA study suggests that tracking medical-conditions like blood pressure, cholesterol levels, and blood sugar levels over time, in addition to exercise patterns, can provide valuable insights into heart health.
- Scientists and healthcare providers increasingly recognize the importance of looking at the health aspects of a person beyond just their physical body, including the role of mental-health, fitness and exercise, and overall health-and-wellness in maintaining cardiovascular health.
