Intense
Weight Lifting Linked To Heart Condition
May Be Caused
By Tear In Heart's Major Artery
High-intensity strength
training may lead to a potentially deadly condition called aortic
dissection, in which the heart's major artery tears, according
to a report in the Journal of the American
Medical Association.
"Dissection happens
in a split second," says Dr. John Elefteriades, chief of cardiothoracic
surgery at Yale University and Yale-New Haven Hospital, and
the lead author of the report.
In those who lift
weights and already have an enlarged aorta, the elevated blood
pressure that occurs during weight training may lead to the
dissection, Dr. Elefteriades says.
Aortic dissection
strikes about two of every 10,000 people, according to the National
Institutes of Health (NIH). While it can affect anyone,
it's most often seen in men ages 40 to 70, the NIH
states.
The condition of aortic
dissection is "uncommon but not rare," says Dr. Elefteriades,
adding that it is what caused the death of actor John Ritter
earlier this year and has been declared the cause of death of
many athletes who died suddenly.
Researchers Review
Underlying Causes
Using a Yale database,
Dr. Elefteriades and his colleagues identified five people who
suffered acute dissection of the aorta during high-intensity
weight training or other strenuous exercise.
At the moment the
dissection occurred, two of the people were weight training,
one was trying to move a heavy granite structure, and two were
doing pushups, the researchers say.
All were found to
have an enlarged aorta, but not at a level expected to present
a high risk of dissection, Dr. Elefteriades says.
Three patients who
had surgical repair survived; the other two died before surgery
could be attempted.
"We're not saying
stop weight training," says Dr. Elefteriades, a long-time weight
trainer himself. "It's a wonderful activity and a very important
activity." It can help maintain muscle mass as you age, for
instance, and help maintain strength for everyday chores such
as carrying groceries.
Expert
Advises Caution in Select Group
But Dr. Elefteriades
does recommend caution in certain people, including those with
known aortic aneurysms - a widening or ballooning of the vessel
caused by disease or a weakening of the vessel wall.
Also, those with a
family history of aneurysm or dissection, underlying high blood
pressure, and those at or beyond middle age should be cautious,
he says, because the aorta stiffens with age.
Those with connective
tissue disease, such as rheumatoid arthritis, are also at higher
risk, Dr. Elefteriades.
"I think there has
to be this underlying enlargement [of the aorta] before the
dissection happens," Dr. Elefteriades says.
"But we wanted to
sound this warning bell that strength training and weight lifting
can cause these dissections in people who already have a mild
enlargement of the aorta," he adds.
The problem, Dr. Elefteriades
says, is that many people with an enlargement do not know they
have it. An echocardiogram - an ultrasound evaluation of the
heart - can determine whether the aorta is enlarged, he says.
When dissection of
the aorta occurs, "the aorta splits into two layers," Dr. Elefteriades
says. "It splits in such a way that it becomes a double-barreled
tube instead of a single-barreled one." You can quickly lose
blood internally and die.
Until more research
is done, what should weight lifters who may be at risk do? Avoid
weight training so strenuous that your blood pressure rises
excessively, Dr. Elefteriades says.
"We do know that levels
of blood pressure that are high are dangerous," he says. Serious
weight trainers, who often bench press 300 or 400 pounds, may
get blood pressures that are dangerously elevated, even up to
370 millimeters of mercury systolic, he says. Normal systolic
pressure, measured as the heart beats, is below 120; normal
diastolic pressure, measured as the heart rests between beats,
is below 80, Dr. Elefteriades says.
While it is difficult
to pinpoint how much weight is too much, Dr. Elefteriades suggests
that for upper body weight training, "above half your body weight
you are starting to get into the high pressure zone. For the
lower body, the legs are stronger, so you could probably lift
more than half your body weight [safely]."
Serious weight trainers
should consider having an echocardiogram, he says.
The other take-home
advice from the report is very obvious for weight lifters or
would-be weight lifters, says Dr. Craig Miller, a surgeon at
Stanford University Medical School.
"If they have dilation
or aneurysm of the thoracic aorta or a connective tissue disorder
or a family history of premature aortic catastrophic complications,
do not weight lift," Dr. Miller says.
Always consult your
physician for more information.
|
January 2004
Intense
Weight Lifting Linked To Heart Condition
Researchers
Review Underlying Causes
Expert
Advises Caution in Select Group
What
Is Aortic Dissection?
Online
Resources
What
Is Aortic Dissection?
According to the National
Institutes of Health (NIH), aortic dissection involves
bleeding into and along the wall of the aorta (the major artery
from the heart), most often because of a tear or damage to the
inner wall of the artery.
This usually occurs
in the thoracic (chest) portion of the aorta, but may also occur
in the abdominal portion.
The exact cause is
unknown, states the NIH, but risks include
atherosclerosis (hardening of the arteries) and hypertension
(high blood pressure).
Traumatic injury is
a major cause of aortic dissection, especially blunt trauma
to the chest as can be caused by hitting the steering wheel
of a car during an accident.
Aortic dissection
may also be associated with other injury, infection, congenital
(present from birth) weakness of the aorta, and collagen disorders
(such as Marfan's syndrome, pseudoxanthoma elasticum, Ehlers-Danlos
syndrome, relapsing polychondritis, or abdominal aortic aneurysm).
The NIH
lists the following as symptoms of aortic dissection include
the following:
-
-
sudden, severe, sharp, or
stabbing pain located below the sternum, then radiates
under the shoulder blades or to the back; may radiate
to shoulder, neck, arm, jaw, abdomen, or hips; location
may change - pain typically moves distally (to arms and
legs) as the aortic dissection progresses in the same
direction
-
changes in thought ability,
concentration (confusion, disorientation)
-
decreased movement, any location
-
decreased sensation, any
location
-
-
-
-
-
dry skin/mouth, thirst
nausea, vomiting
dizziness, fainting
-
shortness of breath (dyspnea);
difficulty breathing when lying flat (orthopnea)
Always consult your
physician for more information.
Online
Resources
(Our Organization
is not responsible for the content of Internet sites.)
American
College of Sports Medicine
American
Heart Association
Healthfinder,
US Department of Health and Human Services (HHS)
National
Academy of Sports Medicine
National
Institute on Aging Exercise Guide
National
Institutes of Health (NIH)
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