Training & Nutrition - Heart attacks in cyclists

I was commenting to a different thread here in the forum and it got me thinking.

There is some fairly reliable statistics on heart attack mortality among marathon runners. It's around 1 per 100,000 marathons, counting deaths during the marathon and the first 24 hours after the finish.

As far as the heart is concerned, marathon running isn't all that different from vigorous cycling, except that runners spend less time at high HR than cyclists, during training and during events. If I assume that marathon mortality scales as total time spent in high HR zones, then a cyclist who spends 5 hours/week (one long weekend ride) at comparable intensity would have 1 in 1600 odds of dying of a heart attack in any given year. Which is huge (on par with traffic accident mortality rates among active motorcyclists, or with homicide mortality rates in most violent cities in the United States.)

Then I tried to find statistics on heart attacks in cyclists, and I drew a blank there. All I could find were anecdotal stories of two young pro cyclists dying of heart attacks in 2004 (alluded to be linked to doping), and references to Ed Burke.

Am I wrong in assuming that heart attack mortality scales with time? Or are there predisposing factors that determine whether you're at high risk of having a heart attack eventually? If I get a EKG it says that I don't have hypertrophic cardiomyopathy now, does that say anything about my odds?

Just a free opinion but I don't think there is any strong correlation to runners and cyclists heart attack rates unless you find studies involving a large number of people over a long period of time comparing both sports in as similar conditions as possible if possible. If you do enough searching, learning, and reading about HR training, you'll find that there are many fallacies in that kind of training partly due to the differences in people. What is a high HR for me, might not be high for you for many different reasons. That said, using a HRM when riding can be very useful for an individual. Yes, there are definitely predisposing factors such as family history, diet, tobacco and alcohol use, drug use, race, genetics, etc.

As far as a good reading on your EKG, all that would mean to me was what it said that day. EKG's aren't always a consistently accurate way to measure the heart metrics they were designed to measure. The results of an EKG are very subject to mis-interpretation. There are too many other factors that can cause heart problems to generalize much on the subject. All of this dialogue from me is based on my hobby of being an amateur heart surgeon....partially. The rest of it is based on direct experience in being more closely involved than I wanted to be in other people's heart problems.

As I understand it, the evidence is pretty clear that lifelong vigorous exercisers tend to live longer, and enjoy better health into old age, than their more sedentary contemporaries. There is some evidence that elite cyclists (the best-known study related to men who when younger had competed in the Tour of Switzerland) are at greater risk of developing atrial fibrillation in later life. So as things stand, you are probably improving your chances by doing a lot of cycling. If you're one of the unlucky ones, then training at the level of a top pro cyclist might do you some damage. But sitting in a chair for too long is much likelier to do you in prematurely.

... If you do enough searching, learning, and reading about HR training, you'll find that there are many fallacies in that kind of training partly due to the differences in people. ...

What type of HR training do you mean? Do you mean that Z2 or Z3 might be right (safe) for one but not for another? Or, that they're not as effective as RPE? I'm not arguing, just curious what you meant.

I have told my close ones that dying suddenly of something I love doing is my absolute first choice of ways to leave this earth. There are pros and cons to everything, cycling has far more pros IMO.

I don't know about the marathon statistics but the average 5 hr weekend ride of a cyclist is nothing like the intensity of a marathon. There are very few cyclists who race for 5 hrs so the level of effort is not really comparable.

I don't know that marathon runners have a higher rate of death by heart attack than the average population. The ones that do die generally have some type of CV disease or condition that the marathon exacerbates.

From what I know, greg is correct. They tend to have defects of the heart or heart disease. Your odds are extremely low. You said it yourself: 1 death per 100,000 marathons. Assuming each has an average of 100 runners, you have a 1 in ten million chance. Their hearts work a hell of a lot harder during a marathon than a cyclists during typical ride. Stop worrying and go ride.

related but maybe not, are cycling strokes

My understanding is that there is little correlation between heart disease and exercise. No doubt that someone who exercises is more fit, and may have a stronger heart, but that in itself doesn't make them less susceptible to a heart attack. If the exerciser is following a healthy lifestyle then some risk factors may be reduced, obesity, smoking, etc. The one thing none of us can beat though, is our genes. Blame it on our parents, but you may have been born susceptible to heart disease and could be a heart attack waiting to happen. These ultra fit people who fall over like trees in a windstorm died very fit. They were fit, but they still died.

What to do? Knowledge is power. Find out how fit your heart really is. Go to a cardiologist. Run the tests that measure blood flow and can see the plaque build up. Who should do this? Anyone who is at risk due to family history or other risk factors. Knowing where you stand can head off potential problems. Doing this seperates you from guys like Ed Burke who no doubt thought his heart was just fine. A life ending wrong assumption that didn't have to be.

I know a guy who is around 50 (not sure to the year) that has gotten to a point where, on the biggest hills around, during a 50 mile ride, he has to stop and sit for a while after climbing these tough hills. Didn't used to need that rest. Gets out of breath bad now and is highly fatigued. Talked to his Doc about this, who ordered a nuclear stress test. They told him he was lucky he wasn't dead and not to get on that bike again cause he had a blockage(s). Went in for catherization and blockage removal and found he didn't have one nor any heart problem. They haven't found what his problem is yet, but he's out of breath and fatigued after a simple lawn mowing with a push mower. I think he's back riding despite any difficulty. I told him he's crazy to ride until the source is pinned down.

As I understand it, the evidence is pretty clear that lifelong vigorous exercisers tend to live longer, and enjoy better health into old age, than their more sedentary contemporaries. There is some evidence that elite cyclists (the best-known study related to men who when younger had competed in the Tour of Switzerland) are at greater risk of developing atrial fibrillation in later life. So as things stand, you are probably improving your chances by doing a lot of cycling. If you're one of the unlucky ones, then training at the level of a top pro cyclist might do you some damage. But sitting in a chair for too long is much likelier to do you in prematurely.


I am 25 and have afib, I still love to cycle but slow down if I palpitate. I would rather die than give up an active life (one that I grew into at the age of 23 I dropped 1/3rd of my bodyweight thanks to cycling and subway!) So if I gave up what made me who I am today that would suck!

I know a guy who is around 50 (not sure to the year) that has gotten to a point where, on the biggest hills around, during a 50 mile ride, he has to stop and sit for a while after climbing these tough hills. Didn't used to need that rest. Gets out of breath bad now and is highly fatigued. Talked to his Doc about this, who ordered a nuclear stress test. They told him he was lucky he wasn't dead and not to get on that bike again cause he had a blockage(s). Went in for catherization and blockage removal and found he didn't have one nor any heart problem. They haven't found what his problem is yet, but he's out of breath and fatigued after a simple lawn mowing with a push mower. I think he's back riding despite any difficulty. I told him he's crazy to ride until the source is pinned down.

Sounds very similar to what my dad's symptoms were. Very fit guy, no problem cycling in the past. He started having issues with lactic acid build up, and any little blip of a hill would cause him to need to stop, and rest or he felt like he was going to black out. After about a year of testing, turns out he has MSA, a very rare disease. May want to mention to your friend, may not be that, but at least could be a different direction and may be able to narrow down the cause.

http://en.wikipedia.org/wiki/Multiple_system_atrophy

I had a friend that had completed more than 50 double centuries and died on his last one of heart failure. I suspect that he had a heart problem and he used cycling to combat it. Maybe he wouldn't have lived as long if he hadn't cycled but no one really knows.

My understanding is that there is little correlation between heart disease and exercise. No doubt that someone who exercises is more fit, and may have a stronger heart, but that in itself doesn't make them less susceptible to a heart attack. If the exerciser is following a healthy lifestyle then some risk factors may be reduced, obesity, smoking, etc. The one thing none of us can beat though, is our genes. Blame it on our parents, but you may have been born susceptible to heart disease and could be a heart attack waiting to happen. These ultra fit people who fall over like trees in a windstorm died very fit. They were fit, but they still died.

What to do? Knowledge is power. Find out how fit your heart really is. Go to a cardiologist. Run the tests that measure blood flow and can see the plaque build up. Who should do this? Anyone who is at risk due to family history or other risk factors. Knowing where you stand can head off potential problems. Doing this seperates you from guys like Ed Burke who no doubt thought his heart was just fine. A life ending wrong assumption that didn't have to be.

I had an attack in '08 while riding a bike. I weighed 290, and had cholesterol levels that were way out of whack due in part to genetics, and a diet that got me to 290. Back then, I was commuting 2 miles each way to work, and on this day was doing a five mile lunch ride "for my health".

I was fortunate that the damage was not severe. I required two stents, and am now on a drug cocktail that includes beta blockers, statins and blood thinners. I am now down to 230 now, and riding an average of eighty mile a week.

I don't know how much of my improved health is drugs, diet or exersize, but I am sure all play some part, and will be kicking some of the drugs soon.

I had a friend that had completed more than 50 double centuries and died on his last one of heart failure. I suspect that he had a heart problem and he used cycling to combat it. Maybe he wouldn't have lived as long if he hadn't cycled but no one really knows.

I suspect that he may have lived longer if he had sought professional help, and not relied on exercise alone, as I had done.

I was commenting to a different thread here in the forum and it got me thinking.

There is some fairly reliable statistics on heart attack mortality among marathon runners. It's around 1 per 100,000 marathons...

Cool, I have 99,998 to go.

at greater risk of developing atrial fibrillation in later life.


I am 25 and have afib

I just ran into an article that reminded me of this topic. You are at greater risk of atrial fibrillation as you age if you take high levels of vitamin D. (Seems to be very high levels.)

http://www.diabetesincontrol.com/index.php?option=com_content&view=article&id=11833

I just ran into an article that reminded me of this topic. You are at greater risk of atrial fibrillation as you age if you take high levels of vitamin D. (Seems to be very high levels.)

http://www.diabetesincontrol.com/index.php?option=com_content&view=article&id=11833



To get there most people would need to take 10,000iu a day.

Docs have gotten interested in D lately, a lot of them suggest taking it,
but the dose is a grand or two. Depends on you, mostly.

I have been taking 2K, but on the suggestion of my PA, I was taking
5K for months to build some up in my system.

Omega 3 can help in preventing a heart attack. If you fit the profile, a baby aspirin
is also good. I do both.

I have told my close ones that dying suddenly of something I love doing is my absolute first choice of ways to leave this earth.

Here, here!!!

I also heard cycling doesnt let your wee wee go up!:cry:

I also heard cycling doesnt let your wee wee go up!:cry:

When I first started, it did go up. . . inside. Better riding position and proper cycle clothing took care of that.

It may also be important to state that athletes of all types have had sudden death heart attacks. Remember that Olympic ice skater who dropped dead a few years ago after a afternoon training session?

I'm not a doctor, but common sense should go along with your habits, good or bad.

If you are 45 something, then you should let your doctor know. They may want to schedule you for a proper heart stress test. They may even want to use contrast to see just what's going on in there. The results are more concise, and they can let you know what your actual level of fitness is. (If they are a credible cardiologist)

Good health sometimes requires some good check-ups. If your concerned, let your doctor know.

I know a guy who is around 50 (not sure to the year) that has gotten to a point where, on the biggest hills around, during a 50 mile ride, he has to stop and sit for a while after climbing these tough hills.
this sounds like something that is actually reasonably common among older endurance athletes and is treatable. Probably needs to go to a physician that is capable of googling "arrhythmia in endurance athletes"