- The Washington Times - Sunday, April 7, 2002

With research showing a slightly higher risk that a heart may give out during exercise, doctors are urging health clubs to buy portable defibrillators.
The added risk that comes during a workout is more than offset by the benefits of regular exercise throughout life, but industry officials think they need to do better in the event someone suffers cardiac arrest from the stress of exercising.
No more than 5 percent of health clubs have portable defibrillators, but 60 percent should have them in five years, said John McCarthy, executive director of the International Health, Racquet and Sportsclub Association, a health club trade group.
"We don't want anybody who is intent on exercising to have a potentially life-threatening event," he said.
In cases of cardiac arrest, when nerve impulses no longer trigger a normal heart rhythm, "a defibrillator can shock the heart back into normal use, and nothing else can do that," McCarthy said.
"People who exercise have fewer cardiac arrests, live longer and do better," said Dr. Gary Balady of Boston University School of Medicine. "However, in the short term, when one is exercising, risk increases for the 30 minutes to an hour you are doing moderate or vigorous exercise."
A Harvard study published in 2000 found the added cardiac arrest risk from exertion was about 1death for every 1.5million exercisers during 30 minutes of exercise and the half-hour that followed. The 12-year study of thousands of male physicians also showed that men who exercised at least five times a week had about a sevenfold lower risk of cardiac death than those who exercised only once a week. The study was published in the New England Journal of Medicine.
The American Heart Association and the American College of Sports Medicine advise larger health clubs, and facilities with seniors programs, to buy defibrillators and train staff in their use. But even before the joint recommendation in March, clubs were buying units, which cost $3,000 to $4,000 each.
With defibrillation given in the first minute after cardiac arrest, the survival rate can be as high as 90 percent, the joint statement said. The odds of survival fall as much as 10 percent with every minute the shocks are delayed, it said.
The industry serves a population that potentially could need defibrillation. Most new members are over 35, and the greatest risk for cardiac arrest is among men over 45 and women over 55, said Balady, who chaired the group that drafted the statement. The risk also is higher among people who smoke, are overweight or have diabetes, he said.
Those are about the same age ranges that have a higher risk of heart attack. The emergency treatment for a heart attack is cardiopulmonary resuscitation, which pushes blood through the heart. Clubs have staff members trained in CPR, McCarthy said.
However, a report in a fitness professionals' magazine said clubs fall short in preparation for heart emergencies. The article in IDEASource, a publication of IDEA Health and Fitness Association, said a survey of Ohio clubs found 28 percent of 122 facilities failed to prescreen members for indications of heart disease.
"While this study was limited in scope, many industry experts feel it is a fair reflection of the industry at large," said the article by fitness instructor and writer Shirley Archer of Palo Alto, Calif. "Certainly the ability to respond effectively to emergencies is an important aspect in promoting our credibility as professionals."

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