No matter how fit you are, genetics play a major role in your cardiovascular risk.
If you've ever seen The Biggest Loser, you know that trainer Bob Harper means business. He's a fan of CrossFit-style workouts and eating clean. That's why it was seriously shocking when TMZ reported that Harper had suffered a heart attack just two weeks ago while working out in an NYC gym. Since much of the advice about preventing heart disease is related to nutrition and fitness, it was pretty confusing to hear that someone who has dedicated his life to being healthy and active could suffer a heart attack at the young age of 51. So what's going on here? We talked to top cardiologists to find out exactly how someone so fit could end up in this dangerous situation.
There are some risk factors that you can't control.
No matter how much you focus on keeping yourself healthy, unexpected things can happen. "It is always important to remember that bad things happen to good people all the time," says Deirdre J. Mattina, M.D., director of the Women's Heart Center at Henry Ford Hospital. That might sound a little morbid, but the truth is, sometimes there's no good explanation for why one person gets sick and someone else doesn't. Aside from the general unpredictability of life (sigh), another big factor is genetics. "Certain genetic and vascular conditions can predispose individuals to heart attacks at young ages," says Malissa J. Wood, M.D., co-director of the Corrigan Women's Heart Health Program at Massachusetts General Hospital. In Harper's case, the trainer revealed that his mother passed away from a heart attack, so it's very possible that genetics played a role in his case.
But before you cancel your gym membership, know that all that hard work does make a difference. Though a family history does play a role, "healthy lifestyle habits have been proven to cut the risk of heart disease in half in people with a strong family history of heart disease," says Nisha B. Jhalani, M.D., director of clinical and educational services at the Center for Interventional Vascular Therapy at New York-Presbyterian Hospital/Columbia University Medical Center. That doesn't mean heart attacks can't happen to people who make an effort to be healthy, unfortunately, as was the case for Harper. That being said, it is still *absolutely* worth it to lead a healthy lifestyle. "Coronary artery disease (the buildup of cholesterol in the heart's arteries) is mostly preventable by avoiding 'toxic' substances in your diet, like sugar, processed foods, and high amounts of animal protein, and 'toxic' habits, such as inactivity and smoking," says Dr. Mattina. "A whole food plant-based diet is the ultimate form of preventive medicine." (Need another reason to eat your veggies? Breast cancer rates are lower in those with a plant-based diet.)
Heart attacks *can* happen while working out, even if you're fit.
Though most people believe that heart attacks usually happen after exercise, it's definitely possible to have one during your workout due to the stress you're putting on your body. "It can happen and we have seen people develop heart attacks or arrhythmias (abnormal heart rhythms) during exercise," explains Dr. Jhalani. "If you're on the verge of having a heart attack and have not yet had any warning signs—or didn't realize that they were warning signs—exercise can certainly trigger one." But don't freak out, she adds that this "shouldn't deter people from exercising out of fear because it is still very rare."
Knowing what to watch for can help.
If you're into high-intensity exercise like Harper, you know that it can be tough to distinguish between run-of-the-mill workout fatigue and something more serious. It's not unusual to feel exhausted or fatigued during or after one of these workouts, but there are some different and specific signs to look out for that could mean there's more going on. "Symptoms which should raise concern include new onset chest pressure, arm discomfort or tingling, neck or jaw pain, severe nausea and sweating," says Dr. Wood. If you have any of these symptoms, it's a good idea to stop what you're doing (yes, even mid-workout) and don't be afraid to ask for help if the symptoms don't improve quickly. Even if you're not sure what's causing the uncomfortable sensations, "it is always better to be safe than sorry!" reminds Dr. Wood.