Exercise is generally recommended as a preventative measure against many health complications; after all, sitting is the new smoking. However, when it comes to patients with cardiovascular trouble, it’s all about finding that happy medium.

A recent study conducted by researchers from Johns Hopkins and the Henry Ford Health System has found that patients with high levels of physical activity tend to have a lower risk for death after suffering their first heart attack, but they should remember not to overdo it.

"We knew that fitter people generally live longer, but we now have evidence linking fitness to survival after a first heart attack," said Dr. Michael Blaha, director of clinical research for the Ciccarone Center for the Prevention of Heart Disease and assistant professor of medicine at the Johns Hopkins University School of Medicine, in a statement. "It makes sense, but we believe this is the first time there is documentation of that association."

Blaha and his colleagues gathered data using the Henry Ford Exercising Testing Project, also known as the FIT Project, which included patients who underwent various exercise stress tests between 1991 and 2009. They focused on the medical records of people who had taken a taken a treadmill test before suffering their first heart attack. Energy consumption at rest and during physical activity was measured using their metabolic equivalent score (MET).

MET scores range from 1 to 12, with 1 being equal to sitting on the couch, 3 to walking, 7 to jogging, 10 to jumping rope, and 12 to sprinting. Participants were at an average age of 62, while 38 percent were female, and 56 percent were Caucasian. The research team excluded patients who suffered heart attacks prior to the fitness test, patients who never had a heart attack, and patients with incomplete fitness tests.

A total of 634 people recorded MET scores of 10 or higher and this group suffered 40 percent fewer deaths after their first heart attack compared to those who scored under 10. Among all 754 patients who recorded MET scores of 6 or less, one-third died within a year of suffering their first heart attack. For each whole-number increase participants made in their MET scores after their initial heart attack, they were able to reduce their risk for death by 8 percent.  

"Our data suggest that doctors working with patients who have cardiovascular risk factors should be saying, 'Mr. Jones, you need to start an exercise program now to improve your fitness and chances of survival, should you experience a heart attack,'" said Dr. Clinton Brawner, clinical exercise physiologist at Henry Ford Health System.

Although every healthcare agency recommends exercise for improving our overall survival, most also recognize a little something called overexercising. In fact, a recent study published in the Mayo Clinic Proceedings found that death caused by cardiovascular issues were reduced by upward of 60 percent among physically active heart attack survivors who ran less than 30 miles or walked less than 46 miles per week. Exercising for any longer than that was shown to reverse the benefits of exercise.

If the goal of your workout is to remedy preexisting health concerns or prevent future ones, there’s no reason to overwork yourself in the gym or on the track. A bevy of recent studies have suggested that exercise, even in small bursts, can lower our risk for heart disease. To find that happy medium, heart disease patients and people with risk factors for heart disease should consider adding yoga as a therapeutic treatment that teaches us to focus on our breathing, practice body-mind awareness, and promotes slow and relaxed movements.

Source: Brawner C, Qureshi W, Blaha M, et al. High Exercise Capacity Attenuates the Risk of Early Mortality After a First Myocardial Infarction. Mayo Clinic Proceedings. 2016.