According to the Centers for Disease Control and Prevention, one of every four deaths in the United States is from heart disease. This equates to approximately 610,000 people every year.

Around 735,000 Americans have a heart attack each year, with 525,000 of those being a first heart attack. New research from Johns Hopkins Medicine suggests those who survive likely have their exercise regimens to thank.

“We knew that fitter people generally live longer, but we now have evidence linking fitness to survival after a first heart attack,” Michael Blaha, M.D., M.P.H., director of clinical research for the Ciccarone Center for the Prevention of Heart Disease and an assistant professor of medicine at the Johns Hopkins University School of Medicine, said.

Clinton Brawner, Ph.D., a clinical exercise physiologist at Henry Ford Health System, believes the findings underscore the importance of patients taking preventative measures to forestall the onset of heart disease.

“Our data suggests 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,” Brawner said.

For the study, the researchers examined the medical records of more than 2,000 individuals who had taken a treadmill stress test before the date of their first heart attack. Blaha and his team were able to determine fitness levels from these records by determining metabolic equivalent scores (MET) both at rest and during physical activity. The higher the MET score, the more physically fit the patient.

The researchers found the 634 patients with MET scores of 10 or higher—the equivalent of jumping rope—to have the best prognosis. In this group, there were approximately 40 percent fewer deaths after a first heart attack as compared to the rest of the patients. Researchers also found that one-third of the 754 patients with a MET score of 6 or less—equivalent to an activity such as shoveling—died within a year of their first heart attack. As a whole, each whole number increase in MET score showed an eight percent reduction in death risk after a first heart attack.

Although more physically fit patients still experienced heart attacks, their mortality risks were significantly lower. However, researchers noted the limitations of their study given the existing pool of data, citing their inability to assess the relationship between improving fitness levels and decreased risk of heart attack death.

One likely factor to lower mortality rates is the relationship between cardiovascular fitness and increased blood flow, which may aid in healing and has been documented in previous research.

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