Cardiovascular disease is a global concern 
Cardiovascular disease is a global concern. According to the World Health Organization, it is the leading cause of death, responsible for approximately 17.9 million deaths annually. At a previous Saudi Heart Association Conference, a study revealed that one in four adults in Saudi Arabia is at high risk of having a heart attack in the next 10 years. Other countries in the Gulf Cooperation Council are also significantly impacted. A study by the Cleveland Clinic Abu Dhabi showed that around 55 percent of UAE residents who participated said they had been affected by heart disease during their lifetime.
Exercise is highly recommended to maintain and improve heart health, including for those with existing heart disease.
It is assumed that someone physically active would have perfect health, but there have been increasing reports of athletes experiencing sudden heart attacks, and even dying, while engaged in physical activities.
Several football players, including Denmark’s Christian Eriksen, Algeria’s Sofiane Lokar, Croatia’s Marin Cacic, Muscat FC’s Makhlid Al-Raqqadi, and Barcelona’s Argentinian Sergio Aguero all experienced either heart attacks, sudden cardiac arrest, collapsed and/or had chest pains related to heart issues during a game or warm-up. The American National Football League’s Damar Hamlin collapsed mid-game in what was later discovered to be a heart-related issue. Even the very young are not immune: A 12 year old soccer player from USA, and 16 year old cricketer in India, and ice hockey player from Canada, who all collapsed during training, are other unfortunate examples of athletes suffering from sudden or unexpected heart problems.
Sudden cardiac death is the leading medical cause of death in athletes. The Mayo Clinic notes that the number of young athletes dying from sudden cardiac arrest annually ranges from one in 50,000 to one in 80,000. Another emerging trend is the relatively young age of people suffering heart attacks. Previously, one would be more worried about heart attacks in the 50+ age group, but we are increasingly noticing heart attacks in persons aged 20-40.
It is interesting to note the commonalities between professional athletes and astronauts, as both need to be healthy, train hard, and their profession puts a significant physical strain on their body. In order to maintain their health, astronauts in space have to exercise for around two hours every day. Microgravity in space provokes changes to the heart, and now that we are aiming to go to the moon and eventually Mars, one area I (Asrar) am investigating is the impact of long-duration space flights on cardiovascular health. I have been invited to share our findings at the upcoming world’s largest space-themed conference, the International Astronautical Congress 2023.
Being physically active is crucial for overall health, and especially heart health. News reports of athletes and celebrities suffering heart attacks should not deter us from being physically active. Several factors are involved, and we need to consider them all to reduce the chances of having a heart attack and stroke. Factors that place a person at risk of heart problems include obesity, smoking, stress, genetic predisposition, high levels of lipids (fats) and diabetes. Unfortunately, we are seeing increasing cases of diabetes and obesity around the world, including in Saudi Arabia, the UAE and other GCC nations.
Athletes and others whose professions put their bodies through strenuous activities and require them to be physically fit are, generally speaking, healthy individuals. Current research suggests that in cases involving sudden cardiac arrest or death in young athletes, the most common causes are heart rhythm changes, heart muscle thickening, and congenital/genetic issues.
Therefore, it is important to research this area further to determine the underlying causes and to provide national and international recommendations for athletes and other professionals with similarly physically strenuous lifestyles. Athletes can also be regularly monitored so that any changes and/or underlying health issues can be detected and appropriately addressed. Such research would also be vital to sports loving nations such as Saudi Arabia.
Another key recommendation is to ensure that all gyms and sporting facilities are adequately prepared to address emergencies immediately. We recommend that all facilities have adequately trained personnel and CPR-qualified staff and are equipped with automated external defibrillators.
One study found that for people who experienced sudden cardiac arrest during sports, 16 percent had a preexisting cardiac disease, 56 percent had one or more cardiovascular risk factors, and around 36 percent were already having some cardiovascular symptoms a week before the heart attack. Therefore, the main recommendation for everyone would also be to periodically check in with their regular doctor. Even if you feel great, check in with your doctor regularly to confirm this, and do not brush off any chest pain or related symptoms.
• Dr. Farhan M. Asrar is an internationally recognized and award-winning leader, physician, educator, researcher and expert in family medicine, public health and space medicine. Asrar has been invited to Chair the Department of Human Performance in Space (Space Medicine & Life Sciences) at the International Space University's 2023 Space Studies Program. Asrar is Co-Chairing the Dept. with NASA's Chief Science Officer of the Human Health & Performance Directorate
• Dr. Amin Daoulah is a consultant cardiologist and cardiac electrophysiologist at King Faisal Specialist Hospital and Research Centre. Daoulah is a published researcher, with over 35 published. He has collaborated with fellow expert cardiologists across the GCC.
