Stroke: Strenuous exercise increases the risk for people with blocked arteries

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A recent study looked at the impact of strenuous exercise on stroke risk among people with blocked arteries. Drazen Zigic/Getty Images
  • New research has found that an increased heart rate can lead to strokes in people with carotid artery stenosis (blocked arteries).
  • For people without blocked arteries or minimal blockage, exercise helps maintain healthy blood flow.
  • More research is needed to understand the relationship between elevated heart rates and adverse effects in people with moderate to severe carotid artery stenosis.
  • For those with moderate or higher levels of strictures, lighter forms of exercise such as walking, yoga and balance training are recommended.

While exercise is generally considered good for our health, an elevated heart rate can have negative effects on people with specific health conditions.

According to a new study published in Physics of fluids an increased heart rate can cause a stroke in people with carotid artery stenosis, a condition that narrows or blocks arteries.

While the findings are concerning, the prevalence of carotid artery stenosis remains low, affecting around 3% of the general population.

Regular exercise supports healthy blood flow among people with mild, moderate, or no arterial blockage and is recommended by doctors for heart disease prevention.

For the study, the researchers analyzed the impact of heart rate during exercise and heart rate at rest.

They used a computational model to stimulate blood flow in the carotid arteries at the following stages of stenosis:

  • without block
  • with a mild blockage of 30%.
  • with a moderate block of 50%.

The results show that for people with moderate blockage, exercise increased stress on the blocked area of ​​the arteries, which could cause the stenosis to burst.

Once this blockage reaches the brain, it could lead to an ischemic stroke.

But for individuals with no blockage and mild blockage, exercise was beneficial for the stimulated carotid artery.

Study author Dr. Somnath Roy, PhD, an associate professor in the Department of Mechanical Engineering at the Indian Institute of Technology Kharagpur, India, told Healthline that exercise is a common recommendation for preventing cardiovascular disease .

Existing literature has shown that an exercise-induced higher heart rate improves stress levels on the artery wall and prevents the formation of a stenotic blockage, Roy said.

We have observed similar characteristics for healthy arteries across our numerical predictions.

But for artery models with already progressed stenosis or narrowing, Roy explained that there were higher levels of oscillations in the WSS (known as the oscillatory shear rate).

Higher levels of these oscillations can increase the risk of further progression of the stenosis together with very high shear stresses.

If the levels are substantially high, the stenotic plaque could begin to rupture and form blood clots or an embolism (a blocked artery caused by a foreign body), which could travel to the brain, block finer vessels and lead to a stroke.

The authors reported the effect of elevated heart rates on hemodynamics[how blood flows] in healthy and stenotic carotid arteries by deploying computational simulations based on physiologically relevant data. AND Not a clinical study, Dr. Joseph C. Maroon, clinical professor, vice president and Heindl scholar in neuroscience in the Department of Neurosurgery at the University of Pittsburgh.

The observations are interesting. They’re suggesting that a lesion is 50% stenotic or greater May they have an increased risk of blocking the flow and thus resulting in a stroke or heart attack, Maroon added.

For future studies, the research team plans to investigate the effects of high heart rate on other arterial patterns such as a coronary artery, aorta, etc., Roy explained.

In addition, they plan to examine the effect of varying blood viscosity on flow characteristics and stress levels. Blood viscosity can change due to diseases such as anemia, leukemia, and sepsis.

They’re also looking at the effects of exercise on people with heart valve replacement.

As noted in the study, vigorous exercise can have adverse effects on patients with moderate to high levels of strictures.

Although the volume of flow is not reduced until there is a 90% or greater stenosis in an artery, the suggestion is that shear and flow disturbances caused by a 50% narrowing of an artery can disrupt the flow. lining the artery (the intima) and precipitating clotting and blockage despite a normal flow, Maroon said.

This is an important observation that should be further investigated and confirmed.

To better understand the relationship between exercise and stenosis, it is also important to note the potential differences between human heart rate and a computer model.

Substantial variability in human heart rate (compared to a computer model) can occur over the course of different-impact isometric workouts, sports, and exercises, said Dr. Sandra Narayanan, board-certified vascular neurologist and neurointerventional surgeon at the Pacific Stroke & Neurovascular Center at the Pacific Neuroscience Institute in Santa Monica, California.

Further studies are needed to understand the relationship between the duration of sustained elevated heart rate and the negative impact on cerebrovascular risk in patients with moderate-to-severe carotid artery stenosis.

Narayanan also explained that it would be useful to identify whether specific activities carry a higher lifestyle risk or whether the risk stems more from the tachycardia and is independent of the cause.

The study authors suggested a carefully prescribed exercise regimen for people with moderate to severe strictures or those with a history of stroke.

Roy warned that the elevated heart rates resulting from exercise could lead to fatal effects for people with severe strictures.

He added that arterial blockage might be underreported among athletes or performers until an elevated heart rate situation occurs, the impacts of which could be harmful.

Regular medical checkups and opting for lighter exercise patterns would be important for these people, Roy said.

Exercise is good for healthy people to prevent arterial degeneration, Roy said. Even light exercise or a moderate increase in heart rate can be helpful for people with moderate strictures.

Low impact exercises include activities such as walking, yoga and Tai Chi.

Walk at a normal pace and gradually increase the distance, the elliptical or stationary bike at a comfortable pace but don’t run out of breath, bands for stretching and flexibility, Maroon suggested.

Additionally, balance training can help you avoid falls.

An increased heart rate can lead to a stroke in patients with highly blocked carotid arteries, according to a new study.

However, the prevalence of carotid stenosis is relatively low in the general population. For patients with no blockage or minimal blockage, exercise maintains healthy blood flow.

Regular exercise still offers one of the best protections against heart disease for most people.

More research is needed to understand the connection between exercise-induced heart rate and stenosis.

Experts recommend walking, yoga, and balance training for patients with moderate or higher stricture levels.

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