Dr Vivek Baliga Health Check Before Taking Up Running

We recently conducted a blood pressure camp at a nearby gym, where all members who walked through the door had their blood pressure checked.

Of the 25 members we screened in 2 hours, we detected high blood pressure in 3 of them! One had a blood pressure of 220/130 mmHg (normal is around 120/80 mmHg), and he was just 37 years old! He had been working out without knowing he had high blood pressure, and it is likely that if you continued without treatment that he would be at risk of a heart attack, stroke or kidney disease.

Why get a medical check up?

The problem with illnesses such as high blood pressure and heart disease is that it can be ‘silent’. People are unaware they have a problem until they have undergone a health check-up. 

You may have heard of cases where young people have died suddenly when out for a walk or even when sitting at home. Many a time, these tragedies are due to undiagnosed heart disease which could have been detected if the person had undergone a medical check up.

What to get done

The important tests that must be done in all people looking to take up running as a hobby (or professionally) must include a blood test, electrocardiogram, echocardiogram and an exercise treadmill test.

Blood tests can help determine if an individual has low haemoglobin, high blood sugar and/or high lipids. All these can be risk factors for heart disease and can be easily treated though lifestyle modification and medicines.

An electrocardiogram (or ECG) is a test that looks at the electrical activity of the heart. An abnormality in the conduction of electricity is clearly seen on the ECG and this may need treatment. Rare cases that need immediate treatment have been picked up on an ECG and the information put together with other tests has helped reach a diagnosis. In some cases, the ECG can be normal even there is an underlying problem, though this is rare.

An echocardiogram is a specialised test where ultrasound waves are used to visualise the heart on a machine. The test will provide information on the structure of the heart muscle, the state of the valve and how strong the heart is pumping (called ejection fraction). Causes of sudden cardiac death such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy (ARVC) can be detected through this scan. Narrowing of the heart valves and abnormalities in their function such as leaks can also be detected easily. 

You can read about these conditions on the website www.heartsense.in.

An exercise treadmill test is a very useful test that can help determine how the heart performs when the person is exercising. The normal response is for the heart rate and blood pressure to go up and for the ECG to remain in normal limits. Exercise tests are doctor supervised and the patients are pushed till the heart rate reaches a particular value (called target heart rate, which is 220-age of the individual). Some tests are continued beyond the target heart rate, but this is rarely necessary.

The treadmill test can help determine the following – 

1. Is there any abnormality in the way the heart conducts electricity? This can be seen with the way the waves look, the regularity of the heart beating and the presence of extra beats or abnormal rhythms.

2. Is there any problem with the circulation of blood to the heart? This can be determined if there are changes in particular segments of the ECG on exercise or at rest.

If any abnormality is found, your doctor will let you know if you need any further investigations. Some patients may be advised not to exercise until all additional tests have been done.

While most patients who undergo these tests have normal results, it is not uncommon to pick up the odd case where the tests are positive. These patients have gone on to have either angioplasty, bypass surgery or have commenced medication. Lifestyle changes form part and parcel of these treatments as well, and must be followed strictly.

‘It is better to be safe than sorry’

 

You may have heard this before. It cannot be any further from the truth when it comes to running and your heart. These tests are simple to perform and take no more than a couple hours of your time. Numerous centres now offer these tests at a good price, with only a handful running specialist packages. 

Now that you have read this tip, make time to see your doctor and talk to them about getting the tests arranged. 

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