Affairs of the Heart

one of the problems with AF is that there seems to be no one single thing that can pinpoint whether you will get it or not - it’s true cause has yet to be determined or is a classic multifactorial thing that has many contributors and between them cause it. But even here there are so many factors implicated that how do you research and identify the prime cause if there is one?


I had a text from the doctors with a link to fill in my blood pressure twice a day for a week. I did it a year or so ago and it was a touch high so I think this was a follow up.
The average for the week came out at 118/87 and I had to book an appointment to discuss.
When they phoned I explained I’d put a bit of weight on and hadn’t trained as much as I’d like recently but was trying to get back into a routine once Mrs J was back on her feet and they were happy with that.
The doctor/nurse said she didn’t want to prescribe anything as that would lower both numbers and the top one was already low, it was just the bottom one that was slightly high. She seemed to be working to 135/85 as being Ok, and said I might run into problems, feeling faint etc. if they reduced the top one.
Any idea how you get one high and one low figure, I would have thought they would go up and down together?


Mine is the same, although now I am on medication for it. I am sure once I lose the rest of the weight I wont need the meds anymore.

Mine is about 122/89. You cant lower just one, but the usual stuff like losing weight, cutting down on the booze, exercise all helps to keep it at the right level. Beetroot juice has shown some success at lowering it as well, as has Omega 3 if you don’t get much of that in your diet. Reducing salt intake helps some people to lower theirs. Dropping caffeine also for some people. I tested mine, then had a double espresso and tested again and it was no different so if you like your coffee test if you are sensitive before binning it.

Everywhere seems to state the 120/80 being the correct level, but I was also told by the doctor that anything below 135/85 is generally ok.


I have been trying to keep on top of this lately but do get carried away with the Zwift races now and then and a parkrun at the weekend, but overall I don’t think I do that much at high intensity.

I read another article today that suggested a link between gum\oral health and afib, but I suspect that people that have poor health like that might have poor overall health and the causes are lifestyle rather than just a bad mouth.

Interesting about Omega 3 and blood pressure, haven’t heard that before, I knew about beetroot juice but I’m not sure mine particularly dropped when I used to drink it.

Fascinating subject though.


Thats correlation and causation isnt it. There was a similar study years back that said people who floss daily lived on average 7 years longer. The obvious conclusion was flossing led to a longer life. But of course people who bothered to floss everyday also took care of themselves in many other ways.


I think there is a well estalished causal link to inflammatory conditions like preicarditis and wider vascualr inflammation leading to CVD or other circulatory conditions and gum disease(s).


Petty comment but it seems common how easily we’re mixing up heart attacks (blockage of the hearts plumbing) and cardiac arrest (electrical stoppage)

I thought there was a big public message at some point recently, but seeing journalists use them interchangeably in same article about van Hooydonck


This might be of interest to Chris & Fruity, and others? Another research study trying I think trying to decide if there’s a point where too much exercise can be a bad thing? My reading is that it is partly down to intensity as much as anything? Interestingly though it suggests deaths during events tend to be mostly recreational athletes, but doesn’t necessarily define recreational versus competitive. Although I’m clearly neither elite or professional in the grand scheme of things I’m probably classed as competitive like a lot of us regular racers on here.

Fairly sure it’s a combination of factors including genetics & lifestyle though? And in reality we’ll only know if things go wrong or when we are very old!

Bottom line still seems clear though, even light exercise is good for us.


Thanks for that @jeffb . Very interesting.

Here’s what I took home:

  • Exercising is much better than not exercising. Each metabolic equivalent (MET) gain in fitness confers a 30% reduction in all-cause mortality in unfit individuals. That’s massive.

  • We still don’t know for sure if there is a safe upper limit, or if this varies from person to person. Women seem less affected than men.

  • There is some evidence that the maximum benefit may be seen some way short of deca-iron :grinning:

  • However not many people do deca-iron, or whatever, so we don’t know for sure. No-one has set up a big head-to-head study. This is why the evidence is mostly indirect.

  • Lifers tend to have changes in the heart (more coronary artey plaque and calcium, more heart muslce fibrosis or scarring)

  • However this doesn’t necessarily mean the higher cardiac risk of heart attack. It might. But there is not conclusive proof. They say “It is difficult to conclude that these cardiac maladaptations are completely benign. However, currently the functional relevance of such findings is of undetermined significance. This issue will require more study with larger patient populations of veteran endurance athletes.”

  • Exercise reduces the risk of AF, with maximal risk reduction seen in populations with around 20 MET hours per week (say, 4 hours of training) but populations above 55 MET hours per week (10 hours) have probably lost that benefit, and their risk may rise. I actually went and looked up their reference for this, it’s here.

I guess the bit which I can latch on to is this: “During times of strenuous exercise cardiac output increases approximately five-fold above resting values, rising from 5 L/min to 25 L/min or more, leading to disproportionately distributed increases in (ventricle wall stress). These physical strains in conjunction with sustained elevations in catecholamines and reactive oxygen species likely cause cumulative injuries in the myocardium—ultimately leading to scarring as demonstrated by LGE (a type of MRI scan of the heart).” To me this feels like a convincing mechanism for damage over time. But the word likely is in there - we still don’t know for sure.

Their conclusion seems fair to me: Very high amounts of exercise may reduce some of the benefits bestowed by less extreme amounts; the current body of data is not strong enough to recommend that recreational athletes cap their exercise dose, but be aware the maximal benefit for CVD risk reduction occurs at moderate not extreme exercise doses.


Another thing I have wondered (although have no idea if correct) is whether any increased risks nay not actually be due to exercise itself, but to some other thing.

For example, people who are regularly doing 50 MET hours of exercise per week are expending an extra 3000-4000Kcal and so need to eat more. So maybe overall they are eating more sugar or transfats or something else, and this is what is driving cardiovascular risk?

Or… large data sets like the UK biobank project, which allow researchers to link genetic variants with all sorts of things including behaviour. It seems that some people are born with “exercise genes” (combinations of single nucleotide polymorphisms) which pre-program them to exercise more. But, these genetic variants may also be associated with other disease states - for example, motor neurone disease / ALS is one that has been studied.

So perhaps sometimes it is not clear if exericse is the cause of the condition, or just an association with something else that causes the condition. I don’t claim to have much of a scooby about this, but it’s interesting how complex the answers might seem to be.


so bottom line, we are all going to die, no one knows when, so may a well do what you enjoy and go out on a high :wink:


I think we can afford to be a little more involved than that.

A life style that puts you at significant risk of death before 30, 40, 50, 60, 70…80? Or one that puts you at an advantage?

And don’t forget that the things we do encourage/inspire other people, and sometimes they ask our advice.

We may know a lot of inactive people but there are one or two on this forum that are at the other extreme and it’s fair to examine if there is an upper limit. Maybe one Ironman a year is healthy limit, maybe not ten.


The definition of training is probably different across people as well, some would class training as walking from the car to Maccies or going up 1 flight of stairs.

Those of us who mostly take the stairs, and do decent amounts of walking but don’t class that as training are possibly doing more than we think.

Or would the definition be something that raises your HR to a certain level?


To a certain percentage of resting or of max? Possibly. But this is a moving feast…

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Either really.

I know the government health advice is something like a brisk walk several times a week etc., whilst I’m not discounting that, it’s possibly because that’s an easier target than trying to get everyone to run 5K several times a week.

A bit like the 5 a day message, because who’s going to eat 10 portions of fruit and vegetables.

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brisk, regular walks are probably much better/safer for most people.

5k running is far too far