Association of Level of Physical Exertion with Acute Myocardial Infarction in Bangladeshi Population

Md Kamrul Azad, Abdul Wadud Chowdhury, Mohammad Arifur Rahman, Shohael M Arafat, Sheikh Foyez Ahmed, Sathi Dastider

Background: Evidences suggest that heavy physical exertion can trigger the onset of acute myocardial
infarction. But there have been no clean cut data in Bangladesh about the risk of myocardial
infarction during and after heavy exertion. To address this question the study was conducted.
Methods: It was a multicentre cross sectional study was conducted from July 2012 to June 2013
with patient of diagnosed acute myocardial infarction (AMI) admitted in department of cardiology
of National Institute of Cardiovascular Diseases (NICVD), Bangabandhu Sheikh Mujib Medical
University (BSMMU) and Dhaka Medical College Hospital (DMCH). From selected samples, two
hours activity prior to onset of symptom of AMI was asked according to standard questionnaire.
Activities were quantified on a scale from 1 to 8 metabolic equivalents (METs) according to generally
accepted values. Collected data were analyzed by SPSS version 16.
Results: In this study 246 patients (74 .4 percent of whom were men; mean age [±SD], 64.68 ± 7.63
years) were interviewed. The study showed that 11.38% patients were engaged in strenuous physical
exertion (e” 6 METs) within two hours prior to symptom onset of AMI. Strenuous exertion group of
AMI patients were all most all sedentary worker [26 (92.86%) of 28]. Most of the patients (82.14 %) of
strenuous group had history of less than 8 hours work per day. Strenuous exertion group had
history of longtime exertion (72.57%, 1-2 hours) than non-strenuous group (42.66%, <0.5 hours).
Moreover, 67.86% AMI patients of strenuous exertion group had experienced irregular exertion
whereas most of the patients (64.22%) of non strenuous group had a history of regular exertion.
Conclusions: The result of the study indicates that a period of strenuous physical activity is
associated with increased risk of having AMI, particularly among patients of sedentary worker who
have dyslipidemia and who exercise irregularly. Those who exercise regularly have lower chances of
AMI as shown by the negative correlation.