BBC presenter Andrew Marr appeared on the TV yesterday for the first time since he suffered a stroke four months ago. Marr blamed his stroke on overworking and an overly vigorous exercise session on a rowing machine.
You can see the interview with him and read the article here,
http://www.bbc.co.uk/news/health-22150091
Whilst I am, of course, sympathetic to Marr's plight, I believe he is being irresponsible by blaming solely the exercise session that he performed as the cause of his stroke.
The article rightly points out that "People of all ages can have a stroke, although they occur most commonly in people who are older.. Most of the time there will be underlying health problems like having high blood pressure".As Marr and the online article points out, "Studies suggest that high-intensity interval training causes significant changes in a number of important health parameters, and more so than hours of conventional exercise"., whereas there is only "anecdotally [evidence] that some activities like vigorous exercise can sometimes cause blood vessels to burst”. So the science says it is good for you but some people say different.
The Australian Association for Exercise and Sports Science (AAESS) issued a Position Statement on Exercise and Hypertension in 2009, based on an extensive review of the literature, which states in the abstract, "Vigorous exercise training is generally safe and well tolerated by most people, including those with hypertension, although some special considerations are required". Those considerations being "the risk of exercise-induced adverse events is heightened in older people with coronary artery disease, a condition often associated with hypertension. Therefore, prior to
initiating an exercise program, older patients with hypertension should be medically evaluated to identify if exercise training may be hazardous". The BBC article does make the same recommendation.
The AAESS Position Statement recommends that a qualified Exercise Physiologist supervise those with hypertension undergoing exercise training.
I do not know what state of health or physical fitness Marr was before he begun his vigorous exercise routine, but hypertension is more likely to develop in people who are physically inactive, overweight
(BMI ≥30); waist circumference >102 cm for men or >88 cm for women, those who consume excess dietary sodium or more than two standard alcoholic drinks on average per day for men and one standard drink for women. Given that Marr is a 53 years old journalist, he most certainly has a sedentary job and most probably fell into at least one other risk factors. Marr acknowledges that he was overworked for at least a year before his cerebral infarction meaning he was probably stressed and had elevated blood pressure.

The BBC article rightly acknowledges, "pushing your body to its limit gives you a better workout" and "Studies suggest that high-intensity interval training causes significant changes in a number of important health parameters, and more so than hours of conventional exercise... It can boost aerobic fitness, as well as improve how the body's metabolic processes", but you have to work within your bodies limits.
I agree with The Stroke Association that it is important to find a balance between how hard the exercise is, how long you exercise for and how often you exercise but disagree with the statement, "You will benefit more from doing regular gentle exercise for a good length of time, than exercising very vigorously for a short length of time or infrequently". This is contradictory to all of the evidence presented above.
In summary, it is recommended that you get medical clearance before beginning any exercise routine, especially a high intensity one, and most certainly if you fall into a risk factor group for cardiovascular events. Working to your maximal limits is recommended as the best exercise protocol for improving and/or preventing diseases of lifestyle including stroke, heart disease, diabetes and obesity.
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