MONDAY, March 4, 2002 (HealthDayNews) -- The well-equipped fitness club should have a defibrillator to handle heart emergencies alongside its weights, treadmills and stair climbers.
That's the recommendation of two leading medical groups concerned about the heart.
The benefits of exercise far outweigh the risks, says a joint statement by the American Heart Association and the American College of Sports Medicine. However, a defibrillator -- and staff members trained to use it -- can save a life when someone's heart stops, the position paper says. It appears in tomorrow's issue of Circulation.
A defibrillator is a computerized device, no bigger than a large textbook and costing $3,000 to $4,000, that is programmed to analyze the heart's rhythm and deliver a potentially lifesaving shock if cardiac arrest occurs. It's especially important for large exercise clubs and those with big senior memberships to have them as part of an overall cardiac emergency plan, the statement says.
"What we are doing is encouraging all clubs to have them," says Dr. Gary Balady, a professor of medicine at Boston University School of Medicine who chaired the group that drafted the statement. "We strongly encourage large clubs to have them because the larger the club, the more members of diverse age ranges and the more members who are older."
The call for more defibrillators comes amid rising use of health and fitness clubs; about 30 million Americans, most of them over 35, now visit them. The overall number of fatal heart attacks isn't known, but estimated to be low. One study of nearly 3 million members in several large chains reported 71 deaths in a two-year period, the heart group says. Another study of randomly chosen clubs in Ohio reported that 17 percent of their members had had either a fatal or nonfatal heart attack in the last five years.
The recommendation gets a generally warm reception from the International Health, Racquet and Sportsclub Association, which represents about a third of the estimated 12,000 clubs in the United States.
"We certainly support a club having a defibrillator as part of a cardiac emergency plan," says Helen Durkin, director of public policy for the association. "Especially the fact that the American Heart Association makes a distinction between certain kinds of clubs, that is something we highly agree with."
A survey done a year ago indicated that a quarter of the clubs in the association had defibrillators, Durkin says. "Since then there has definitely been an increase, although we're not sure of the percentage."
While the association encourages clubs to install defibrillators, "we don't agree with a blanket rule saying every club should have one," Durkin says. Smaller clubs might not be able to afford the devices and the training needed to use them properly, she says.
Durkin also says the risk of having a cardiac emergency during exercise is low. A Harvard study of 21,000 doctors in 2000 concluded there was one sudden death per 1.51 million episodes of exercise.
True, says Balady, but that number changes with age and cardiac condition. "If you are older or have known heart problems, the risk of cardiac arrest during exercise appears to be 10 times higher than that number," he says.
Those numbers should not scare anyone away from regular exercise, because "the more physical activity we have, the better off we are," Balady says. Regular physical activity, 30 minutes a day at least three days a week, is the standard recommendation to reduce the risk of heart attack and stroke.
What To Do
"If you go to a health club, you want to know if they have an emergency plan, with people on site who can handle an emergency," he says. "One way to assess a health club is to note if they ask you questions about your health. If they ask a lot of questions, they clearly have an emergency plan. If you know you are in a higher-risk group, you should know if you are in a place that can handle it."
Detailed information about exercise, its benefits and possible risks for some people, consult the American Heart Association, which also has a page on defibrillation. To learn more about the health club industry, try the International Health, Racquet and Sportsclub Association.
