Should Gyms Have Defibrillators?

Mar. 18, 2004 -- If you are exercising at a health club and your heart goes into a potentially fatal rhythm, your survival may depend on a shock from an automatic external defibrillator or AED.

But odds are good that your gym does not have one of these potentially life-saving devices. One recent study in Ohio found that 17 percent of the fitness centers reported at least one sudden heart attack over a five-year period, but only 3 percent of the facilities had an AED.

Yet defibrillators work. If you have a cardiac arrest outside the hospital, you have only 10 minutes before it's too late. Every minute you lose, you lose your chance of recovery. So they have to be nearby.

AEDs have been coming down in cost, and they are easy enough to use that even people without training can save lives. These devices have been used successfully in airports and casinos and malls for years now.

We're reaching the point where I think we have to start recommending them. In a health club setting, we know the risk of cardiac arrest is high, especially in people that are older. I believe AEDs should be used given their safety.

The American Heart Association encourages AEDs at all types of fitness centers, but specifically recommends them for centers that cater to people at higher risk of cardiac events (senior citizens, people with disabilities, centers for cardiac rehabilitation, etc.)

"We want fitness centers to evaluate all the links in the survival chain," says Vinay Nadkarni, spokesperson for the association's emergency cardiovascular care committee. "If a fitness center is right across from a fire station, they would have easy early access to a defibrillator. That center might want to concentrate their financial efforts on training staff in recognizing emergency situations. A rural center that is far from EMS help should consider a defibrillator even if their customers are generally low-risk."

One thing it is important to keep in mind is that heart attacks from exercise are still quite rare. Barry A. Franklin, director of the Cardiac Rehabilitation and Exercise Laboratories at Beaumont Hospital in Michigan, explains, "We studied over 300 clubs in a major health chain and found that there were 71 deaths per 180 million workouts. That's about 1 death per 2.6 million."

Still, Franklin points out that those are 71 lives that might have been saved if the clubs had an AED, and other cardiac and emergency care specialists agree that AEDs in health clubs are a good idea.

Should people ask if their club has an AED? Yes. And maybe even choose your health club accordingly.

Others are moving to make AEDs even more common. Douglas Zipes, director of the Division of Cardiology at Krannert Institute of Cardiology in Indianapolis, is testing a plan to have AEDs located in residential areas, rather like payphones of yore. He calls it "Neighborhood Heart Watch."

"Four out of five sudden cardiac deaths occur in the home," Zipes points out. Currently Zipes has an AED stored in a lock box on his front lawn. His 38 neighbors, after receiving training from the AHA on how to use an AED, will all get keys to the lock box. "This is a relatively inexpensive way (around $3,000 per neighborhood) to get a potentially life-saving device to a large number of people," Zipes says.

Wine and Women

A new study this week in the International Journal of Cancer finds that drinking wine is linked to a slight increase in breast cancer risk. The large study of over 10,000 women in Sweden found that women who drink an average of about 2-3 glasses of wine every day have more than double the risk of breast cancer.

However, previous research has shown moderate red wine drinking is associated with a lower risk of heart disease and stroke. What should women do?

Overall, I would say the balance is in favor of one or two glasses of wine a day for preventing heart disease. In a family with very high risk for breast cancer, that may be enough to say you shouldn't consume alcohol, but for most women I think the benefit outweighs the risk.

Heart disease is a much greater threat to women's health than breast cancer. Heart disease is way ahead; 10 times more.

Bottom line: no need to give up wine with dinner unless your breast cancer risk is greater than average.

Osteoporosis Drug Safe

For years, many postmenopausal women with the bone disease osteoporosis have been taking a drug they hoped was safe. The drug is Fosamax, and the good news is that Fosamax is both safe and effective for use up to 10 years.

A study published this week in the New England Journal of Medicine finds women taking the Fosamax had stronger bones, less loss of height, and fewer bone breaks than those in the placebo group. They also found that bones gradually lost their added strength when women stopped taking the drug.

What you can do in your 30s and 40s to prevent osteoporosis.

But women should still wait until they need Fosamax before they being taking it. Even though this is good news for most people, we have to be cautious. We shouldn't give this drug, or any drug, to people unless they need it. A lot of women are overdiagnosed with osteoporosis and started on drugs too early.

A 50-year-old woman has a 40 percent lifetime risk of developing osteoporosis. While drugs can help combat the disease, the best advice for young women is to avoid this terrible bone loss.