I have been asked this many a times. I am no doctor but I do understand what goes in and out of heart, what stops it, and heart’s health in general. So here are my views on the subject:
Coronary artery disease (CAD) is the main cause of heart attack. A less common cause is a severe spasm, or sudden contraction, of a coronary artery that can stop blood flow to the heart muscle – heart fail.
Fitness: firstly, we must understand where fitness is also about cardio/heart health, it is often the most difficult one to access in real. Why? Because one has to measure RHR (resting heart) & VO2 to predict cardiovascular health which is not possible for everyone.
We often think of fitness as running, cycling, building body in the gym, or regularly getting involved in fitness of any sort. Yes, it is one part of fitness.
2nd part is metabolism which, to me again, is the major cause of heart attacks in fit people. An artery blockage is feature of what we eat. One can be racing or training at gym and still have an artery blockage!
In simplest terms, coronary artery gets blocked which interrupts the supply chain of nutrients to heart. One can live with a blocked artery all their life or may not even for a day.
Analogy – think of a blocked fuel pipe in your car. It works fine at normal speeds but one fine day, you are forced to press the pedal hard asking for extra fuel. But it can’t because its partially blocked.
Think of a heart now. Regardless of how much you can run or cycle, we may not be able to meet the demands if an artery is blocked.
Blaming genes – well, in the scientific world, we say and perhaps researched that 30% is genes and 70% is what you make of yourself. I believe it could be 90% of what we make of ourselves. Of course, some discomforts are purely genetic but some are driven by metabolism.
Am born with certain genes. I then live 40/50/60 years of life with my will and taste. Then blaming genes is unfair? Right?
Recommendation – those of you who fear an attack due to overweight, or genetics, or any other reason; get CAC test done. Google it. Researches have shown it to be quite a good marker.
A nutritional intervention is also a good option but I would recommend it post test especially if you are fearful.
Conclusion: So regardless of how much you exercise, you can still be living with blocked arteries. Fitness is often seen in terms of your body structure, or how much we exercise. And this is fine. But there is a caveat with regard to your organelle health or these kind of blockages in your arteries.
We all need heart conditioning work out in our training regime. Something that challenges our breathing capacity. Slowly improve it over a period of time. This is also linked to your mitochondrial health or fat oxidation which is shown to be related to diabetes, cancer, etc in latest researches.
Yogic breathing, in my opinion, is a good tool for cardio health besides physical training.
Trust this helps