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A lot of people consider their pursuit of fitness in the gym to be an entirely aesthetic exercise.

That is to say, a lot of us can pay a whole lot more attention to what we look like on the outside than what is going on under the hood but if you don’t have a healthy heart, pretty much everything else you do in there is for naught.

The recent heart attack suffered by 56-year-old UFC Hall of Famer Randy Couture indicated that even a lifetime of physical fitness doesn’t make you immune from heart issues. While exercise can exacerbate heart issues (we recommend you see your doctor urgently if you have any concerns here), it is also the best method with which to prevent cardiac problems — as oxymoronic as that sounds.

A recent study as noted by focused on 762 Australian adults who have suffered from heart problems and looked at the amount of exercise they were doing in advance of their problems and it showed that people who do isometric exercises (weight-lifting etc.) are at greater risk to those who do anaerobic routines like running. It also showed that people who took up vigorous exercise without working up to it are 77-times more at risk.

“It can go up to 135 fold [in risk],” lead researcher Dr .Tom Buckley of the University of Sydney’s Faculty of Medicine and Health said. “The risk goes down incrementally. Somebody who already does [vigorous exercise] one-to-two days a week is still 20 fold.

“It’s when you exercise at that level more than four days a week that you really, really lower the risk.”

However, the other side of that coin is that when you are sitting idle and have already done your workout in the gym, you are four times less likely to have a heart attack so long as your workouts raise your heart rate and are not low-impact exercises like walking.

“There is an emerging body of literature that, to ameliorate your risk during high-intensity activity, you have to be exposed to it regularly,” Dr Buckley continued. “That was one of the key findings here.”

The key is to work up to your intended level and pace gradually, rather than placing too much stress on any one area of your body, including your heart. There is risk involved, but the benefits are massive.