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After six seasons and a couple of films, Sex and the City is back – and viral. No sooner did the show’s spin-off series And Just Like That… air last Thursday than its die-hard fans’ cheers turned to boos, when Carrie Bradshaw’s husband Mr Big suffered a fatal heart attack after working out on a Peloton bike.

The indoor cycling brand, which signed off on the use of its bike with no forewarning of the plot twist, swiftly issued a statement exonerating itself: “Mr Big lived what many would call an extravagant lifestyle… and was at serious risk as he had a previous cardiac event in Season Six.”

Cardio over 50? Yes, just don’t go from zero to 100.Credit:HBO Max

But should a man of a certain age – especially one who enjoys such luxuries – avoid strenuous cardiovascular exercise and accept that it’s time to take up golf?

Mr Big is a good (if fictional) case study. The fabulously wealthy financier, played by Chris Noth, is now in his 60s. He has always been depicted enjoying the fruits of his success, being chauffeured around Manhattan or sinking martinis, but we never saw him exercise – until now. And just like that, 390 testosterone count Big died.

While on one hand we’ve been jauntily encouraged to take up high-intensity interval training (HIIT), or spin, or sign up for that bucket list marathon, there is evidence that excessively strenuous exercise can affect heart health as we age. And ageing is the central theme in And Just Like That….

Real-life cautionary tales include Andrew Marr, who had a stroke on a rowing machine, or Sheryl Sandberg’s husband Dave Goldberg, who died while running on a treadmill. Yes, sticking to a nutritious diet, avoiding smoking, and exercising is medically recommended – but studies also suggest that too much high-intensity exercise could cause problems. One, which monitored 1000 over-60s with stable coronary artery heart disease for 10 years, concluded that while the most physically inactive were twice as likely to have a heart attack or stroke as those who were physically active (and were four times as likely to die of all causes), those who did the most strenuous daily exercise were also more than twice as likely to die of a heart attack or stroke. More does not always mean better when it comes to exercising as we age.

But hold your horses before you stick the Peloton on eBay: none of this means that men over 40 should avoid exercise. Far from it, according to Julie Ward, senior cardiac nurse at the British Heart Foundation. “It’s never too late to increase your physical activity or start a new sport, regardless of how little you have exercised in the past,” she says. “Whatever your age, being active now will make an immediate impact on your health, reducing your risk of heart and circulatory diseases.”

“It’s never too late to increase your physical activity or start a new sport, regardless of how little you have exercised in the past.”

It is important, though, not to go from zero to 60 too quickly. “Start small and build the exercise up so you don’t push yourself too hard to begin with. Try a brisk walk or steady swim, and increase the intensity over time,” says Ward. “To keep your heart healthy, you should ultimately aim for 150 minutes of moderate intensity activity a week.” This can be broken down into short 10-minute sessions throughout the day if that suits you. “If you have a health problem that might interfere with your ability to exercise, it’s important that you speak with your doctor so they can recommend the type of activity that’s best for you.”

Personal trainer Matt Roberts is also very firmly on the “do” side. “Over 40, your heart will have less flex,” he says. “But the benefits outweigh the risks by so much that it’s absolutely worth starting to do some form of exercise, no matter how long you’ve neglected yourself. A super-intense HIIT class may not be the best place to start. Begin with some fast walking, building up each day to gradually condition your heart to exerting itself.

Mr Big in the first episode of And Just Like That…, the Sex and the City reboot series streaming on Binge. Credit:HBO Max

“There are loads of other lifestyle choices, such as diet, stress and lack of sleep, that can cause heart problems. Exercise very rarely causes any kind of heart problem – it just makes good television.”

How you live the rest of your life counts massively. I have a friend in his late 40s who is overweight, drinks heavily and smokes whenever his wife’s not looking. Like Big, he recently took up a new sport: getting healthy.

Thinking that his lifelong passion for rugby was no longer a good idea, he took up powerlifting. He loves it and tells me he can deadlift “an impressive amount”. The problem is he still carries his body fat, because he refused to give up the aforementioned vices. So is this new endeavour going to improve his health? Unlikely. I’d tell him, but I think he already knows – he is a doctor.

That’s the rub. It’s one thing to know what’s right, another to force yourself to do it. The fictional Mr Big will have known that his lifestyle was problematic, so perhaps his search to prolong his life by way of fitness was in vain. If we’re looking for a villain in his death, let’s blame the booze and cigars.

Or we could blame Bradshaw, who does not call an ambulance as Big slumps to the ground.

The Telegraph, London

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