HYROX has suddenly become a fresh fitness challenge for anyone willing to test the limits of their strength and endurance. The typical gym session will soon be swapped out with a HYROX race, a hybrid of running and brutal functional fitness movements that have you shifting constantly between cardio and muscular efforts. Being able to lift heavy weight, run for kilometers, or knock out the crazy gym session doesn't guarantee the heart is ready to match that level of high-intensity work. An individual having great strength and endurance doesn't guarantee he/she has a healthy heart. The significance of this difference is that cardiovascular disease is still a huge problem. According to the WHO, as many as 19.8 million people died from cardiovascular diseases worldwide in 2022, representing approximately 32% of all deaths. In India, the disease is also a significant cause of death; WHO states that 27% of deaths in India are caused due to CVDs, and it is estimated that around 220 million people in India suffer from high blood pressure. It does not mean that people should be scared of hard exercise. Exercise is a vital component of heart health. The question is, is the individual adequately prepared for the intensity of effort they are undertaking? Prioritizing heart before HYROX: When?Also read: Is 'Hyrox' Challenge Worth The Hype Or Just Another Fitness Trend?People who are starting a program of vigorous exercise should be familiar with the symptoms of distant chest pain, abnormal breathlessness, fainting or dizziness, palpitations or irregular heartbeats, or abrupt decrease in exercise capacity. If you have a personal or family history of early cardiac disease, known hypertension, diabetes, high cholesterol, smoking, obesity or prior cardiac disease, it would also be worth discussing with your physician prior to high intensity training. Most importantly, we emphasise that there is no universal cardiac screening test that every participant of HYROX requires. Cardiovascular screening should be risk stratified and individualized. Sometimes just taking your blood pressure and examining you will be sufficient. A doctor might choose to do additional tests – eg, an ECG or exercise stress test – if you have symptoms and/or risk factors and/or other diseases, especially if you are 40 years or older. Additional tests may also include images of your heart.Risk Assessment Before Exercise The European Society of Cardiology's sports-cardiology guidance recommends on risk determination before strenuous physical activity, but not on the use of the same testing algorithm for all. An evaluation with a clinical assessment, ECG, and exercise testing may be recommended for adults who are not physically active or have a high cardiovascular risk for a planned high-intensity exercise. Don't confuse fitness with cardiovascular clearance One may have very strong muscle and not be aware that he or she has an unrecognized risk factor for cardiac health. Alternatively, a person with a known cardiac condition may safely perform a monitored exercise program with appropriate testing and management. The goal is not to keep you from any additional HYROX or heavy training, but only to Know what your heart is capable of and your risk factors, warning signs and symptoms. Strength is one element of fitness. But before you question whether you have enough strength to finish the next workout, here's a question for you: Is your cardio ready? By Dr. Rajat Kar, Consultant - Adult Cardiology, Narayana Hospital, Howrah