Heart disease in marathoners
There’s a new preprint online at Medicine & Science in Sports & Exercise, from researchers at the University Clinic Essen in Germany, describing a study of heart disease in marathon runners. They recruited 100 runners aged 50-75, all of whom had completed at least five marathoners in the previous three years, and ran them through a battery of tests to assess the health of their arteries, both in the heart and elsewhere in the body. (They used, among other measures of risk, ultrasound imaging and “electron beam computed tomography,” which I’ve never encountered before and which sounds pretty cool!)
Anyway, the gist: they found plaques in the arteries of all but 10 of the runners. They run a bunch of analyses trying to figure out how to predict what differentiates the plaque-free runners from the plaque-y runners — but eventually they conclude that the subjects at highest risk are those who would be identified as high-risk by conventional analyses (e.g. the Framingham Risk score). In other words, being a runner doesn’t exclude you from or make you immune to these conventional risk factors.
Is this news? Well, it reminded me of an anecdote Tim Noakes told me last summer, about the conventional wisdom in the 1970s that devoted runners were essentially immune to heart disease. So what did Noakes, a lifelong paradigm-buster, do? Amby Burfoot described it a few years ago in a Runner’s World article about the very first New York Academy of Sciences meeting on the running and medicine in 1976:
So Tim Noakes, M.D., gave a presentation that documented the heart attack of a veteran marathoner, which became one of the most-talked-about sessions. Prior to this, several running physicians enjoyed notoriety for claiming that a marathon finisher could never have a heart attack.
Still, it’s always good to get a reminder — or as the German researchers conclude: “These data support an increased awareness of atherosclerosis prevalence and cardiovascular risk factor in marathon runners.”