Heart disease in marathoners


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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.”

5 Replies to “Heart disease in marathoners”

  1. It would be interesting to know how much of a running back ground these people came from?

    Were most of these runners new to the sport (being inactive during most of their adult lives and now trying to get back into shape over the past 5 or so years) or had most of them been running since their school days?

  2. Dean Ornish, MD, one of two docs who independently showed the CHD is reversible has pointed out that you need to be fit to be healthy, but you can be fit without being healthy.

    Even the training inherent to marathon running and the fitness required to finish a marathon ( in a reasonable time ) can’t undo the deleterious cardiovascular changes of a Western dietary pattern and inherent stressors of life in a modern culture.

  3. A different take on this is that I have come across several articles of runners who had heart attacks or other medical problems and claim they wouldn’t have survived if they hadn’t been runners. For example, this from a Runners World article entitled Running Saved My Life, Aug. 2007:

    -After 5 hours of surgery, the anesthetist peered down at Elves, then asked the medical team around the table: “How come she’s still with us? How come this woman’s still alive?”

    The head surgeon didn’t look up. “She’s a runner,” he said. “It’s her runner’s heart.”–

    Any science behind this?

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