Sun, Apr 14, 2019 - Page 11 News List

Doctors remind of marathon health risks


It was the death heard ’round the running world.

In July 1984, acclaimed author and runner Jim Fixx died of a heart attack while trotting along a country road. Overnight, a nascent global movement of asphalt athletes got a gut check: Just because you run marathons does not mean you are safe from heart problems.

Fast-forward 35 years, and Boston Marathon race director Dave McGillivray is amplifying that message for marathoners, especially those who have coronary artery disease or a family history of it.

“Being fit and being healthy aren’t the same things,” McGillivray said.

He should know. Six months ago, the lifelong competitor underwent open-heart triple bypass surgery after suffering chest pain and shortness of breath while running.

As marathons, ultramarathons, megamile trail races and triathlons continue to explode in popularity, doctors are represcribing some longstanding advice: Get a checkup first and talk with your doctor about the risks and benefits before hitting the road.

For McGillivray, 64, the writing was on his artery walls. Both his grandfathers died of heart attacks, his father had multiple bypasses, his siblings have had heart surgery and a brother suffered a stroke.

Neither McGillivray’s marathon personal best of 2 hours, 29 minutes, 58 seconds, nor his decades of involvement in the sport could protect him.

“I honestly thought that through exercise, cholesterol-lowering medicine, good sleep and the right diet, I’d be fine,” he said. “But you can’t run away from your genetics.”

Aerobic exercise is known to reduce the risk of heart disease, high blood pressure, stroke and certain types of cancer, and it has been a key way to fight obesity, Type 2 diabetes, osteoporosis and more.

However, new research is providing a more nuanced look at “extreme exercise” and the pros and cons of running long.

In a study published in December last year in Circulation, the journal of the American Heart Association, researchers in Spain found signs suggesting that full marathons such as Boston might strain the heart.

They measured substances that can signal stress and found higher levels in runners who covered the classic 42.2km marathon distance compared with those who raced shorter distances.

Only about one in 50,000 marathoners suffers cardiac arrest, the researchers said, but a high proportion of all exercise-induced cardiac events occur during marathons — especially in men ages 35 and older.

The Boston Marathon and other major races place defibrillators along the course.

“We typically assume that marathon runners are healthy individuals, without risk factors that might predispose them to a cardiac event during or after a race,” wrote Juan Del Coso, the study’s lead investigator, who runs the exercise physiology lab at Madrid’s Camilo Jose Cela University.

Running shorter distances might reduce the strain, especially in runners who have not trained appropriately, he said.

Kevin Harris, a cardiologist at the Minneapolis Heart Institute at Abbott Northwestern Hospital, said he had a patient preparing for the Twin Cities Marathon who struggled to exceed 16km in training.

The man’s family doctor insisted he get a stress test and he wound up needing double bypass surgery.

“Running is good and we want people to be active, but your running doesn’t make you invincible,” Harris said.

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