Experts Warn That Some Marathoners May Be Pushing Themselves Too Hard

Review study examines why people are suffering heart attacks during high intensity and endurance exercises such as marathons and triathlons.
Man running at sunset with overlaid image of heart and EKG.
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Composite image by Abigail Malate.

Yuen Yiu, Staff Writer

(Inside Science) -- In the ancient Greek legend, the messenger Pheidippides ran from the battlefield of Marathon to Athens -- a distance of more than 20 miles -- to bring news of the Greek's victory over the Persians in the battle of Marathon. Then he collapsed and died. 

The race now known as a marathon was developed for the first modern Olympic Games in Greece in 1896 and its popularity has surged in recent decades. Between 2008 and 2018, the number of participants increased by almost 50% globally, with a peak in 2016. Marathoners have overall become a bit slower and older, with an average finishing time of 4:29:53 in 2018, compared to 3:52:35 in 1986, and an average age of 39.3 in 2018 versus 35.2 in 1986.

According to a scientific statement from the American Heart Association , which was published today in the journal Circulation, the increased participation of older and potentially less fit individuals may have contributed to the observations of increased risk of heart attacks observed among marathoners. The writers also noted the occurrence of sudden cardiac death was 3.5 times more frequent among male runners compared to female runners.

In a press release, Barry Franklin, a researcher at the William Beaumont Hospital system in suburban Detroit and chair of the group that authored the scientific statement, said "Exercise is medicine, and there is no question that moderate to vigorous physical activity is beneficial to overall cardiovascular health. However, like medicine, it is possible to underdose and overdose on exercise -- more is not always better and can lead to cardiac events, particularly when performed by inactive, unfit, individuals with known or undiagnosed heart disease."

To minimize the risk, the writers suggest that people only slowly increase the intensity of physical activities, especially if they are not currently physically active. People with known heart conditions should seek their doctor's approval before beginning a new exercise program.

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Yuen Yiu is a former staff writer for Inside Science. He's a Ph.D. physicist and fluent in Cantonese and Mandarin. Follow Yuen on Twitter: @fromyiutoyou.