The risk of marathon runners-live it up, run fast, die young?

Abstract

Marathon running enjoys an astonishing popularity. Because of the enormous number of applicants, it is quite difficult to get a starting place for one of the marathon races in Berlin, London, or New York. Almost every European city appears to have its own marathon race in the months between April and October. Regularly, out of the tens of thousands of runners, one or two succumb to an acute coronary syndrome or sudden arrhythmias. It is quite evident that the extreme exertion of a marathon race, as mentally rewarding as it may be, offers little benefit in terms of health and longevity. Indeed, in clinically healthy runners, markers of cardiac injury are elevated after a race.1,2 An inverse relationship between myocardial injury and the amount of training for the race has been described, with the greatest amount of injury incurred by runners with the least training mileage.2 However, the clinical relevance of acute post-race elevations in markers of myocardial injury remains open. There is little evidence to suggest permanent cardiac damage in healthy runners, but the issue is complex. With increasingly sophisticated biomarkers and imaging methods to measure cardiac damage—what is a healthy runner? Mohlenkamp and colleagues from the University Clinic Essen, Germany, have collected unique data in 108 male recreational marathon runners aged ≥50 years.3 The runners had completed at least five marathon races during the preceding 3 years and were free of clinical coronary heart disease, diabetes mellitus, and other major cardio-renal disease. An important aspect of this study is that the authors in part are investigators of the Heinz Nixdorf Recall study, a large epidemiological study in the general, unselected population in the Ruhr area in Germany. This ongoing study examines the predictive value of state-of-the-art risk factor analysis compared with … *Corresponding author. Tel: +49 69 9450 28 0, Fax: +49 69 461613, Email: A.Schmermund{at}ccb.de