Marathon Research Articles

Risk factors associated with a history of iliotibial band syndrome (hITBS) in distance runners: a cross-sectional study in 76 654 race entrants – a SAFER XXXIII study

ABSTRACT Background Despite the numerous health benefits of distance running, it is also associated with the development of ‘gradual onset running-related injuries’ (GORRIs) one of which is Iliotibial Band Syndrome (ITBS). Novel risk factors associated with a history of ITBS (hITBS) have not been described in a large cohort of distance runners. Objective To identify risk factors associated with hITBS in distance runners. Design Descriptive cross-sectional study. Setting 21.1 km and 56 km Two Oceans Marathon races (2012–2015). Participants 106 743 race entrants completed the online pre-race medical screening questionnaire. A total of 1 314 runners confirmed an accurate hITBS diagnosis. Methods Selected risk factors associated with hITBS explored included: demographics (race distance, sex, age groups), training/running variables, history of existing chronic diseases (including a composite chronic disease score) and history of any allergy. Prevalence (%) and prevalence ratios (PR; 95% CI) are reported (uni- & multiple regression analyzes). Results 1.63% entrants reported hITBS in a 12-month period. There was a higher (p < 0.0001) prevalence of hITBS in the longer race distance entrants (56 km), females, younger entrants, fewer years of recreational running (PR = 1.07; p = 0.0009) and faster average running speed (PR = 1.02; p = 0.0066). When adjusted for race distance, sex, age groups, a higher chronic disease composite score (PR = 2.38 times increased risk for every two additional chronic diseases; p < 0.0001) and a history of allergies (PR = 1.9; p < 0.0001) were independent risk factors associated with hITBS. Conclusion Apart from female sex, younger age, fewer years of running and slower running speed, two novel independent risk factors associated with hITBS in distance runners are an increased number of chronic diseases and a history of allergies. Identifying athletes at higher risk for ITBS can guide healthcare professionals in their prevention and rehabilitation efforts.

Biomechanical Investigation of Lower Limbs during Slope Transformation Running with Different Longitudinal Bending Stiffness Shoes.

During city running or marathon races, shifts in level ground and up-and-down slopes are regularly encountered, resulting in changes in lower limb biomechanics. The longitudinal bending stiffness of the running shoe affects the running performance. This research aimed to investigate the biomechanical changes in the lower limbs when transitioning from level ground to an uphill slope under different longitudinal bending stiffness (LBS) levels in running shoes. Fifteen male amateur runners were recruited and tested while wearing three different LBS running shoes. The participants were asked to pass the force platform with their right foot at a speed of 3.3 m/s ± 0.2. Kinematics data and GRFs were collected synchronously. Each participant completed and recorded ten successful experiments per pair of shoes. The range of motion in the sagittal of the knee joint was reduced with the increase in the longitudinal bending stiffness. Positive work was increased in the sagittal plane of the ankle joint and reduced in the keen joint. The negative work of the knee joint increased in the sagittal plane. The positive work of the metatarsophalangeal joint in the sagittal plane increased. Transitioning from running on a level surface to running uphill, while wearing running shoes with high LBS, could lead to improved efficiency in lower limb function. However, the higher LBS of running shoes increases the energy absorption of the knee joint, potentially increasing the risk of knee injuries. Thus, amateurs should choose running shoes with optimal stiffness when running.

Marathon Health Pitfalls: What Every Runner Needs to Know

Introduction and Purpose: Long-distance running, especially marathons, tests human endurance and physical limits. While the benefits of marathon running are well-documented, the associated health risks often go unnoticed. This review aims to synthesize current knowledge on the health risks and complications faced by marathon runners, providing crucial insights for both amateur and professional athletes.State of Knowledge: Marathon running imposes significant stress on the cardiovascular system, musculoskeletal structure, and metabolic processes. Issues such as acute myocardial injury, overhydration leading to hyponatremia, and musculoskeletal injuries are prevalent. The review also examines less common but severe risks like rhabdomyolysis and marathon-related cardiac arrests. Despite the robust fitness levels of runners, these health risks remain a serious concern, necessitating preventive strategies and proper health monitoring.Summary: Marathon runners must be aware of the potential health risks associated with prolonged endurance activities. Precautionary measures, including tailored training programs, dietary adjustments, and regular medical check-ups, are essential to mitigate these risks. Additionally, further research is required to develop more effective interventions and guidelines that can safeguard the health of marathon participants. This review underscores the need for a balanced approach that respects the physiological demands of marathon running while ensuring the health and safety of the runners.

Thirty days of double-strain probiotic supplementation increases monocyte phagocytosis in marathon runners.

Marathon runners, subjected to intense training regimens and prolonged, exhaustive exercises, often experience a compromised immune response. Probiotic supplementation has emerged as a potential remedy to mitigate the impact of prolonged exercise on athletes. Consequently, this study sought to assess the influence of probiotic supplementation on monocyte functionality both before and after the official marathon race. Twenty-seven runners were randomly and double-blindly assigned to two groups: placebo (n 13) and probiotic (PRO) (n 14). Over 30 d, both groups received supplements - placebo sachets containing maltodextrin (5 g/d) and PRO sachets containing 1 × 1010 colony-forming unit Lactobacillus acidophilus and 1 × 1010 colony-forming unit Bifidobacterium bifidum subsp. lactis. Blood samples were collected, and immunological assays, including phagocytosis, hydrogen peroxide production, cytokine levels and monocyte immunophenotyping, were conducted at four different intervals: baseline (start of supplementation/30 d pre-marathon), 24 h-before (1 d pre-marathon), 1 h-after (1 h post-marathon) and 5 d-after (5 d post-marathon). Monocyte populations remained consistent throughout the study. A notable increase in phagocytosis was observed in the PRO group after 30 d of supplementation. Upon lipopolysaccharide stimulation, both PRO and placebo groups exhibited decreased IL-8 production. However, after the marathon race, IL-15 stimulation demonstrated increased levels of 5 d-after, while IL-1-β, IL-8, IL-10, IL-15 and TNF-α varied across different intervals, specifically within the PRO group. Probiotic supplementation notably enhanced the phagocytic capacity of monocytes. However, these effects were not sustained post-marathon.

Marathon runner algorithm: theory and application in mathematical, mechanical and structural optimization problems

Abstract This study proposes a novel human-inspired metaheuristic search algorithm called marathon runner algorithm. This method mimics competitive behaviors observed in real marathon runners through mathematical modeling. Unlike classical elitist algorithms that prioritize position of the best agent, the marathon runner algorithm introduces a novel concept called vision point. This point considers the quality of the entire population, not just the leader. By guiding the population towards vision point, the risk of getting trapped in local optima is reduced. A two-part evaluation was conducted to thoroughly assess the search capabilities of the marathon runner algorithm. First, it is tested against a set of unconstrained benchmark mathematical functions and the algorithm’s quantitative attributes, such as complexity, accuracy, stability, diversity, sensitivity, and convergence rate are analyzed. Subsequently, the algorithm was applied to mechanical and structural optimization problems with both continuous and discrete variables. This application demonstrated the effectiveness of the algorithm in solving practical engineering challenges with constraints. The outcomes are compared with those obtained by six other well-established techniques. The obtained results indicate that the marathon runner algorithm yields promising and competitive solutions for both mathematical, mechanical, and structural problems.

Author Correction: Wasted efforts of elite Marathon runners under a warming climate primarily due to atmospheric oxygen reduction

Author Correction: Wasted efforts of elite Marathon runners under a warming climate primarily due to atmospheric oxygen reduction

Themes and trends in marathon performance research: a comprehensive bibliometric analysis from 2009 to 2023.

Background: When marathon runners break the 2-h barrier at the finishing line, it attracts global attention. This study is aimed to conduct a bibliometric analysis of publications in the field of marathon running, analyze relevant research contributors, and visualize the historical trends of marathon performance research over the past 15years. Methods: On 8 December 2023, we extracted high-quality publication data from the Web of Science Core Collection spanning from 1 January 2009 to 30 November 2023. We conducted bibliometric analysis and research history visualization using the R language packages biblioshiny, VOSviewer, and CiteSpace. Results: A total of 1,057 studies were published by 3,947 authors from 1,566 institutions across 63 countries/regions. USA has the highest publication and citation volume, while, the University of Zurich being the most prolific research institution. Keywords analysis revealed several hotspots in marathon research over the past 3years: (1) physiology of the elite marathon runners, (2) elite marathon training intensity and pacing strategies, (3) nutritional strategies for elite marathon runners, (4) age and sex differences in marathon performance, (5) recovery of inflammatory response and muscle damage. Conclusion: This study presents the first comprehensive bibliometric analysis of marathon performance research over the past 15years. It unveils the key contributors to marathon performance research, visually represents the historical developments in the field, and highlights the recent topical frontiers. The findings of this study will guide future research by identifying potential hotspots and frontiers.

Toe Box Shape of Running Shoes Affects In-Shoe Foot Displacement and Deformation: A Randomized Crossover Study.

Long-distance running is popular but associated with a high risk of injuries, particularly toe-related injuries. Limited research has focused on preventive measures, prompting exploration into the efficacy of raised toe box running shoes. This study aimed to investigate the effect of running shoes with raised toe boxes on preventing toe injuries caused by distance running. A randomized crossover design involved 25 male marathon runners (height: 1.70 ± 0.02 m, weight: 62.6 + 4.5 kg) wearing both raised toe box (extended by 8 mm along the vertical axis and 3 mm along the sagittal axis) and regular toe box running shoes. Ground reaction force (GRF), in-shoe displacement, and degree of toe deformation (based on the distance change between the toe and the metatarsal head) were collected. Wearing raised toe box shoes resulted in a significant reduction in vertical (p = 0.001) and antero-posterior (p = 0.015) ground reaction forces during the loading phase, with a notable increase in vertical ground reaction force during the toe-off phase (p < 0.001). In-shoe displacement showed significant decreased movement in the forefoot medial (p < 0.001) and rearfoot (medial: p < 0.001, lateral: p < 0.001) and significant increased displacement in the midfoot (medial: p = 0.002, lateral: p < 0.001). Impact severity on the hallux significantly decreased (p < 0.001), while impact on the small toes showed no significant reduction (p = 0.067). Raised toe box running shoes offer an effective means of reducing toe injuries caused by long-distance running.

Quantitative Analysis of 92 12-Week Sub-elite Marathon Training Plans

BackgroundA typical training plan is a mix of many training sessions with different intensities and durations to achieve a specific goal, like running a marathon in a certain time. Scientific publications provide little specific information to aid in writing a comprehensive training plan. This review aims to systematically and quantitatively analyse the last 12 weeks before a marathon as recommended in 92 sub-elite training plans.MethodsWe retrieved 92 marathon training plans and linked their running training sessions to five intensity zones. Subsequently, each training plan was grouped based on the total running volume in peak week into high (> 90 km/week), middle (65–90 km/week), and low (< 65 km/week) training volume plan categories.ResultsIn the final 12 weeks before a race, recommended weekly running volume averaged 108 km, 59 km, and 43 km for high, middle, and low distance marathon training plans. The intensity distribution of these plans followed a pyramidal training structure with 15–67–10–5–3%, 14–63–18–2–3%, and 12–67–17–2–2% in zones 1, 2, 3, 4, and 5, for high, middle, and low volume training plans, respectively.ConclusionsBy quantitatively analysing 92 recommended marathon training plans, we can specify typical recommendations for the last 12 weeks before a marathon race. Whilst this approach has obvious limitations such as no evidence for the effectiveness of the training plans investigated, it is arguably a useful strategy to narrow the gap between science and practice.

Factor and Correlation Analysis for Predicting Marathon Race Performance Using Machine Learning Algorithms

A marathon race is a long-distance running event typically spanning 26.2 miles or 42.195 kilometers. It is a test of endurance, stamina, and mental fortitude, attracting participants from all walks of life, ranging from elite athletes to recreational runners. The origins of the marathon can be traced back to ancient Greece, where legend has it that a messenger named Pheidippides ran from the battlefield of Marathon to Athens to deliver news of victory before collapsing and dying from exhaustion. Machine learning has increasingly become a valuable tool in optimizing training strategies, performance prediction, and injury prevention for marathon runners. By analyzing vast amounts of data collected from wearable devices, training logs, and race results, machine learning algorithms can identify patterns, trends, and correlations that help runners improve their training regimens and race-day strategies. This paper introduces a novel approach, the Factor Analysis Probabilities Prediction Ranking Machine Learning (FA-PP-R-ML) methodology, for predicting marathon race outcomes. With historical race data, factor analysis, and machine learning techniques, the FA-PP-R-ML methodology aims to accurately estimate marathon finish times and rank predicted outcomes based on their probabilities. Through a comprehensive analysis of marathon race data, including training metrics, environmental conditions, and physiological parameters, the FA-PP-R-ML model identifies latent factors influencing race performance. Through factor analysis, latent factors influencing race performance are identified, with values ranging from 0.5 to 0.9. Machine learning algorithms utilize these factors to predict marathon finish times, resulting in accurate predictions with an average error of ±0.1 hours.

Increased risk of acute kidney injury in the first part of an ultra-trail-Implications for abandonment.

Acute kidneys injuries (AKIs) have been described in marathon and trail running. The currently available data allows assessment of before/after comparisons but does not allow an analysis of what happens during the race. A multidisciplinary assessment protocol was performed during the first trail of Clécy (Normandy France) in November 2021. This allowed an initial assay to be carried out, then at the end of each of the 6 loops of 26 km, and finally after 24 h of recovery. The race extends over 156 km in hilly terrain and 6000 m of elevation gain (D+). The level of impairment according to the RIFLE classification was defined for each runner at each assay. Fifty-five runners were at the start, and the per protocol analysis involved 36 runners (27 men and 9 women, 26 finishers). Fifteen (41.7%) of the riders presented at least one result corresponding to a "RIFLE risk" level. After 24 h of rest, only one runner still had a "RIFLE Risk". The distance around the marathon seems to be the moment of greatest risk. For the first time, we find an association between this renal risk and the probability of abandonment. Many runners are vulnerable to kidney damage during long-duration exercise, which is why it's important to limit risk situations, such as the use of potentially toxic drugs or hydration disorders. The consumption of NSAIDs (nonsteroidal anti-inflammatory drugs) before or during an ultra-distance race should therefore be prohibited. Attention should be paid to hydration disorders.

Wasted efforts of elite Marathon runners under a warming climate primarily due to atmospheric oxygen reduction

Meteorological conditions exert influences on sport performances via complex processes. Previous studies conventionally investigate the effects of weather conditions on marathon performance by following events held at the same places, which brings large uncertainties due to the changed participants. Via following each athlete to eliminate these uncertainties, we show that elite athletes’ marathon-running performance tends to monotonically worsen as ambient temperature rises except when it is extremely cold based on the best 16 athletes from each of the sex continents. It worsens by 0.56 (0.39 for men and 0.71 for women) min/°C when it rises beyond 15 °C. Theoretical analysis based on global marathon performance and weather observation datasets shows that more than half of this effect is mediated by reduced oxygen partial density as warmer temperature expands air and increases vapor pressure for both the men and women athletes, which is confirmed by the methods of Baron–Kenny. This atmospheric thermodynamic mechanism has not been emphasized previously. We also show that world-top athletes’ marathon performance approximately linearly worsens as ambient pressure decreases and slightly worsens as relative humidity rises if not extremely wet. These results substantially differ from the previous ones following the events instead of each athlete. Multi-variable changes in climate system are projected to slow Olympic marathon athletes by 2.51 and 1.06 min by the end of the 21st century in relative to 2020 under the high and intermediate emission scenario, respectively. Therefore, future progression of marathon performance is likely to be substantially slowed or even halted by climate changes without efficient greenhouse gas mitigation.

Prediction of half-marathon performance of male recreational marathon runners using nomogram.

Long-distance running is a popular competitive sport. We performed the current research as to develop an easily accessible and applicable model to predict half-marathon performance in male recreational half-marathon runners by nomogram. Male recreational half-marathon runners in Zhejiang Province, China were recruited. A set of literature-based and panel-reviewed questionnaires were used to assess the epidemiological conditions of the recruited runners. Descriptive and binary regression analyses were done for the profiling and identification of predictors related to higher half-marathon performance (completing time ≤ 105min). Participants were assigned to the training set (n = 141) and the testing set (n = 61) randomly. A nomogram was used to visually predict the half-marathon performance, and the receiver operating characteristic (ROC) was used to evaluate the predictive ability of the nomogram. A total of 202 participants (median age: 49 years; higher half-marathon performance: 33.7%) were included. After multivariate analysis, three variables remained as significant predictors: longer monthly running distance [adjusted odds ratio (AOR) = 0.992, 95% confidence interval (CI): 0.988 to 0.996, p < 0.001], faster mean training pace (AOR = 2.151, 95% CI: 1.275 to 3.630, p < 0.001), and better sleep quality [the Pittsburgh Sleep Quality Index (PSQI), AOR = 2.390, 95% CI: 1.164 to 4.907, p = 0.018]. The AUC of the training and testing sets in nomogram were 0.750 and 0.743, respectively. Further ternary and linear regression analyses corroborated the primary findings. This study developed a nomogram with good potential to predict the half-marathon performance of recreational runners. Our results suggest that longer monthly running distance, faster mean training pace and better sleep quality notably contribute to better half-marathon performance.

Comparative electroencephalography analysis: Marathon runners during tapering versus sedentary controls reveals no significant differences.

Previous studies described various adaptive neuroplastic brain changes associated with physical activity (PA). EEG studies focused mostly on effects during or shortly after short bouts of exercise. This is the first study to investigate the capability of EEG to display PA-induced long-lasting plasticity in runners compared to a sedentary control group. Thirty trained runners and 30 age- and sex-matched sedentary controls (SC) were included as a subpopulation of the ReCaP (Running effects on Cognition and Plasticity) study. PA was measured with the International Physical Activity Questionnaire (IPAQ). Resting-state EEG of the runners was recorded in the tapering phase of the training for the Munich marathon 2017. Power spectrum analyses were conducted using standardized low-resolution electromagnetic tomography (sLORETA) and included the following frequency bands: delta: 1.5-6Hz, theta: 6.5-8.0Hz, alpha1: 8.5-10Hz, alpha2: 10.5-12.0Hz, beta1: 12.5-18.0Hz, beta2: 18.5-21.0Hz, beta3: 21.5-30.0Hz, and total power (1.5-30Hz). PA (IPAQ) and BMI differed significantly between the groups. The other included demographic parameters were comparable. Statistical nonparametric mapping showed no significant power differences in EEG between the groups. Heterogeneity in study protocols, especially in time intervals between exercise cessation and EEG recordings and juxtaposition of acute exercise-induced effects on EEG in previous studies, could be possible reasons for the differences in results. Future studies should record EEG at different time points after exercise cessation and in a broader spectrum of exercise intensities and forms to further explore the capability of EEG in displaying long-term exercise-induced plasticity.

Effects of probiotic supplementation on 12 min run performance, mood management, body composition and gut microbiota in amateur marathon runners: A double-blind controlled trial

BackgroundProbiotic supplementation has a positive effect on endurance exercise performance and body composition in athletes, but the underlying mechanisms remain unclear. Gut microbiota can provide measurable markers of immune function in athletes, and microbial composition analysis may be sensitive enough to detect stress and metabolic disorders caused by exercise. MethodsNineteen healthy active amateur marathon runners (15 male and 4 female) with a mean age of 29.11 years volunteered to participate in this double-blind controlled study. Based on the performance of the Cooper 12-min running test (CRT), the participants were allocated into two groups to receive either a probiotic formulation comprising lactobacillus acidophilus and bifidobacterium longum (n = 10) or placebo containing maltodextrin (n = 9) for five weeks. Consistency of diet and exercise was ensured throughout the experimental period. Before and after the intervention, all participants were assessed for CRT, emotional stability and gastrointestinal symptoms, gut microbiota composition, body composition and magnetic resonance imaging (MRI) indicators of skeletal muscle microcirculation. ResultsCompared to before the intervention, the probiotics group showed an increase in CRT score (2.88 ± 0.57 vs 3.01 ± 0.60 km, P＜0.05), significant improvement in GSRS and GIQLI (9.20 ± 4.64 vs 7.40 ± 3.24, 118.90 ± 12.30 vs 127.50 ± 9.85, P＜0.05), while these indicators remained unchanged in the control group, with a significant time-group interaction effect on gastrointestinal symptoms. Additionally, some MRI metabolic cycling indicators of the thigh skeletal muscle also changed in the probiotics group (P＜0.05). Regarding microbiota abundance, the probiotics group exhibited a significant increase in the abundance of beneficial bacteria and a significant decrease in the abundance of harmful bacteria post-intervention (P＜0.05). ConclusionAs a sports nutritional supplement, probiotics have the potential to improve athletic performance by optimizing the balance of gut microbiota, alleviating gastrointestinal symptoms.

Exploring the attitudes and behavioral intentions of marathon racers: a cross-national inquiry

ABSTRACT In light of the anticipated expansion of marathon events on a global stage, this study collected survey data from marathon participants who traveled to two prominent events in Chicago, USA, and Xiamen, China. On average, Chinese marathon travelers had higher scores than their American counterparts in all major constructs, including embodied experiences, destination personality, perceived event image, and behavioral intentions. This study adopted the Stimulus-Organism-Response framework to propose a conceptual model that illustrates how embodied experience affects destination personality, event image, and intentions to participate in a sports event. Both an exploratory factor analysis (EFA) and the PLS-SEM technique were then used to analyze the data. The empirical findings demonstrated a positive impact of embodied experience (a stimulus) on destination personality and event image (organisms). Furthermore, both destination personality and event image positively impacted the behavioral intentions of marathon racers (a response). Both theoretical implications and managerial implications are discussed.

Klebsiella Meningitis Leading to Early Death in an Immunocompetent Marathon Runner (P8-13.010)

Klebsiella Meningitis Leading to Early Death in an Immunocompetent Marathon Runner (P8-13.010)

Analysis of over 1 million race records shows runners from East African countries as the fastest in 50-km ultra-marathons

The 50-km ultra-marathon is a popular race distance, slightly longer than the classic marathon distance. However, little is known about the country of affiliation and age of the fastest 50-km ultra-marathon runners and where the fastest races are typically held. Therefore, this study aimed to investigate a large dataset of race records for the 50-km distance race to identify the country of affiliation and the age of the fastest runners as well as the locations of the fastest races. A total of 1,398,845 50-km race records (men, n = 1,026,546; women, n = 372,299) were analyzed using both descriptive statistics and advanced regression techniques. This study revealed significant trends in the performance of 50-km ultra-marathoners. The fastest 50-km runners came from African countries, while the fastest races were found to occur in Europe and the Middle East. Runners from Ethiopia, Lesotho, Malawi, and Kenya were the fastest in this race distance. The fastest 50-km racecourses, providing ideal conditions for faster race times, are in Europe (Luxembourg, Belarus, and Lithuania) and the Middle East (Qatar and Jordan). Surprisingly, the fastest ultra-marathoners in the 50-km distance were found to fall into the age group of 20–24 years, challenging the conventional belief that peak ultra-marathon performance comes in older age groups. These findings contribute to a better understanding of the performance models in 50-km ultra-marathons and can serve as valuable insights for runners, coaches, and race organizers in optimizing training strategies and racecourse selection.

Dynamic and stationary monitoring of air pollutant exposures and dose during marathons

Marathon running significantly increases breathing volumes and, consequently, air pollution inhalation doses. This is of special concern for elite athletes who ventilate at very high rates. However, race organizers and sport governing bodies have little guidance to support events scheduling to protect runners. A key limitation is the lack of hyper-local, high temporal resolution air quality data representative of exposure along the racecourse. This work aimed to understand the air pollution exposures and dose inhaled by athletes, by means of a dynamic monitoring methodology designed for road races. Air quality monitors were deployed during three marathons, monitoring nitrogen dioxide (NO2), ozone (O3), particulate matter (PMx), air temperature, and relative humidity. One fixed monitor was installed at the Start/Finish line and one mobile monitor followed the women elite runner pack. The data from the fixed monitors, deployed prior the race, described daily air pollution trends. Mobile monitors in combination with heatmap analysis facilitated the hyper-local characterization of athletes' exposures and helped identify local hotspots (e.g., areas prone to PM resuspension) which should be preferably bypassed. The estimation of inhaled doses disaggregated by gender and ventilation showed that doses inhaled by last finishers may be equal or higher than those inhaled by first finishers for O3 and PMx, due to longer exposures as well as the increase of these pollutants over time (e.g., 58.2 ± 9.6 and 72.1 ± 23.7 μg of PM2.5 for first and last man during Rome marathon). Similarly, men received significantly higher doses than women due to their higher ventilation rate, with differences of 31–114 μg for NO2, 79–232 μg for O3, and 6–41 μg for PMx. Finally, the aggregated data obtained during the 4 week- period prior the marathon can support better race scheduling by the organizers and provide actionable information to mitigate air pollution impacts on athletes' health and performance.

Exercise-induced Hypertension and Carotid Intima-media Thickness in Male Marathon Runners.

This study aimed to identify the relationship between exercise-induced hypertension and carotid artery intima-media thickness in long-distance runners. Sixty healthy male runners aged 40 to 60 years were assigned to the following three groups based on resting blood pressure and maximal systolic blood pressure during a maximal exercise test: normal blood pressure response, exercise-induced hypertension, and complex hypertension. An exaggerated systolic blood pressure response was defined as a maximal systolic blood pressure+≥+210 mmHg during the maximal exercise test, while carotid intima-media thickness was measured using B-mode ultrasonography. The carotid intima-media thickness mean values were the highest in the complex hypertension group (0.72±0.11 mm), followed by exercise-induced hypertension (0.62±0.12 mm) and normal blood pressure groups (0.55±0.13 mm), with a significant difference between the groups (p+<+0.002). In linear regression analysis, the mean intima-media thickness was independently associated with age (p=0.015) and maximal systolic blood pressure (p=0.046) but not with resting systolic blood pressure. These results suggest that exercise-induced hypertension is associated with carotid intima-media thickness, a surrogate marker of cardiovascular disease, in long-distance runners. Therefore, evaluating the blood pressure response during exercise is important for the early detection of potential cardiovascular disease risks in long-distance runners.