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Jan 24, 2012

Cardiac Arrest During Marathons—What are the Chances?

What every runner should know about cardiac arrest.

Marathons have become increasingly popular over the years, attracting individuals striving to achieve better health or runners who simply enjoy the sport. And while regular physical activity is recommended for a healthy heart, the long distances that marathons demand—13.1 miles for half-marathons, 26.2 miles for marathons—raise concerns for some health experts. Not only can participating in these runs take a toll on the body over time, runners may be at increased risk for cardiac arrest during the event itself.

A recent study published by the New England Journal of Medicine reports that although risk of heart attack during a marathon or half-marathon is low, the number of cardiac events has risen over the years. From 2000 to 2010, nearly 11 million runners have participated in U.S. marathons and half-marathons. In total, researchers found that there were 59 cases of cardiac arrest—42 of them proving fatal—during or soon after completing their run.

Given these statistics, the good news is that risk of developing cardiac arrest during or after a marathon or half-marathon is similar to or even lower than risk associated with other vigorous activities. Most concerning, however, is the significant rise in cardiac arrests from the first five years of the study to the last five years—particularly in men. Not only did the rate of cardiac arrest among males nearly triple over this period, but men were more than five times more likely to have cardiac arrest than women.

Experts attribute many of these trends to the overall increase in marathon participants in the last ten years, since more runners means more cases of cardiac arrest. However, they also believe that the rise in “new” marathoners who may be older in age and are trying to improve their health may also play an important role. These runners may not be as fit as typical marathon athletes and could contribute to the increased risk statistics.

One of the most important take-home messages is that most of those surviving cardiac arrest in this study received immediate CPR and/or defibrillation—practices that can help restore normal heart rhythm after a cardiac event. And because CPR and defibrillation are so crucial to survival and can be performed by any onlooker, many marathons are now training their participants in these areas to better equip them in case of emergency.

Questions for You to Consider

  • Isn't running one of the best ways to stay healthy?

  • Although running is a great form of exercise, especially when practiced regularly, runners can have many of the same risk factors as their non-running counterparts. That’s why it’s important to see your doctor regularly and discuss which types of physical activity are the safest and most effective for you.
  • What is the risk of developing cardiac arrest during or after a marathon?

  • Based on recent research, risk of cardiac arrest among marathon runners is about 1 in 184,000, with risk of sudden death being much lower (1 in 259,000). In contrast, risk of death among relatively healthy middle-aged joggers is significantly higher (about 1 in 7,620).

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Resources to Help You Compare Treatment Options

Guidance from the Agency for Healthcare Research and Quality (AHRQ) in making health decisions