Q The death of a runner at this year’s Bupa Great North Run means that 13 out of 700,000 runners have died in its 26-year history. During the same period 650,000 have run the Flora London Marathon and there have been eight deaths. Is this because people are less likely to prepare assiduously for the shorter distance of the GNR?
A Possibly. There’s anecdotal evidence that more people start walking in the first mile or two of a half-marathon than a full one, maybe because it is easier to be blasé about a shorter distance, and feel that you don’t actually have to train to run it.
However, moving away from an anecdotal view, there are a number of key points to be made here. The first is that if you take 30,000 people and observe them over three hours – exercising or not – some will experience heart problems simply due to the law of averages.
The next is that elevated levels of fitness do not by themselves exclude you from heart disease. Regular running reduces the overall risk of sudden death in people with latent heart disease, but it can increase the risk of sudden death during exercise for those with undiagnosed heart disease that predisposes to sudden death. Because sudden death in public races makes for high-profile media coverage, the public can gain a distorted impressi on of the relationship between exercise and sudden death.
In a study of the London Marathon over 23 years there were seven cardiac deaths and five other runners who suffered heart attacks but survived – all five were subsequently found to have previously unknown heart disease. Overall, the study found that the risk of death in the London Marathon was one in 67,414 – a risk comparable to many daily activities. This finding is also borne out by an analysis of the annual Marine Corps and Twin Cities marathons in the USA.
As a group, runners have a lower risk of cardiac death than the general population, so I continue to promote running as a form of exercise to patients. However, if you are over 45, or have risk factors such as smoking, high blood pressure, high cholesterol levels, obesity, diabetes or a family history of heart disease – and suddenly think that running 13 miles with little training is a good idea – make sure you have a medical MOT first.
— Dr Roger Henderson, general practitioner and marathon runner
