Over 35? Weigh the benefits…
Here’s another paradox: older people with risk factors for coronary artery disease (see 'Do you run the risk?' on the next page) are the most likely to die in a marathon. Yet running is actually one of the best ways for them to get those factors in check and avoid degenerate heart disease. In a study published by the journal Hypertension, exercise helped reduce risks of high blood pressure by 25 per cent even in people with a family history of the condition. The ‘magic’ amount of exercise? Two and a half hours a week, exactly the amount currently recommended by the UK Government.
It’s not just your heart that will thank you. “Almost every bodily system reaps the rewards – exercise reduces rate of cancer, Alzheimer’s, diabetes and many other diseases and conditions,” says Stuart. “The benefits hugely outweigh the risks.” In the 27-year Copenhagen City Heart Study, researchers analysed data from 20,000 men and women aged between 20 and 93. They found joggers lived significantly longer than their couch potato friends: an extra 6.2 years for a man, and 5.6 for a woman.
On first examination, it seems that the more you run, the higher the rewards. According to another study published in the New England Journal of Medicine, people who suffer heart attacks on the run tend to be those who are otherwise sedentary. The relative risks of heart trouble reduced steadily with the number of days a week participants worked out, up to five or more sessions a week. Another study, published in the Archives of Internal Medicine, looked at 8,283 male runners who ran a weekly mileage of up to 79K. Compared with the men who clocked less than 16K, the longer-distance runners were 50 per cent less likely to need medication for high cholesterol and blood pressure, significantly further lowering their 10-year risk of coronary heart disease.
Too much of a good thing?
Earlier this year, however, Mayo Clinic research suggested extremely high levels of training could actually damage the hearts of endurance athletes. So, is there a tipping point beyond which you’re simply doing more exercise than is healthy? “That’s a much debated point,” says Stuart. “The answer is probably yes, but again this depends on your genetic make-up. After a very long endurance race such as a marathon or an Ironman, most athletes show enlargement on the right side of the heart, but the majority are back to normal within the week. In some athletes, though, the pattern remains and this may indicate a higher likelihood of scarring in the heart.”
A study published in the Journal of Applied Physiology found evidence of this scarring in the hearts of life-long veteran marathoners, with the worst affected those who had trained longest and completed the most races. But with a sample size of only 49 athletes – many drawn from the 100 Marathon Club – it’s by no means clear that the findings can be extrapolated to the wider population.
The truth is that that most of us will be able to tackle even multiple endurance events without any long-term damage to the heart. But as ever, take caution and bear in mind that it only takes 30-60 minutes’ running a day to reap the biggest bulk of the health benefits you’ll get from the sport. Stuart says wannabe ultra-runners should heed the same advice given to those targeting a 5K: “Build up gradually, train properly, listen to your body and if you’re in any doubt, get checked.”
Among older runners, the ESC recommends that this check takes the form of an exercise stress test – running on the treadmill with an ECG attached. (The ECG alone can’t pick up degenerative problems such as coronary artery disease.) Your doctor may also refer you for a more detailed test called an echocardiogram, which is an ultrasound of the heart. As with the ECG, you’re unlikely to get screened on the NHS unless in an at-risk group. A private clinic would be your only option; Cardiac Screen Ltd charges £330.Ultimately, though, you are likely to be simply buying peace of mind: if you’ve never had any symptoms, family history or acquired risk factors such as being a heavy smoker, your risk of SCD from any cause is infinitesimally small.
But don’t take our word for it. “The danger is that high profile deaths put people off running, and all that comes with it – sleeping enough, healthy eating, not drinking too much," says Sharma. "A handful of people may die during exercise but far more would die if we stopped exercising altogether. Running doesn’t cost money, it has no side-effects, and it is more effective for your general health than any pill a doctor could prescribe.”
On the next page: Take our test to find out if you fall into an at-risk group.