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Heart Smart Living
Heart Smart Living

Cardiologist, author, and heart health expert Dr. Sarah Samaan offers advice on how to live a heart smart life.

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Can Marathon Running Damage the Heart?

Ted*, a fit 55-year-old runner with 10 marathons under his belt, recently visited me in the office at his family doctor’s suggestion. A lean and healthy guy with no symptoms and no major risk factors for heart disease save his age and gender, Ted wanted to be sure that he was doing everything possible to ensure a long and healthy life. He had recently signed up for a coronary calcium score, a test that can discover heart disease in its earliest stages, and was shocked to find that his score was 200. Atherosclerosis, or cholesterol plaque, naturally calcifies over time, allowing a quick and noninvasive way to assess cholesterol buildup. A score of zero implies a very low likelihood of cholesterol buildup in the heart arteries, and was clearly what Ted had expected. Instead, his score indicated that Ted’s arteries had accumulated substantially more plaque than would be expected for the average man in his age group.

Ted’s story is one that I encounter several times a year. Until recently, I had no way to explain such a paradoxical situation. However, there is now a substantial amount of medical research linking marathon running to early calcification of the coronary arteries. In 2008, a German study of 108 experienced male marathoners over age 50 found that on average the runners had more coronary calcification than their non-athletic counterparts who otherwise shared the same risk factors for heart disease. Not surprisingly, those with coronary calcification were more likely to go on to suffer heart attacks than those without evidence of cholesterol plaque.

Other studies have found evidence of heart muscle stress and fatigue after extreme exertion. On the other hand, a recent report from the Oschner Health System in New Orleans, presented at the American College of Sports Medicine 2012 Annual Meeting, reported that runners who ran between 10 and 15 miles each week, at a pace of six to seven miles per hour, had a nearly 20 percent reduction in mortality from any cause compared to non-runners. Running longer or faster seemed to diminish the overall benefits.

Years ago, only truly elite athletes competed in marathons, but current estimates suggest that half a million Americans have participated in at least one marathon in the past year. In my community, there is sometimes a sense of peer pressure and competitiveness amongst runners that might lead some to feel obliged to choose this path. While it would probably be taking things too far to say categorically that extreme running is unhealthy, those of us who enjoy a moderately paced 3 to 5 mile run a few evenings a week may be choosing the smarter -- and safer -- road.

* name and identifying characteristics have been changed to preserve confidentiality

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Tags: Exercise

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About the Author


Dr. Samaan is an acclaimed cardiologist, writer, and heart health educator.