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Running Over the Idea that Running Causes Heart Attacks

Over the past decade, a debate about the healthiness of endurance running has simmered.

Some research has connected strenuous endurance activities among amateur athletes with increased prognostic factors that would suggest cardiac risk.1 Think marathons and triathlons. Many find these warnings interesting and counterintuitive, considering traditional research associates regular physical activity with an improved cardiovascular risk profile.2

The science on this subject is evolving. Two recent entries fall on the side of encouraging endurance running. Last year, the journal of the British Cardiovascular Society, Open Heart, published an international study that did ten years of follow-up with amateur half-marathon runners. Researchers measured various prognostic indicators of cardiovascular risk. They concluded that the moderate-to-vigorous activity of these runners was “quite beneficial.”3

Frontiers in Cardiovascular Medicine published a separate study out of Belgium and France earlier this year.4 This study focused on mountain ultra-marathon runners. These are footraces over mountainous terrain that range from 42.2 km to 5,000 km. Competitors may run over multiple days or run for 24 hours straight through, depending on the event.  It is known that certain biomarkers that would normally be associated with cardiovascular risk temporarily appear during vigorous exercise but dissipate quickly with rest. Researchers found that the prognostic factors endure longer with ultramarathoners, perhaps a week or more. Their study suggests that no permanent structural damage to the myocardium is occurring. They did not measure long-term effects of this activity.

Obviously, with exercise, there are right and wrong ways to do it. Taking on too much too fast is always a risk factor, and “too much” will vary dramatically between individuals. In general, exercise is good for the heart, even vigorous endurance exercise. What’s more, running does not cause damage to the knees (as is often guessed). Research shows that running protects the knees. If you would like to have a professional help you develop a safe and effective exercise plan for your condition or athletic goals, please feel free to make an appointment. We can help.    



  1. Dalla Vecchia LA, Barbic F, De Maria B, et al. Can strenuous exercise harm the heart? Insights from a study of cardiovascular neural regulation in amateur triathletes. PLoS One 2019;14:e0216567.
  2. Tesema G, George M, Hadgu A, et al. Does chronic high-intensity endurance training have an effect on cardiovascular markers of active populations and athletes? systematic review and metaanalysis. BMJ Open 2019;9:e032832–2019.
  3. De Maria B, de Oliveira Gois M, Catai AM, Marra C, Lucini D, Porta A, Pagani M, Dalla Vecchia LA. Ten-year follow-up of cardiac function and neural regulation in a group of amateur half-marathon runners. Open Heart. 2021 Feb 1;8(1):e001561.
  4. Le Goff C, Gergelé L, Seidel L, Cavalier E, Kaux JF. Mountain Ultra-Marathon (UTMB) Impact on Usual and Emerging Cardiac Biomarkers. Frontiers in Cardiovascular Medicine. 2022 Mar 24;9:856223.

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