The USA Track and Field Road Running Information Center estimates four to six people will die running a marathon each year. And with the number of people running marathons increasing, that number is on the rise. Heart disease, genetic heart defects, hyponatremia (low blood sodium levels) and heat stroke are all real risks. Yet we shouldn't let that stop us from doing something we love as long as we are smart about it.
"According to the American College of Cardiology, the chances of an endurance athlete suffering an acute heart attack or sudden cardiac death during or shortly after an event are about one in 50,000. Other studies put the risk at about one in 75,000.
"Every death is a horrible tragedy. But I don't think it's time to say stop running marathons," says Dr. John Dieck, a cardiologist with Texas Cardiovascular in Austin. "The focus on fitness for the nation from a public health perspective is a great thing. By the same token, running 26 miles puts a very extraordinary stress on the human body, and you've got to be careful."
That means proper training, adequate hydration (without overhydrating) and an honest assessment of your personal health. "If there is any family history at all of coronary heart disease or congenital heart disease or sudden death or passing out for unexplained reasons, you really should talk to a doctor before running a marathon," Dieck says.
People with high blood pressure or diabetes, and older runners, should take special care.
"Unfortunately, you're never going to pick up everybody through screening," Dieck says.
Patients frequently ask Dieck if it's safe to run long distances. He suggests they buy a blood pressure cuff, go for a short 1- or 2-mile run, check their heart rate and blood pressure and report those numbers to a physician. "Tell your physician all your history, and then the two of you can come up with a judgment," he says."