Photo/Illutration The Kobe Marathon starts on Nov. 17 in Chuo Ward. (Yoshinori Mizuno)

Researchers studying the risk of cardiac arrest during marathons are warning men aged 60 and over to check their health conditions before entering the long-distance races.

The team of scientists from Keio University and other institutes analyzed 516 marathons officially recognized by the Japan Association of Athletics Federations (JAAF) that were held between fiscal 2011 and 2018.

They found 69 runners suffered cardiac arrest. Men accounted for 66 of them, and the rate of incidence increased with age.

“We particularly recommend that men over 60 undergo checkups for potential cardiac problems before participating in races,” said Tomohiro Manabe, an associate professor of cardiovascular internal medicine at Keio University’s Sports Medicine Research Center.

Manabe and his colleagues sent a query list to organizers of the 42.195-kilometer races.

About 4.1 million people entered the 516 marathons studied, and males accounted for 79 percent of the competitors.

The median age of the 69 runners stricken by cardiac arrest during the races was 53. One person died.

Overall, the incidence of cardiac arrest was 1.7 per 100,000 participants.

Among those in their 40s and younger, the risk was 0.9 per 100,000 people, while it was 2.6 per 100,000 among runners in their 50s.

The frequency jumped further to 5.5 per 100,000 among those 60 or older, six times the rate among runners under 50.

Among men, the cardiac arrest incidence was 2.1 per 100,000 people, compared with 0.3 for women.

The three women who suffered cardiac arrest in the races were each younger than 50. No significant correlation was observed between incidence and age in women.

In light of the research results, the JAAF is planning to urge caution, especially among men 60 and older, by distributing a health checklist immediately before they enter marathons.

The research team’s survey also asked organizers whether cardiac massages and automated external defibrillators (AED) were used to deal with cardiac arrest during the races.

Other topics included what types of first-aid systems were available at race sites.

Manabe is also a member of the JAAF’s committee to discuss medical issues.

“The survey does not imply that elderly men should completely stop participating in marathons, given that the overall likelihood of cardiac arrest during such events is quite low,” Manabe said.

“It should be noted that the risk for individuals from this age group can more easily be assessed via prior health checkups than their younger counterparts because cardiac arrest is often linked to angina pectoris and other coronary artery disorders associated with arteriosclerosis.”

The scientists said they will investigate how weather conditions during marathons can affect the risk of cardiac arrest, as well as study the effectiveness of first-aid systems available in races.

The team’s ultimate goal is to eliminate sudden cardiac deaths at marathons.

The findings have been published in the specialized European journal Resuscitation at (https://www.resuscitationjournal.com/article/S0300-9572(24)00309-5/fulltext).

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