The Runner's Heart


Common cardiovascular wisdom sees aerobic activities like running as healthy habits that can do only good for the heart. But a study released this summer by a German clinic has spurned controversy around marathon runners and the phenomenon of artery-clogging plaques that can cause a heart attack.

The study, administered at the West-German Heart Center Essen, focused on male marathoners age 50 and up. Among its findings, while the runners had lower than average cholesterol levels and better blood pressure, they had more measurable coronary calcium buildup or plaque than the general population.

The running world has no shortage of high-profile heart attack cases. Famous runners including the health-book author Jim Fixx, who died while running in 1984, to Brian Leigh Maxwell, founder of Powerbar, and Greg Marr, an editor at Silent Sports magazine, all were struck down by heart attacks, despite ostensibly being in perfect health.

Twin Cities Marathon 2008 Regenold.jpg

Author Stephen Regenold (in blue) at mile 25 at this year’s Twin Cities Marathon

The question begged by the German study’s findings — and now perpetuated by a study at the Minneapolis Heart Institute this autumn — is one that bucks conventional thought: Can athletic activities like long-term marathon training actually contribute to poor heart health?

“Running is a proven healthy activity, but we’re looking to find if there can be too much of a good thing,” said Dr. Robert Schwartz, the Minneapolis Heart Institute cardiologist heading up the study, which will look at about 50 men who have run marathons for more than 25 years straight.

Cardiac Case Study
John Tantzen, a manager at a technology company from Eagan, Minn., runs up to 60 miles a week. A family history of heart disease pushed Tantzen, 48, into athletics years ago, and since the 1980s he has competed in dozens of races, including running the annual Twin Cities Marathon for the past 27 years straight.

Tantzen is thin and fit, and he has trouble keeping weight on no matter what he eats. But a scan this fall with Schwartz revealed high levels of coronary plaque. “It was a surprise to say the least,” Tantzen said.

Doctors immediately put Tantzen on medication. He changed his diet, all but eliminating fried food and pastries, which he ate for years without a second thought.

Heart Image.jpg

Heart scan image with plaque buildup visible in artery

Tantzen said he has never had high blood pressure. His cholesterol checks always came back normal. But before the scan, he was unaware of the potential for coronary plaque buildup.

“People think they are protected from heart troubles if they are in good shape,” said Schwartz. “But diet and other factors can still affect coronary health in the fittest of athletes.”

A Second Look
Beyond examining whether elite athletes are immune to cardiovascular maladies, Schwartz’s study — called the Ken Rome Fund Marathon Study — aims to assess potential links between extreme athleticism and coronary plaque buildup, which is a top cause of heart attacks.

Schwartz said stress from years of running — including states of dehydration, exercise-induced high blood pressure, prolonged high pulse rates in events like marathons, and the movement and twisting of arteries while on the run — has unknown long-term effects.

Suggesting running as a potential health hazard sparked controversy with the German study, including editorials in publications like Runner’s World that questioned the test’s conclusions. Schwartz hopes to provide an objective second look using a more powerful heart scanner.

Marathon-Start -wt.jpg

Runners in Grandma’s Marathon near Duluth, Minn.

With a CT scanner at the Minneapolis Heart Institute, Schwartz said his study will include a higher-detail image of each subjects’ heart data plus a subject field that’s more homogenous and more elite than in the German study.

With money from the Ken Rome Fund, which is named for a Minnesota runner who died of a heart attack last March, and other sources, the Minneapolis Heart Institute has about $100,000 to commit to the study. The entire project will take 20 months.

Schwartz and his team have scanned about 25 runners already, with 25 to go in the initial batch. Results are inconclusive thus far, he said, with subjects like Tantzen showing high plaque levels and other runners exhibiting perfect heart health.

Schwartz hopes to publish findings in a medical journal this winter before moving on to a larger study on the subject, including the analysis of women marathoners as well as runners who are less elite.

“We know that athletics has huge benefits for the heart,” said Schwartz, himself a runner. “But what we don’t know is how much exercise is too much exercise, or even if there is such a thing.”

(Stephen Regenold writes The Gear Junkie column for eleven U.S. newspapers; see for video gear reviews, a daily blog, and an archive of Regenold’s work.)

Posted by Steve - 11/20/2008 01:40 PM

It’s probably true that athletes/runners who overexert themselves regularly are at a much higher risk than they would ever think. That excessive participation in long-term endurance sports at higher BPs and pulse rates in conjunction with dehydration can cause cardiac arrests over time is only news to athletes. The number one cause of in-the-line-of-duty fatalities every year (excepting 2001) for firefighters is exertion/stress induced cardiac arrests. Not smoke inhalation, not fire, but exertion/stress due to repeated high level of exertion. And with high levels of athletic exertion you’re going to have electrolyte imbalances no matter what you do, and if excessive, those will lead to cardiac dysrhythmias.

Posted by Pat - 11/24/2008 08:12 AM

The older I get, the more I believe “moderation in all things” is the best advice. I wonder about marathoning, and the intense levels of training required in order to be successful

Posted by Elite Health - 06/17/2009 08:54 PM

This is a very astonishing break-through in the field of heart operations. The heart valve procedure is negligibly invasive as compared to the traditional approach of heart valve operation that requires quite an invasion over the chest, and really a very long recovery. This research will bring great revolution in the field of heart operations. Undergoing a heart valve replacement can never be such an easy task. Using the traditional approach, one has a high risk on survival, a very long recovery process, and a long period of medical supervision. All this adds to troubles for a person facing such an operation. But the newer technology will completely invade the traditional approach. I had an experience with the traditional heart valve replacement in my early stage of life. They were quite a miserable days of my life when I was made to aware that I am having such a problem, and would require the heart valve replacement operation. The worst part of such operation is its recovery. One needs to be under constant medical supervision over a long period of time to allow the heart to adjust with the newer valve. But, in recent times, because of the advancements in the medical research and medical services, the life has become quite easier to live. Many medical service providers like Elite Health helps you to be comfortable with all the medication and facilities, which helps you to recuperate your health by providing full time access to the doctors who are ready to solve your health problems at any time. Such care helps you to thwart any possibility of getting serious medical problems. You can find some really informative information from their websites that helps you to understand your problem better. Websites like and provides very crucial information that can help you reclaim your health at a faster pace.

Posted by Yura - 08/27/2010 06:43 AM

I’ve been told by a cardiologist that anything more, than 10km or 40-60 minutes is harmful for the heart, since it increase its heart, thus making the heart less efficient, so it may not necessarily just the build-up, but the heart mechanics.

Add Comment

  1. Add link by using "LinkText":