Marathons and the female heart

Is marathon running good or bad for your heart? That question has become a hot topic over the past few years thanks to a few studies showing negative effects like heart scarring and artery hardening in veteran marathon runners. One of those studies was a conference presentation last year that looked at 25 male runners who had each completed the Twin Cities marathon 25 years in a row. Compared to matched controls, the runners had greater plaque volume in their coronary arteries.

Now the same group of researchers has followed up with a similar study of 25 female runners who have run a marathon each year for the past 10 years. In this case, the result (as presented at the American Health Association conference) is exactly the opposite: the runners have fewer coronary plaques than matched controls.

So what to make of this? Neither study has been published in a journal yet, so it’s difficult to analyze the results in detail. It’s possible that the conflicting results are simply a result of the fact that the male marathoners were older, on average, that the female marathoners. Or it may be a physiological gender difference. Or it may have something to do with training history. Or it may be a complete fluke: in the male group, the key difference in the plaque volume was 274±176 vs. 169±170. Those are rather large ranges of uncertainty.

But the real question is none of the above: it’s whether these findings about elevated risk factors translate into compromised health. So far, I’m not aware of any study that links marathon running, or any form of endurance exercise, to elevated risk of death (or any other serious ailment) from any cause. That doesn’t mean such risks don’t exist (they could easily be hidden by the overall positive effect of exercise’s other health benefits). Still, as I wrote in the Globe and Mail a few months ago (and probably reflecting my “wishful thinking” bias), I can’t bring myself to get too worried about these apparent risks in the absence of any direct evidence. As Amby Burfoot wrote, “show me the bodies in the streets.”