Pressler A, Suchy C, Friedrichs T, Dallinger S, Grabs V, Haller
B, Halle M, Scherr J

Eur J Prev Cardiol. 2017 Aug;24(12):1328-1335.

Background In contrast to the well-accepted benefits of moderate exercise, recent
research has suggested potential deleterious effects of repeated marathon running
on the cardiovascular system. We thus performed a comprehensive analysis of
markers of subclinical vascular damage in a cohort of runners having finished
multiple marathon races successfully.

Design This was a prospective,
observational study. Methods A total of 97 healthy male Munich marathon
participants (mean age 44 ± 10 years) underwent detailed training history,
cardiopulmonary exercise testing for assessment of peak oxygen uptake, ultrasound
for assessment of intima-media-thickness as well as non-invasive assessments of
ankle-brachial index, augmentation index, pulse wave velocity and reactive
hyperaemia index.

Results Runners had previously completed a median of eight
(range 1-500) half marathons, six (1-100) full marathons and three (1-40)
ultramarathons; mean weekly and annual training volumes were 59 ± 23 and
1639 ± 979 km. Mean peak oxygen uptake was 50 ± 8 ml/min/kg, and the Munich
marathon was finished in 3:45 ± 0:32 h. Runners showed normal mean values for
intima-media-thickness (0.60 ± 0.14 mm), ankle-brachial index (1.2 ± 0.1),
augmentation index (17 ± 13%), pulse wave velocity (8.7 ± 1.4 cm/s) and reactive
hyperaemia index (1.96 ± 0.50). Age was significantly and independently
associated with intima-media-thickness ( r = 0.531; p < 0.001), augmentation
index ( r = 0.593; p < 0.001) and pulse wave velocity ( r = 0.357; p < 0.001).
However, no independent associations of peak oxygen uptake, marathon finishing
time, number of completed races or weekly and annual training km with any of the
vascular parameters were observed.

Conclusions In this cohort of healthy male
runners, running multiple marathon races did not pose an additional risk factor
for premature subclinical vascular impairment beyond age.