Men Over 40 Should Think Twice Before Running Triathlons (Bloomberg)

[Milkworx]

Men Over 40 Should Think Twice Before Running Triathlons: Health 2013-06-20 22:00:00.3 GMT

 

 

By Natasha Khan and Shannon Pettypiece

June 21 (Bloomberg) -- For men competing in triathlons past the age of 40, the grueling slog to the finish line could be their last.

As the average age of competitors in endurance sports rises, a spate of deaths during races or intense workouts highlights the risks of excessive strain on the heart through vigorous exercise in middle age. Among the recent casualties:

Michael McClintock, senior managing director of Macquarie Group Ltd. and a triathlete, who died at age 55 of cardiac arrest earlier this month after training.

The 40-to-60-year age bracket, often referred to as middle aged men in Lycra, or Mamils, now holds 32 percent of the membership in USA Triathlon, the official governing body of triathlon racers in the U.S. More fitness conscious than previous generations, their numbers in competitive races are swelling, along with their risk of cardiac arrest. Triathlons, the most robust of endurance races requiring swimming, biking and running, are also believed to be the most risky.

“People need to understand that they’re not necessarily gaining more health by doing more exercise,” said David Prior, a cardiologist and associate professor of medicine at the University of Melbourne. “The attributes to push through the barriers and push through the pain are common in competitive sport, but that’s also dangerous when it comes to ignoring warning signs.”

While benefits of exercise are well-known, researchers now suspect that there may be a point at which exertion becomes dangerous, especially for middle aged men who, because of gender and changes that accompany aging, are more susceptible to cardiac arrest caused by vigorous exercise.

 

Cardiac Arrest

 

Cardiac arrest, which occurs when the heart suddenly stops beating, can be caused by almost any heart condition, including abnormal heart rhythm, thickening heart muscle and arteries -- changes that can occur silently as healthy people age. The risk of sudden cardiac arrest, which can be brought on with physical stress, increases with age, and men are two to three times more likely to suffer from it than women, according to the National Institutes of Health.

McClintock, the Macquarie Bank executive who died on June 2 at his home in Larchmont, New York, was an avid skier, biker and golfer. The previous September, he completed the Jarden Westchester Triathlon, his first Olympic-length event, taking less than 4 hours to swim 0.9-miles (1.4 kilometers), cycle 25 miles and run 6.2 miles.

While McClintock’s death can’t be directly linked to the race, USA Triathlon has noted an increase in race-related fatalities, with the highest number occurring in the 40-to-49- year age group.

 

Triathlon Risk

 

The death rate for triathlons is about twice that of marathons because of increased intensity of the competition and the initial swimming leg of the events, according to a 2012 study published last year in the journal Mayo Clinic Proceedings.

“The swim seems to be a particularly dangerous time,”

said Andre La Gerche, a cardiologist at Melbourne’s St Vincent’s Hospital and marathoner. “Paradoxically, in the marathon, it’s the opposite: it’s the last mile of the event where the vast majority of fatalities occur.” Researchers speculate that sprinting to the finish produces a rush of adrenalin that may trigger an abnormal rhythm in runners with susceptible hearts.

Runners should maintain their pace or slowdown in the last mile and not sprint unless they have trained for it, the International Marathon Medical Director’s Association, a doctor’s group, said in 2010 in a list of recommendations in response to race-related sudden deaths.

 

Safe Running

 

Running appears to lower the risk for mortality when an athlete doesn’t exceed more than 20 miles a week, log more than five to seven miles per hour, or run more than two to five times a week, researchers at the Ochsner Health System of New Orleans and the University of South Carolina found in a study last year.

More than 2 million people participate in long-distance running races in the U.S. each year -- a number that has doubled since 2000. Even though the risk of death from marathon-running is small, increased participation has resulted in a higher incidence of sudden death at the events, according to a study published in the New England Journal of Medicine in January 2012. Out of 11 million long-distance runners, 59 people suffered cardiac arrest, 51 of them men.

Causes of cardiac events in athletes vary depending on age.

For those under 35, cardiovascular conditions are usually inherited. Heart incidents in older athletes can be due to coronary artery disease that they don’t know they have, Melbourne cardiologist Prior said.

 

Vessel Disease

 

By middle age, most people have developed some underlying early stage vessel disease, such as hardening or plaque buildup in their coronary arteries, said Kade Davison, who teaches clinical exercise science at the University of South Australia in Adelaide.

“If anyone is going to have a cardiac event they’re far more likely to have one during exercise,” said Davison. A person is seven times more likely to have a heart incident while exercising than at rest, he said, citing a 1984 New England Journal of Medicine study.

A person’s electrolyte balance changes while doing long distance endurance events like marathons or long cycle rides, Davison said. People might also suffer potassium or sodium depletion, or become dehydrated, which also contributes to extra stress on the heart.

Intense exercise for periods longer than one to two hours can cause over-stretching and tiny tears of the heart’s tissue, said James O’Keefe, a sports cardiologist and head of preventative cardiology at the Mid America Heart Institute in Kansas City, Missouri. This type of repeated injury over years can cause irregular heart rhythms, increased inflammation, scarring and stiffening of the arteries, he said.

 

CT Scan

 

Athletic over-achievers tend to think that “more is better,” though when it comes to health, “moderation is almost always best,” said Mid America Heart Institute’s O’Keefe.

As a precaution, getting a computerized tomography, or CT, scan of the heart to look for calcified plaque is a good way for endurance athletes to check if their workouts are putting their heart at risk, O’Keefe said. Yet there is no agreement on what the best strategy is for testing.

“The throwaway line is to consult your doctor to make sure you’re fit to race,” said Melbourne cardiologist La Gerche.

“The only good tests depend on people having symptoms and telling their doctors. In healthy asymptomatic people, there is no good test to see if someone is at risk of sudden death.”

 

Screening Value

 

Those who experience a bit of chest pain or become breathless should see a doctor to check it out, especially if the discomfort occurs during training, said University of South Australia’s Davison. Sudden events that occur in people who have had no previous sign of heart disease usually indicate a build- up of plaque.

When plaque ruptures, it can cause a clot in an artery, which often doesn’t show up in typical stress tests of ECG monitoring of the heart’s electrical activity. Clots aren’t often detected until the heart becomes stressed enough to cause a rupture, causing sudden onset of chest pain, Davison said.

Screening typically would have more value in people who are new to exercise and don’t know whether they have developed a disease. People who regularly exercise without any symptoms aren’t likely to show any signs in a stress test, Davison said.

 

Competition Changes

 

World Triathlon Corp., the owner of the sport’s Ironman- branded events, made changes to the swim portion of select races after an increase in competitor deaths in recent years, the company announced last month.

Events in Coeur d’Alene, Idaho; Lake Placid, New York; and Mont-Tremblant, Quebec, no longer feature a mass swim start, eliminating a long-standing Ironman tradition. Athletes at those races will either enter the water in a continuous stream through an access point, with their time starting when they cross a timing mat, or in staggered waves based on their age group.

The changes came two months after Ross Ehlinger, a 46-year- old man from Austin, Texas, died during the swim portion of the Escape from Alcatraz Triathlon and nine months after Andy Naylor, a 43-year-old member of the Hong Kong Police Force, died near the conclusion of the 2.4-mile swim portion of the New York City Ironman. In 2011, two competitors died during the swim portion of the Olympic-distance New York City Triathlon.

 

MetaMan Iron

 

Other organizers are also taking precautions. On the last day of August, triathletes will gather on the beach of Bintan, Indonesia and participate in the MetaMan Iron Distance race. Two speedboats will be on hand to help racers in the event of a medical emergency, said organizer spokeswoman Hollie Avil.

O’Keefe advises his patients, especially those over 45, to run no more than 20 miles a week, spread out over three to four days.

“That’s not to say you can’t get problems when you’re under 45,” said O’Keefe. “But you’re much more susceptible when you’re over 45 because it just takes longer for your body to recover and when you hammer it day in and day out, it just takes a toll on your body.”

 

For Related News and Information:

Ironman Making Changes to Swimming Portion of Races After Deaths NSN MMJJ4J6VDKHV <GO> Middle-Aged Men in Lycra Becoming Target for Bike Makers: Retail NSN MBKZ4C6TTDTB <GO> Exercise Addiction Seen Linked to Withdrawal Depression: Health NSN M81Q3M0YHQ0X <GO> Today’s top health stories: HTOP <GO> Bloomberg’s most-read health-care news: MNI HEA <GO>

 

--With assistance from Michelle Fay Cortez in Minneapolis.

Editors: Angela Zimm, Rick Schine

 

To contact the reporters on this story:

Natasha Khan in Hong Kong at +852-2977-4630 or nkhan51@bloomberg.net; Shannon Pettypiece in New York at +1-212-617-5818 or spettypiece@bloomberg.net

 

To contact the editor responsible for this story:

Jason Gale at +61-3-9228-8733 or

j.gale@bloomberg.net

[Milkworx]

I only have about 10 years of triathlon left

[Christie]

Geepers, as if swimming with sharks is not risky enough!

[Tubehunter]

These studies never take into account how many of the people that do suddenly have a life ending heart affliction, would likely have passed away younger, through NOT participating in endurance sport.

 

Imagine how many more of these people would not be around had they done no training as they weren't competing in any events...

[DJR]

I'm past my "best by" date , but what the hell, I've always known I'm special.

 

Interesting study, but it only tells 1 side of the exercise story. What about how many would have died if they didn't exercise and were lazy fat slobs?

[pezulu]

If anyone is going to have a cardiac event they’re far more likely to have one during exercise,” said Davison. A person is seven times more likely to have a heart incident while exercising than at rest, he said, citing a 1984 New England Journal of Medicine study.

 

If that is true then the average couch potato will have a 7 times less chance of developing heart problems than the average hubber.

Edited June 21, 2013 by pezulu

[Andrew Steer]

These studies never take into account how many of the people that do suddenly have a life ending heart affliction, would likely have passed away younger, through NOT participating in endurance sport.

 

Imagine how many more of these people would not be around had they done no training as they weren't competing in any events...

Spot on! How many couch potatoes pass away daily while tucking in to their KFC bucket...

[Mojoman]

I will just stick to cycling then....!

[rudi-h]

they need a LOT more references etc. to substantiate this claim for me to believe a word of it...

[Thug]

Damn, I should never have done IM.

[Joe Low]

I'm well ahead of the game, cuz i didnt think about running a triathalon once.

 

On heart attacks, middle of the night (1am-3am) is most common as people's blood is thicker then; & doctors' call-outs are most expensive.

[reteid]

I am 6 years past my sell buy date then.Cant wait for 26 Jan 2014.

[Seeker911]

Its the law of averages the more people who do something the more likely someone will die while doing it irrespective of age. Look at the recent deaths at the 70.3 this year.

 

At 48 I am smack bang in the middle of this "Mamils" group and I have absolutely no intention of hanging back. You are as you do when it comes do a game of office cricket I am always the first at the crease. Just make sure you go for regular medicals and keep that cholesterol level in check. If you are not medically fit to do Triathlon then you are just plain dumb if you do it anyway.

[Witkop]

As I don't swim, as a dauthlete I am safe.

[davem]

What complete bollocks.

 

Unhealthy people die.

Healthy people die.

Unhealthy people die on average younger.

 

At my first Ironman, aged 40, I was beaten by a 70 year old!

 

Embarrassing, yes, completely frigging awesome too.

 

I hope at 70 I can beat some cheeky little 40 year old!

[Brogue]

Men over 40 should have their prostates checked, THAT's advice everyone should listen to. As for the triathlon thumb-suck, I've binned it already, the authors probably get paid by the word. Numbskulls!

Edited June 21, 2013 by Brogue