Korean J Sports Med.  2016 Jun;34(1):10-18. 10.5763/kjsm.2016.34.1.10.

Cardiovascular Adaptation and Side Effects in Middle-Aged Marathoners

  • 1Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. rladudwn1383@naver.com


Regular exercise brings about various positive effects on cardiovascular, oncological, psychiatric, neurological, and endocrinological systems of human body. According to exercise types with cardiovascular adaptation, endurance exercise is characterized by eccentric hypertrophy; resistance exercise is characterized by concentric hypertrophy; and the combination of the eccentric hypertrophy and concentric hypertrophy is seen in cycling and rowing. Although the cardiac functions of athletes are not different from those in general population, athletes show higher exercise capacities because of the increased diameter of ventricle. Atrial fibrillation which is the most common in middle-aged marathoners shows 5.3 times higher prevalence compared to that in general population. In addition, higher arterial stiffness is shown in marathoners, and higher resting blood pressure is shown in sub-3 hours-marathoners. Especially the runners with higher resting blood pressure or severe arrhythmia showed superior cardiopulmonary functions and excessive exercise habits when compared to the normal runners. The runners with exercise-induced hypertension are prone to show increased levels of cardiac markers by increasing cardiac muscle burden in exercise, and then be taken with resting hypertension in the future. The major cause of sudden deaths in marathon race of middle-aged marathoners is coronary artery disease (CAD), and the higher prevalence of CAD is shown in middle-aged marathoners being manifested by the exercise stress test or cardiac computed tomography. Therefore, middle-aged marathoners who regularly participate in marathon race are required to undergo annual exercise stress test, and their additional checkups for cardiovascular system should be supervised by specialized medical doctors.


Marathon; Cardiac hypertrophy; Arrhythmia; Hypertension; Sudden death
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