The local running community recently lost beloved member, Canadian Anthony Dean Borg who suffered a heart attack during a fun run in Cebu. Borg collapsed while running the 12k race of the R399 Fun Run, an annual event dedicated to Ramie Igaña Jr. who died of pulmonary embolism on the bike course of the 2012 Cobra Ironman 70.3 Philippines. Prior to his demise, Dean had just finished a 70k race in Cebu. The longest distance he ever ran was 106k. “I would prefer to die running an ultramarathon than sitting on the sofa worrying about things that will kill me,” was the comment the 52-year old posted this month on an article about the effects of running an ultramarathon on the health of older runners.
Dean’s untimely death has sparked fresh concern about the health risks of running marathons. Running, and other endurance sports, has been booming in the Philippines and attracting people of all ages, gender and health profiles.
The author of the international bestseller “The Complete Book of Running” and one of the leading proponents of the running boom overseas, Jim Fixx himself died of a massive heart attack in 1984. In recent years, a number of unlikely candidates or seemingly fit and well-trained runners had died of sudden cardiac death at high-profile, long-distance events.
What is a heart attack?
A heart attack occurs when heart muscles die because their blood supply is suddenly cut off due to an occlusion to the artery which supplies blood to these muscles. The occlusion usually starts out as fatty and cholesterol deposits in the artery wall called plaques. Sometimes, these plaques rupture. When this happens, blood clots form to try and contain the damage done to the artery wall. However, if the artery is already blocked to a certain degree by the plaque, the formation of the blood clot can totally occlude its opening, resulting to complete obstruction of blood flow. When blood flow is cut off, the muscles die and the result is a heart attack.
When an autopsy was done on Jim Fixx’s body, it was found out that the main arteries that supply blood to his heart were already 70-99% blocked with cholesterol deposits. This means that if they ruptured, even a small blood clot would have completely blocked any of his arteries. And this is what probably happened to him.
What are the symptoms of a heart attack?
The most common symptom of a heart attack would be chest pain that is sometimes described as a crushing, vice-like sensation in the chest. This pain may extend to the jaw, left arm or back. Other associated symptoms would be dizziness, difficulty of breathing, nausea, vomiting, and the presence of a cold, profuse sweat.
What are the risk factors for developing a heart attack?
The following are some of the risk factors associated with heart attacks:
- being male
- having diabetes, hypertension and/or high cholesterol levels
- a family history of heart disease
- lack of physical activity
- having a high salt, high fat diet
- stressful lifestyle
Among these risk factors, running only directly addresses one of them – the lack of physical activity. What this means is that even if you run, if the other risk factors are not controlled, then you are still at risk of developing a heart attack. And this was what Jim Fixx failed to realize.
Before taking up running when he was 35 years old, Jim Fixx was a heavy smoker, consuming two packs of cigarettes per day. He was also obese, weighing more than 100 kg, had a stressful job as a writer in a major newspaper, enjoyed a high fat, high salt diet, and had a strong family history of heart disease. His father had a heart attack during his 30’s, eventually dying when he was 43.
When he took up running, he quit smoking. After a few years, he was no longer obese as he lost a lot of weight. Improvement in his general well-being emboldened him to believe he had outrun his past… that as long as he continued to run, he would no longer be at risk for developing a heart attack. However, while Fixx made great changes, there were some risk factors he could not change (being male, family history of heart disease), and there were some he did not change (having a high fat, high salt diet and a stressful lifestyle). The presence of multiple risk factors meant that Jim Fixx was still at risk for developing a heart attack.
Does this mean running doesn’t really help much?
Two years after Jim Fixx died, a cardiologist was able to review Jim Fixx’s medical and autopsy reports. What he found out was that if Jim Fixx did not run, he probably might have had already died of a heart attack at a younger age. In effect, it was running that saved him and extended his life. He was just overcome by poor lifestyle choices when he was younger, by his genes, and his choice not to modify the other risk factors.
What this means is that running is indeed helpful in decreasing our risk for heart disease. However, make sure to improve on the other risk factors to maximize its benefits.
What should we do?
Start young. The earlier in life a healthy lifestyle is followed, the better. Improve on the risk factors that are modifiable to overcome whatever bad effects the non-modifiable risk factors contribute. However, even if you’re already older when you started, don’t lose hope because any improvement is definitely better than none.
Running is not a cure-all, nor does it make us immune from heart attacks. Running has to be combined with a healthy lifestyle (don’t smoke, eat healthy, be less stressed) for it to become truly effective in improving our quality of life.