Marathon Running Gains Popularity While Heart Attack Deaths Decline
Despite a record number of people running marathons in the U.S., the risk of dying from a heart attack during a race has dropped significantly in recent years. This is a key finding from a new study led by Jonathan Kim, an associate professor at Emory School of Medicine. Kim’s latest research builds upon his 2012 study, which was the first to investigate unexpected cardiac arrests in long-distance running events.
Improved Survival Rates for Cardiac Arrest Cases
Published in JAMA, the study reveals that although the overall rate of cardiac arrests among marathon runners has remained steady, survival rates have doubled. Today, fewer runners experiencing cardiac arrests die from them compared to past years.
Kim’s team examined data from 2010 to 2023, a period during which over 29 million people completed marathons in the U.S.—three times the number analyzed in his original study. Since no central database tracks race-related cardiac events, the research team had to gather information from various sources, including race directors and media reports.
“We tapped into multiple sources, including public records and direct contact with race organizers,” Kim explains. “We successfully reached about 70% of race directors, who provided valuable details on cardiac incidents, including fatalities and participant demographics.”
The researchers also conducted extensive online searches to track survivors of cardiac arrests and, where necessary, contacted their families. “Almost all cases were identifiable through public search engines, including fatal incidents,” Kim adds.
Key Data Highlights a 50% Decline in Deaths
Analyzing the collected data, the study found that the incidence of cardiac arrest remained almost unchanged over time—currently at 0.60 per 100,000 participants, compared to 0.54 per 100,000 in the earlier period. However, the death rate from these incidents fell dramatically from 0.39 per 100,000 to 0.19 per 100,000—a 50% decline since 2000-2009.
As in previous studies, cardiac arrests were found to be significantly more common in men than women and occurred more frequently in full marathons than in half marathons.
Increased Awareness and Emergency Preparedness Save Lives
What has contributed to this sharp reduction in death rates? Kim believes that greater awareness within the running community, along with improved access to emergency medical services, has played a crucial role.
“We discovered that every individual who survived received immediate hands-on CPR, and the majority had quick access to an automated external defibrillator (AED),” Kim states. “This accessibility has made a lifesaving difference.”
This survival trend aligns with what has been observed in other public places like airports and casinos, where the presence of AEDs has led to a significant drop in cardiac arrest deaths.
Kim emphasizes that his research underscores the importance of widespread CPR training for race participants and the strategic placement of defibrillators along marathon routes. Additionally, he highlights the need to identify high-risk individuals before they participate in races.
“Many of these cases are potentially preventable,” he explains. “Recognizing individuals—especially older participants with undiagnosed cardiovascular risks—doesn’t mean they shouldn’t run, but it does offer an opportunity for better preventive care. The rate of sudden cardiac arrest in long-distance races has remained constant for over 20 years, making this an important area for future research.”
