Does Running Avert Coronaries?

Not necessarily, says a doctor, after studying five deaths

They are now in their final frenetic weeks of training, crisscrossing city streets and country lanes, eating special foods, subjecting their bodies to all manner of special exercises. The object of all this self-inflicted agony is the Oct. 26 New York City Marathon, when 16,000 runners will try to pound out 26.2 miles (42.2 km) in the world's largest long-distance race. Few will be able to match stride with the likes of Four-Time Winner Bill Rodgers. But for many competitors, just finishing is its own special victory: they are convinced that long-distance running protects them from heart disease.

This magic pill theory has long been popular in the running community, particularly among middle-aged males, a group that is at especially high coronary risk. The theory's most outspoken advocate is Dr. Thomas Bassler, an Inglewood, Calif., pathologist. Dr. William C. Roberts, chief of the pathology branch of the National Heart, Lung and Blood Institute, and Colleague Bruce Waller have provided clinical evidence that Bassler is wrong. They studied the cases of five middle-aged men, 40 to 53, who died while running, including Maryland Congressman Goodloe Byron, a six-time Boston Marathon finisher.

Roberts found that the men had been running for as long as ten years, averaging from 13.5 to 107 miles (22 to 173 km) a week; only one had ever complained of chest pains. Yet post-mortems revealed severe atherosclerosis--the buildup of plaque, or fatty deposits--in the major coronary arteries. Thus, concludes Roberts, heart disease was "the major killer."

Roberts cautiously avoids drawing broader conclusions. He says that no one can say for sure if the men died because of running; on the contrary, they might have died anyway. In fact, he adds, their running may have had some beneficial effects: "I suspect they would have died earlier than they did if they hadn't run."

There is evidence to support such optimism. Studies have shown that running--indeed, all strenuous exercise--can elevate the blood levels of a form of cholesterol called high-density lipoprotein (HDL). This substance helps remove other, more harmful types of cholesterol from the body and presumably reduces the chances of such materials building up in the arteries. Studying 218 marathoners, joggers and nonrunners, G. Harley Hartung of the Baylor College of Medicine in Houston found that the marathoners had the highest level of HDL. Other factors may be at work; marathoners tend to be relaxed, eat healthful foods, not smoke and stay thin.

There is still another factor to keep runners off stride. Cornell's Dr. Thomas Pickering, who has also studied HDL levels, reports that arrhythmias--abnormal heartbeat rhythms--occur more frequently during exercise and thus may be the cause of many unexplained deaths among runners. Says he: "A case could be made that the marathon runner is at a decreased risk of cardiovascular death when he is not running, but at an increased risk when he is." So what is a runner to do? Not to worry, says Roberts, who runs five to ten miles (8 to 16 km) a week: "I think that the purpose of running is to make a person feel better." In other words, running a marathon must be its own reward.

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