Last year, the marathon medical directors' group issued recommendations for preventing sudden death among runners and walkers. Intense bouts of exercise can lead the muscles to release enzymes that promote blood clotting and reduce the blood supply to the heart muscle, the group said. Endurance athletes should be properly hydrated, consume sufficient salt and avoid nonsteroidal anti-inflammatory medications commonly taken for pain, muscle sprains and other sports injuries.
Some studies suggest that caffeine consumption becomes risky at about 200 milligrams, the amount contained in two "diner-size" cups of coffee. A cup at Starbucks contains 320 milligrams, "which is too much," Maharam said.
Although the evidence for caffeine restriction remains anecdotal, he said, "it's a no-brainer to limit caffeine." He said that taking a baby aspirin also may elicit skepticism from cardiologists, but "it just may save a life."
Several veteran marathoners have died in recent months. Jorge Fernandez, a 32-year-old Air Force veteran of the Iraq War, collapsed last weekend soon after crossing the finish line of a half-marathon during the San Antonio Rock 'N' Roll Marathon, where the air was humid and temperatures in the 80s. Although emergency responders tried to resuscitate him, he was pronounced dead at a nearby hospital. A longtime runner who completed the same course last year, Fernandez was pronounced dead at a local hospital.
William Caviness, a 35-year-old North Carolina firefighter and veteran marathoner running to raise money for charity, collapsed 500 yards from the finish line of last month's Chicago Marathon. Although emergency doctors and emergency medical services were able to revive him, he died a couple of hours later. An autopsy proved inconclusive, The Chicago Tribune reported.
Women marathon runners have less plaque in their arteries than male runners, or than sedentary women, researchers from the Minneapolis Heart Institute reported Nov. 14 at the American Heart Association annual meeting. That finding followed a report in 2010 that marathon-running men had more plaque than sedentary men, although those men were older than the women in this year's study, the Minnesota researchers said. Researchers could not account for the gender-based differences.