Wednesday, September 27, 2017

Wisdom Wednesday: Death Risk from Triathlons May Be Higher Than Thought

Could some triathlon participants be pushing themselves too hard? New research suggests the odds that an athlete will die during these tests of endurance are higher than previously believed.

“We identified a total of 135 deaths and cardiac arrests in the U.S. triathlons from the inception of the sport in 1985 through 2016,” said study lead author Dr. Kevin Harris. Most were due to undiagnosed heart issues.

“The vast majority of the deaths occurred in the swim,” added Harris, a cardiologist with the Minneapolis Heart Institute at Abbott Northwestern Hospital.

Researchers also discovered that race-related fatalities most often involved middle-aged or older men. And the investigators found that sudden death, cardiac arrest, and trauma-related death during triathlons are not rare.

Overall, risk of dying during a triathlon was 1.74 for every 100,000 athletes – the equivalent of about five triathlete deaths a year, investigators found. This is higher than previous estimates.

“To put this in context, the risk is about twice as high as that reported in marathon races,” Harris said. Also, “compared to populations of athletic individuals, the risk for a single triathlon seems to exceed the annual risk for recreational athletes. Still, in absolute terms the fatality risk among triathletes remains low, Harris said.

As to what might explain the findings, Harris pointed to the “acute stress” of triathlon participation. “It is important to realize that an athlete may be physically fit but have severe underlying cardiovascular disease that becomes manifest only under very significant stress,” he noted. Harris suggested that male triathletes over 40 review their risk factors for coronary disease when considering entering a race.

Of the 135 fatalities, cardiac arrest and sudden death were the most common causes: 90 occurred during the swim portion, 15 while running and 7 while bicycling. Another 15 deaths during biking were attributed to traumatic injury, and 8 competitors died during post-race recovery, according to the report.

The higher risk linked to swimming is likely due to several factors, he added. These include the potential for drowning if an athlete becomes weak or unconscious, coupled with the greater difficulty that observers might have identifying and treating a swimmer in trouble.

The study results were published online Sept. 18 in the Annals of Internal Medicine.

My Take – I think the competitive nature of the triathlon “race” is also a big factor. These athletes didn’t die during training, which typically involves longer distances than the race itself. I stopped entering triathlons when my Afib symptoms became apparent. I still train – running, swimming, and cycling. I just don’t compete.

Well-meaning friends have tried to get me to compete with them. “Do it just for fun, don’t worry about your time.” However, I know myself too well. At 65, I have a good shot at placing or even winning my age group. The competition is less and less, the older you get. Americans are not great at maintaining a healthy lifestyle. So, despite best intentions, I know I would push the envelope.

Bottom Line:
Endurance activities like running, swimming and cycling are at great for building and maintaining cardiovascular health. You must know your limits. Wear a heart rate monitor and stay in “orange”, the aerobic zone.

Finally, the “risk factors” for anyone over the age of 40 qualifies them for statin drug therapy, regardless of their general health, cholesterol levels, or any other parameters. Based on those criteria, all of us over 40 should be couch potatoes taking Lipitor.

Source: September 18, 2017 National Institutes of Health

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