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  • Male runners are more susceptible to cardiac arrest than females.
  • Atherosclerosis is the leading cause of cardiac arrest in male marathon runners over the age of 40.
  • Low dose pre-race aspirin use might save lives by reducing the “stickiness” of the blood.
  • The use of low dose aspirin has been shown to reduce the chance of an acute cardiac event by as much as 44%.
  • The International Marathon Medical Directors Association recommends low dose aspirin use prior to marathon races in males 40 years of age or older.

Cardiovascular exercise benefits all of us even as we age. At the same time, there can be risks of a “cardiac event” for the 40 and older crowd who suddenly start an intense exercise program like running marathons.  This is especially true for adults who have lived primarily sedentary lives and then suddenly began to train for an endurance race or some other intense physical event. Many healthcare providers have started prescribing a pre-race aspirin for older marathon runners.

Heart health can be significantly improved with the participation in a sound, consistent cardiovascular exercise program. Being physically active has been proven to improve one’s heart health even in people who have some form of cardiovascular disease (CVD) or are pre-disposed to it.   Cardiac events occur more frequently in males who have been sedentary for most of their life but begin to participate in cardiovascularly challenging activities.

Sedentary people begin to exercise for many reasons but many times it is in response to a desire to participate in a community-based event such as fun runs and marathon/half marathon races.  Many cardiac events occur during these events, and it is thought to be caused by an increase in physical demand on the former sedentary person’s heart.  Regardless of training, some individuals are susceptible to cardiac events due to their history of a sedentary lifestyle.  In many instances these individuals have developed atherosclerosis or hardening of the arteries when they lived a sedentary lifestyle and an increase in cardiac output during the race is too great for their heart to handle.  This has led some healthcare providers to conclude that taking a low dose pre-race aspirin before a big event that is more likely to place significant stress on an individual’s heart might be the best way to prevent cardiac events from occurring.

pre-race aspirin

Aspirin in low doses has been shown to reduce the “stickiness” of blood and this can prevent plaque buildup in the arteries.  The aspirin inhibits the effects of the COX 1 enzyme which slows down the conversion of certain lipids that have a tendency to cause blood platelets to stick to the wall of the artery. Low dose aspirin use before a challenging event has been shown to reduce the occurrence of cardiac events by as much as 44% in a population of men over 40 years of age, who lived a sedentary lifestyle and began to participate in cardiovascularly challenging events.

The positive outcomes of low dose pre-race aspirin use encouraged the International Marathon Medical Directors Association to recommend its use following a discussion with the individual’s doctor.  Prior to any drug use, the treating physician should be brought into the decision making process.

Cardiovascular exercise has many benefits that heavily outweigh the possible negative side effects.  Unfortunately, a severe cardiac event could result in sudden death during a cardiovascularly challenging activity and with this in mind many healthcare professionals recommend the use of low doses of aspirin prior to the activity to significantly reduce the chances of the incident occurring.

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