A Guide to Cardiovascular Health for Runners above Forty.

As midlife runners, maintaining cardiovascular health is paramount for both performance and overall well-being. Cardiovascular health holds utmost significance, particularly for older runners, as undetected issues could potentially result in critical emergency scenarios. Understanding the signs, undergoing appropriate investigations, and implementing preventive measures are crucial. In this comprehensive guide, we’ll delve into the cardiovascular health in midlife runners.

Understanding Cardiovascular Health:

The cardiovascular system comprises the heart, blood vessels, and blood, functioning together to deliver oxygen and vital nutrients throughout the body. A healthy cardiovascular system promotes efficient circulation, regulates blood pressure, and supports overall well-being. As we age, cardiovascular health is paramount, as it not only enhances athletic performance but also mitigates the risk of cardiovascular diseases, such as heart attacks and strokes.

 

The foundation of cardiovascular health lies in thorough comprehensive health assessments. It is essential to tailor the cardiovascular health risk assessment to their unique circumstances.

 

For beginner midlife runners or those returning to running after a break of six months or more

The initial health assessment should be extensive, encompassing all tests recommended by the healthcare provider following a comprehensive evaluation of the current condition and medical history. This comprehensive assessment may include the following investigations, particularly for individuals initiating their running journey at the age of 40 or older:

  1. Detailed Blood Pressure Monitoring
  2. Comprehensive Cholesterol Profile Analysis
  3. Resting Electrocardiograms (ECGs)
  4. Cardiac Stress Testing
  5. Echocardiography Examination
  6. Coronary Calcium Scoring

By undergoing these specific tests we can gain a comprehensive understanding of our cardiovascular health status, enabling us to embark on the running journey with confidence and safety.

For seasoned and active runners.

Even though  cardiovascular assessments were completed comprehensively prior to the commencement of their running journey. It is strongly recommended to undergo two comprehensive health assessments annually without exception. These assessments provide a current snapshot of the present cardiovascular health. Typically, the first check occurs at the conclusion of a running season or before the commencement of the next season, marking the beginning of the training cycle. The second evaluation is ideally conducted mid-season. The type of investigations  will generally be recommended by a health care professional.

These health checks serve as vital checkpoints to monitor cardiovascular well-being, allowing midlife runners to track their progress, detect any emerging issues, and make informed adjustments to their training regimen. By scheduling these assessments strategically around the running calendar, runners can ensure that their cardiovascular health remains a priority throughout the year, optimizing performance and minimizing the risks and reducing downtime through injury during peak season. 

Signs and symptoms of cardiovascular disorders in elder runners

 Before diving  into the signs and symptoms, let’s briefly discuss some common cardiovascular disorders.

  1. Coronary Artery Disease (CAD): CAD occurs when the arteries that supply blood to the heart become narrowed or blocked due to the buildup of plaque, leading to reduced blood flow and potential heart complications.

  2. Arrhythmias: Arrhythmias are irregular heart rhythms that may manifest as palpitations, skipped beats, or a racing heartbeat. They can range from benign to potentially life-threatening conditions.

  3. Heart Valve Disorders: These conditions involve abnormalities in the heart valves, such as stenosis (narrowing) or regurgitation (leakage), which can impair the heart’s ability to pump blood effectively.

  4. Heart Failure: Heart failure occurs when the heart is unable to pump enough blood to meet the body’s needs.

The signs & symptoms of cardiovascular disorders in endurance athletes   especially in active and seasoned runners are very complex and tricky as compared to sedentary individuals. As runners our threshold pain barriers are very high. We are seasoned and push through pain and fatigue.  Fatigue and recovery cycles happens every time we go out for runs and workouts.  We tend to ignore minor pains, aches, and fatigue. Cumulative fatigue is experienced during every training cycles when one is training for longer races like marathons and ultras . Hence the classical symptoms of cardiovascular disorders go misdiagnosed.

The Primary consideration here is consistency in symptoms

 

Prevention is best

Taking proactive steps to protect our heart health is key to ensuring a lifetime of enjoyable running experiences. Here are some  practical tips for midlife runners to prevent heart issues and promote long-term cardiovascular wellness.

Maintain a Healthy Diet

Fuel your body with a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Totally avoid intake of processed foods and sugary beverages. Try eating a nutritious diet which comes from natural sources.

Manage Stress

Long term stress is not good  on heart health. Practice stress-reduction techniques such as deep breathing, meditation, yoga. Spend time in nature. Indulge in activities that help  unwind and relax, promoting a healthier heart and mind.

Get Quality Sleep

Good quality sleep hygiene  for 7-9 hours of  each night is non-negotiable. Adequate sleep allows your body to rest , repair, and  rejuvenate  optimal cardiovascular function. Try sleeping  at fixed times. Bed room should be pitch dark, clean  and cool. Avoid blue light exposure 1/2  hours before bedtime. Finish dinner 3 hours before hitting the bed.

Listen to Your Body

Pay attention to any warning signs or symptoms of potential heart issues, such as chest discomfort, shortness of breath, palpitations, or fatigue. Don’t ignore these symptoms; seek medical attention promptly if they occur.

Stay Hydrated

Proper hydration is essential for cardiovascular and overall health, especially during and after exercise. Drink water with simple  electrolytes regularly throughout the day and hydrate adequately before, during, and after your runs. Do not consume  artificial  sugary  beverages.

Regular Check-ups

Schedule regular health check-ups with your healthcare provider, even if you feel healthy. These check-ups allow for early detection of any underlying health issues and provide an opportunity to discuss preventive measures tailored to your individual needs. 

Difference between cardiac arrest and heart attack.

 Cardiac arrest and heart attack are often confused because they both involve the heart.  They are different medical conditions with different causes, symptoms, and treatments. Let us deep dive into both these deadly conditions. 

The infamous "Widowmaker"

At the Tata Mumbai Marathon last year (2023), I saw a fellow runner collapse around the 30-kilometer mark. An emergency team was working frantically to revive him, but later, we heard the tragic news that the 35-year-old athlete had died. The cause of death was sudden cardiac arrest.

As endurance athletes, we always assume that our hearts, the engines of our bodies, are incredibly strong and healthy. I had never heard the term “widowmaker” until last year, when a marathoner tragically died during the event.

Sudden cardiac arrest (SCA) during endurance sports, including marathons, is relatively rare but can occur. It is often triggered by underlying heart conditions that may not have been previously diagnosed.

The most common cause of SCA in athletes over 35 years old is coronary artery disease, which includes events like a widowmaker heart attack. In younger athletes, structural heart abnormalities or arrhythmias are more common causes.

 Typically, an individual experiencing SCA may suddenly collapse, become unresponsive, and have no detectable pulse. Immediate recognition and action are crucial.

A widowmaker heart attack is a complete blockage of the LAD artery. It is considered one of the most dangerous types of heart attacks due to the large amount of heart muscle it affects.

It is caused by a sudden rupture of a plaque in the coronary artery, leading to a clot formation that completely blocks the artery.

The symptoms can include chest pain or discomfort, shortness of breath, nausea, light-headedness, and sweating. However, some individuals may not experience obvious symptoms, which can delay seeking urgent care.

 Because the LAD artery supplies a large portion of the heart, its blockage can lead to the heart stopping suddenly, known as sudden cardiac arrest. This is different from a heart attack (myocardial infarction) in that it involves a malfunction in the heart’s electrical system.

Conclusion:

Maintaining cardiovascular health is crucial for elder runners to enjoy a long, active, and healthy life. While running offers numerous benefits, it’s important to recognize the unique risks and needs that come with age. Regular medical check-ups, listening to your body, and adopting a balanced training program can help mitigate the risks of heart-related issues. Incorporating strength training, proper nutrition, and adequate rest into your routine will support overall heart health. By staying informed and proactive, elder runners can continue to enjoy the many physical and mental benefits of running, ensuring that their hearts remain as strong and resilient as their passion for the sport.

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