Training for and running in a first marathon may be associated with reductions in blood pressure (BP) and aortic stiffening in healthy participants that are equivalent to a four-year reduction in vascular age, according to research published Jan. 6 in the Journal of the American College of Cardiology. The greatest benefits were seen in older, slower male marathon runners with higher baseline BP.

Anish N. Bhuva, MBBS, et al., examined a cohort of 138 healthy, first-time marathon runners from the 2016 and 2017 London Marathon. The researchers examined the participants before training and after marathon completion to determine if age-related aortic stiffening would be reversible with real-world exercise training. Participants had no significant past medical or cardiac history and were not running for more than two hours per week at baseline. On average, participants were 37 years old and 49% were male. Exclusion criteria included pre-existing heart disease during the preliminary investigations or contraindication on a cardiovascular magnetic resonance imaging scan.

All participants were recommended to follow the "Beginner's Training Plan" provided by the marathon, which consists of approximately three runs per week that increase in difficulty for a 17-week period prior to the marathon. However, the researchers did not discourage participants who wished to use alternative training plans. The average marathon running time was 5.4 hours for women and 4.5 hours for men. When compared to training data and marathon completion times from 27,000 runners, these times were found to be consistent with a training schedule of six to 13 miles per week.

Results showed that training decreased systolic and diastolic BP by 4 and 3 mmHg, respectively. Overall, aortic stiffness reduced with training and was most pronounced in the distal aorta with increases in distensibility of 9%. This amounted to the equivalent of an almost four-year reduction in 'aortic age.' Older patients had greater changes with exercise training, with males and those running slower marathon times deriving greatest benefit. The authors note that although the study only recruited healthy participants, those with hypertension and stiffer arteries might be expected to have an even greater cardiovascular response to exercise training.

"Despite some limitations, including its observational nature, the study adds to the body of evidence supporting beneficial effects of exercise on multiple aging phenotypes," said Julio A. Chirinos, MD, PhD, in an accompanying editorial comment. "Given the profound implications of arterial stiffness for human health, this study is important and should stimulate further research to identify potential molecular mechanisms by which exercise reduces aortic stiffness. In addition, training for marathons usually involves various concomitant approaches such as better sleep and dietary patterns, and in some instances, over-the-counter supplements, that may confound or interact with exercise training per se. More research to identify optimal integrated training regimens is needed."

Clinical Topics: Diabetes and Cardiometabolic Disease, Geriatric Cardiology, Heart Failure and Cardiomyopathies, Noninvasive Imaging, Prevention, Sports and Exercise Cardiology, Magnetic Resonance Imaging, Exercise, Hypertension, Sports and Exercise and Imaging

Keywords: Aged, Adult, Blood Pressure, Vascular Stiffness, Exercise, Systole, Aorta, Hypertension, Magnetic Resonance Imaging, Phenotype, Heart Diseases, Cohort Studies, Sports

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