Running marathons is more popular than ever in the U.S., but a new study brings encouraging news: fewer runners are dying from cardiac arrest during races, even though the number of people having heart issues during these events hasn’t changed.
The study, led by Dr. Jonathan Kim from Emory University School of Medicine, was published in JAMA.
It follows up on Kim’s earlier research from 2012, which was the first major study on unexpected heart problems during long-distance races.
Between 2010 and 2023, over 29 million people completed marathons in the U.S.—three times more than the decade before.
Dr. Kim and his team wanted to know: Are more people having heart attacks? Are the causes different now? And are more people surviving?
Surprisingly, the rate of cardiac arrest during marathons stayed about the same—0.60 per 100,000 participants now, compared to 0.54 per 100,000 in the earlier period. But the big difference was in survival.
The death rate dropped by 50%, from 0.39 to 0.19 per 100,000 runners. That means more runners are surviving cardiac arrest than ever before.
Finding this data wasn’t easy. There’s no official database for heart-related incidents during races, so Kim’s team used media reports, race director contacts, and online searches to track down cases. They also spoke with survivors and families to better understand what happened during each event.
So, what made the difference?
Dr. Kim found that almost all survivors received CPR right away, and most had immediate access to a defibrillator—a device that can restart the heart.
These tools are now commonly available along race routes, similar to how they’re placed in airports, casinos, and other public areas, which have also seen fewer deaths from cardiac arrest.
Kim believes the running community has become more aware of the risks and better prepared to respond. He stresses the importance of CPR training for race staff and participants, and making sure defibrillators are available along the course.
He also points out that many of these heart events might be preventable. Often, they happen to older runners who may have undiagnosed heart issues. Identifying at-risk individuals beforehand could help reduce future incidents.
“This doesn’t mean they shouldn’t run,” Kim says. “But it gives us a chance to improve their heart health first—and keep more runners safe.”
The number of cardiac arrests during races hasn’t changed in 20 years, but thanks to faster responses and better tools, far more lives are being saved.
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