Long-distance running continues to attract millions, and while it is known for boosting cardiovascular fitness, rare but serious heart-related emergencies can still occur during races. A recent study published in the Journal of the American Medical Association (JAMA) highlights an important trend: although the risk of sudden cardiac arrest during marathons and half-marathons has remained steady over the years, the likelihood of dying from one has significantly decreased.

This improvement points to better emergency preparedness at race events, increased availability of defibrillators, quicker CPR response, and possibly earlier identification of heart risks among runners. Common underlying causes of cardiac arrest in these settings include coronary artery disease, congenital heart abnormalities, and conditions like hypertrophic cardiomyopathy—many of which may be asymptomatic until a crisis occurs.

Unexplained cardiac arrest also remains a notable concern, particularly when standard testing or autopsies do not reveal a clear cause. This highlights the importance of pre-participation screenings, especially for those with a family history of heart disease or symptoms like chest pain or fainting during exercise.

The findings reinforce that while endurance running is generally safe, awareness and preparedness are key. Race organisers, medical teams, and runners themselves all play a role in minimising risks. As long-distance events grow in popularity, ongoing education about heart health and emergency response can help keep runners both motivated and protected.