Study Highlights Hazards of Triathlons

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

Deaths and nonfatal cardiac arrest are not rare among triathletes, particularly during the swim portion of the event, according to an Annals of Internal Medicine study.

Researchers identified 135 race-related deaths and cardiac arrests during U.S. triathlons from 1985 to 2016. Two-thirds of adverse events occurred during the swim, usually the first of the three legs. Roughly 85% of victims were male, and the mortality rate increased with increasing age. The incidence rate, calculated for events between 2006 and 2016, was 1.74 per 100,000 participants.

Among decedents with available autopsies, nearly half had cardiovascular abnormalities, most often atherosclerotic coronary artery disease.

Editorialists write: "Although preparticipation screening may not be popular in this older group of athletes, education (especially men older than 40 years) about the signs and symptoms of cardiovascular disease (including the use of performance-enhancing drugs) and the need for proper medical attention is warranted."