HINTERGRUND
Bei vielen Marathonveranstaltungen kommt es zu Zwischenfällen - zum Teil mit Todesfolgen. Daher führen wir derzeit die weltgrößte Untersuchung zu gesundheitlichen Aspekten des Marathonlaufens durch.
In einer Vorstudie konnten wir nachweisen, dass es im Rahmen eines Marathons - im Vergleich zum Mitteldistanz-Triathlon und Langdistanzradrennen - zu einer gesteigerten Aktivierung der Blutplättchen (Thrombozyten) kommt (Hanke et al.: Eur J Med Res. 2010 Feb 26;15(2):59-65). Durch diese Aktivierung könnten Gefäßverschlüsse erklärbar sein - also ein möglicher Grund für einen plötzlichen Herzinfarkt. Eine denkbare Konsequenz wäre es, die Blutplättchen mittels ASS (dem Wirkstoff von Aspirin) zu blockieren. Dies wird sogar von einigen Ärzten für Läufer über 40 Jahren empfohlen (Siegel AJ: Am J Med. 2013 Dec;126(12):e47). Leider gibt es jedoch wenig Daten, die einerseits diese Empfehlung untermauern und andererseits mögliche Risiken durch Aspirin beim Marathonlauf aufdecken.
Fasst man Aspirin in der Gruppe von Schmerzmedikamenten zusammen, so kann man in der Literatur finden, dass bereits viele Marathonläufer (56% !!!) diese vor dem Rennen einnehmen (Küster et al.: BMJ Open. 2013 Apr 19;3(4)). Dabei würde sich das Risiko vor allem für Probleme des Magen-Darm-Traktes deutlich erhöhen. In einer Kontrollstudie unsererseits beim Hannover Marathon waren die Zahlen der Schmerzmitteleinnahme deutlich geringer (Paper under submission). Um einerseits sicherere Zahlen für Einnahmehäufigkeit wie auch andererseits bessere Daten für mögliche Risiken von Medikamenten während des Marathonlaufes zu ermitteln, führen wir die 2016 Marathon Study durch.
Wichtig ist es dabei, nicht nur Marathonläufer zu befragen, die Medikamente einnehmen, sondern ebenso Läufer, welche ohne Medikamente - laufen. Daher bitten wir alle Marathonläufer, an unserer Studie teilzunehmen, um unseren wundervollen Sport ein wenig sicherer zu machen.
Herzlichen Dank und immer ein gesundes Finish!
PD Dr. Alexander Hanke und Team
BACKGROUND
In many marathons it comes to serious incidents - even deaths during races are regularly reported. For this reason we perform the world´s largest study on health effects of marathon running.
In a prestudy we were able to show a running dependent platelet activation - when compared to mid distance triathlon and long distance cycling (Hanke et al.: Eur J Med Res. 2010 Feb 26;15(2):59-65). According to this activation sudden heart strokes caused by vascular closure might be explicable. One possible consequence would be administration of ASA (the active substance of Aspirin) to reduce platelet aggregation. Ingestion of ASA is recommended by some authors for runners over 40 years of age (Siegel AJ: Am J Med. 2013 Dec;126(12):e47). However, there are few data only to support such a recommendation.
If you add ASA into the group of analgesics you can find a high incidence of ingestion by marathoners before the race - up to 56%(!) (Küster et al.: BMJ Open. 2013 Apr 19;3(4)). A follwed higher risk of gastrointestinal adverse events is described. In a control study we found the incidence of analgesics intake much lower (paper under submission). To gather better information on incidence of medication intake on the one hand and on side effects of such a medication on the other hand we perform the 2016 Marathon Study.
It is very important to include both groups of runners: runners with medication intake and runners without any medication. So we kindly ask all marathoners to participate in the study to make our wonderful sport a bit safer.
Thank you and a safe and healthy finish at all times!
PD Dr. Alexander Hanke and team
Marathon Survey – Questionnaire details
The following questions were to be answered during the survey.
Personal Data
- Sex
- Age (in years)
- Weight (in kg or in american pound (lbs) - please specify)
- Height (in cm or in feet/inches - please specify)
- Country of origin
- Do you smoke?
- Do you drink alcohol?
Training Data
- How many years are you practicing active running?
- How long have you been running marathons (in years)?
- In how many marathons did you participate?
- How many km do you run in a week?
- How often do you train? (times a week)
- Do you practice other sports?
Medication
- Do you suffer from a disease? If yes, which?
- Did you already run a marathon after intake of analgesics (for example ASA,
Asperin, ibuprofen, diclofenac ...)?
- Which painkillers did you take?
- How many times did you run a marathon after intaking painkillers?
- When did you take the pain medicine? (until xxx days before the run - 0 means raceday)
- Was the reason for the painkiller intake EXISTENT pain?
(If so, which pain?)
- Have you taken the painkiller for PREVENTION of pain? (If so, for which pain?)
- Have you taken the painkiller to improve performance?
- Have you taken the painkiller for PREVENTION of a disease? (If yes, which?)
- Have you taken the painkiller for THERAPY of a disease? (If yes, which?)
- Have you taken the painkiller for the following other reasons?
- Was the pain medication prescribed by a doctor?
- Do you otherwise take pain medication on a regular basis?
- Do you take other medications than pain killers? (If yes, which?)
Side Effects
- Did after the marathon one or more of the following symptoms show up?
[Dizziness, Nausea, Vomiting, Heartburn, Tinnitus, Blurred vision ,Stomach pain, Bleeding from the stomach / intestines, Stomach ulcer, Liver dysfunction, Gout attack, Asthma, Shortness of breath, Anemia, Bleeding into joints, Swelling of joints, Hematoma (bruising), others (specify)]
- If hematoma, where?
- Did it come to temporary absence from work because of the adverse event?
- Have you been in medical treatment because of the adverse event?
- Was hospitalization required due to the adverse event?
Personal judgement
- How serious (dangerous) do you think is the use of painkillers before a marathon? [very serious, serious, little serious, not serious]
- Would you (again) take a painkiller before a marathon?