The risk of dying from a heart attack during marathons has fallen by half in recent years, despite a surge in participation, according to a new study by Emory University. Published in JAMA, the research highlights improved emergency response—including widespread CPR and defibrillator use—as the key factor behind the decline.
The study, led by Dr. Jonathan Kim, analyzed cardiac arrest cases among 29 million U.S. marathon runners between 2010 and 2023. While the rate of cardiac arrests remained steady (0.60 per 100,000 participants), deaths dropped from 0.39 to 0.19 per 100,000. Kim attributed this improvement to faster access to life-saving measures: nearly all survivors received immediate CPR, and most had defibrillators nearby.
Men and marathon (vs. half-marathon) runners faced higher risks, mirroring trends from Kim’s 2012 study. The findings align with survival rate gains seen in airports and casinos, where defibrillators are commonplace.
“Every survivor we interviewed had CPR and usually a defibrillator nearby—that’s the difference,” said Dr. Kim. He emphasized the need for broader CPR training and strategic defibrillator placement at races, adding, “These deaths are often preventable. Better screening for cardiovascular risks could further reduce incidents.”
The study underscores how preparedness saves lives in long-distance running. Future research will explore ways to identify at-risk runners earlier, potentially preventing cardiac arrests before they occur.
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