Run Well by Juliet McGrattan (reading books for 5 year olds .TXT) 📕

your risk. Immediate family, such as your parents and siblings, are called first degree relatives and their medical history has the biggest influence on yours. Because your dad had his heart attack when he was less than 55 years old (it would be less than 65 if it was your mum), then you are classed as having a strong family history of heart disease and we know this puts you at increased risk.

You can’t change your genetics, but you can change your environment through making healthy lifestyle choices. Family history is only one risk factor for heart disease. Others include smoking, type 2 diabetes, high blood pressure, high cholesterol and being inactive or overweight. Remember that regular exercise such as running is a very powerful tool for reducing all of these risk factors.

Your family history certainly doesn’t mean that you shouldn’t run, but it would be sensible for you to take some steps to have your personal risk formally assessed. If you are aged between 40 and 74 then you can have this done during an NHS health check at your local GP practice. Your blood pressure, weight, blood cholesterol and blood sugar will be checked to help identify risk factors that need treatment, and you will be given lots of advice. If you have never run before, due to your strong family history, I suggest a check before you begin. However, if you are already running regularly then don’t stop, but make a routine appointment.

Q Why do some people die suddenly in marathons? What are the risks?

A A death during a marathon is always tragic, but be reassured that it is rare. The New England Journal of Medicine published a study in 2012 assessing cardiac arrests during marathons and half marathons in the USA between 2000 and 2010. In the races studied there were 10.9 million runners and 59 cardiac arrests, 42 of which were fatal. This means that approximately one person in 260,000 died from a cardiac arrest in the population studied. According to a table of everyday risks in the British Journal of Medicine, we have a one in 250,000 risk of being hit in our own home by a crashing aeroplane. There were more cardiac arrests in the marathons than the half marathons and more in men than women. Most of the cardiac arrests were due to cardiovascular disease (more common in the older runners) and to hypertrophic cardiomyopathy (HOCM). This is an inherited condition where the heart wall becomes thickened. There are often symptoms of breathlessness, palpitations and chest pain, but it’s a common cause of sudden cardiac death in those under 35 years old. If a diagnosis of HOCM is made, then genetic testing and screening may be offered to close relatives. Some sporting organisations screen their young athletes for HOCM. Remember that not all cardiac conditions that cause sudden death can be detected.

A narrative review of the literature, including the study above, was published in a journal called BMJ Open in 2019. It looked at deaths during or within 24 hours of completing a marathon (no other race distances were included). This found the risk of death to be approximately one per 102,000 in men and one per 244,000 in women. The conclusion was that the risk of death from participating in a marathon is small, higher for men and greatest in the final few miles of the race.

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AT HOME

First aid

Consider going on a first aid course to learn basic life support. A few hours of your time could save a life in the future. Find a course near you and book a place. St John’s Ambulance runs first aid courses up and down the country.

Q What should I do if the runner in front of me during a race collapses?

A Stay calm and follow these basic life support steps:

1 Check it’s safe. Look after yourself first. Don’t trip yourself or others up in a bid to reach the casualty.

2 Call for help. Shout to other runners or a nearby marshal to help you.

3 Talk to the runner. Perhaps they’ve just gone down with a severe leg cramp rather than a cardiac arrest. If they can talk and tell you what’s going on, then you can assist them to get the help they need. If they’re talking but delirious and not making sense, then lie them on their side in the recovery position. Keep talking to them while you summon medical help. Ask them if they have any medical conditions and check the back of their running bib or any medical alert jewellery (bracelets, shoe tags or necklaces) for this information too.

4 Check for breathing. If they aren’t responding when you talk loudly and directly to their face while gently shaking them, then they are unconscious and this is an emergency. You need to see if they are breathing normally, so roll them onto their back and open their airway by gently tipping their head back with one hand and lifting their chin with the other. Now LOOK, LISTEN and FEEL for signs of breathing for up to 10 seconds. If they are breathing normally, then put them in the recovery position and keep checking them while you call and wait for the paramedics.

5 If they aren’t breathing normally. If they are unconscious and not breathing normally, then there are three things that need to happen:

• You need to dial 999 and state that the casualty is not breathing.

• You need to locate an AED (Automated External Defibrillator). The emergency services call handler will tell you where one is located if you don’t know. Race marshals may be able to radio to base to summon one.

• You need to start chest compressions.

If you are on your own, then carry out these steps in this order. Defibrillation is the priority. If you have people around you that can help, then all three can happen simultaneously. You can tell someone to call an ambulance and another to