Firstly, we would like to thank you for completing the online medical questionnaire as part of your registration. This information is extremely useful to us in planning a safe race. As previously mentioned, we would like to assist you in reducing the risk of injury or medical complications while exercising. For those who have not managed to complete the medical questionnaire online whilst entering, we urge you to complete the said at the following link in order for us to have your records at hand on race day. Click here

Heart disease or blood vessel disease
Some of the most important and serious medical complications during exercise are related to underlying heart and blood vessel disease. A range of potential complications in the heart and blood vessels can occur during exercise. This could vary from feeling dizzy to collapsing and developing a non-fatal or a fatal heart attack. Therefore, there are several important safety concerns for runners who have risk factors for heart and blood vessel disease, as well as for runners who already suffer from underlying heart and blood vessel disease. This edition of the newsletter is devoted to giving advice to those of you who have known heart and blood vessel disease or have underlying associated risk factors.

Running with known heart or blood vessel disease
A number of Two Oceans athletes have indicated that you currently suffer from heart or blood vessel disease. Regular exercise, including running, is an important component of the treatment of patients with existing heart disease. However, it is important to realise that if you have heart disease, there is also an increased potential risk of developing a serious medical complication during exercise. In order to reduce the risk of a medical complication during training or on the day of the race, we suggest the following:

• Every runner with known heart or blood vessel disease must undergo a full and comprehensive medical evaluation of the heart and blood vessels’ response to exercise, by a qualified medical doctor
• This medical evaluation should include a history of any symptoms you may have, a comprehensive physical examination, and at least an exercise test during which your heart’s response is monitored through an electrocardiogram (ECG) (also known as a stress ECG)
• This medical evaluation should be conducted at least once a year and more frequently if you develop new symptoms
• All your risk factors for heart disease should be well controlled (see below)
• Be aware of the following symptoms that may develop during exercise: chest pain, a pressure feeling in the chest, dizziness, excessive shortness of breath, sudden fatigue, abnormal heartbeat, pain in the jaw or left arm that is not explained, and sudden nausea or vomiting
• If any of the above symptoms develop during or immediately after exercise, please seek medical attention urgently

What are the risk factors for heart and blood vessel disease?
The main risk factors for heart and blood vessel disease include the following:

• Abnormally high lipid (fat) levels in the blood (hyperlipidaemia)
• Obesity
• High blood pressure
• Cigarette smoking
• A family history of heart disease at a young age
• Physical inactivity (not applicable if you are a regular exerciser)
• Diabetes mellitus (sugar sickness)

Running with risk factors for heart and blood vessel disease
From the information we received in the medical questionnaire, approximately 16% of runners indicated that they have one or more risk factors for heart and blood vessel disease. If you are one of these runners, it is suggested that you consult with your medical practitioner to identify if these risk factors are well controlled, and that you have no active underlying heart disease. This is particularly important if you are a male runner over the age of 45 years, or a female runner over the age of 55 years. Please note, you should not continue to exercise if you have any of the symptoms of heart disease (listed above) until cleared by your doctor to do so.
We trust that this information is of value to you. Please make sure that you read the suggestions carefully, and contact your medical doctor to perform the full medical evaluation as suggested.
We wish you safe and enjoyable training and racing over the next few months.

The Medical Team