Key result
Regular recreational running is associated with up to ~45% lower risk of cardiovascular mortality.
Why the study?
Running is associated with cardiovascular benefits, but the long-term effects and potential risks of prolonged, intensive high-volume endurance running remain uncertain.
Does running improve cardiovascular health and reduce cardiovascular morbidity and mortality in adults?
Does running improve cardiovascular health and reduce cardiovascular morbidity and mortality in adults?
Regular recreational running improves cardiorespiratory fitness and lowers cardiovascular and all-cause mortality even at low volumes, whereas the long-term clinical significance of potential risks from extreme endurance running remains uncertain.
Answers are grounded in this paper and cite their sources.
May support low-volume running for CV mortality reduction; leaves open long-term effects of high-volume endurance training.
Background: Running is an accessible form of aerobic exercise associated with cardiovascular benefits. However, the long-term effects of high-volume endurance running remain uncertain. Aim: To summarise evidence on cardiovascular adaptations and benefits of running, dose–response relationships, and potential risks of prolonged, intensive endurance training. Materials and methods: A narrative review of PubMed/MEDLINE literature from database inception to October 7, 2026, was conducted. Adult studies examining running in relation to cardiovascular adaptations, risk factors, morbidity, mortality, or complications were considered. Only publications with legally accessible full text were included. Evidence was synthesised thematically without meta-analysis. Results: Running was associated with improved cardiorespiratory fitness and lower all-cause and cardiovascular mortality, with benefits reported even at low running volumes. Aerobic exercise also showed beneficial effects on blood pressure, vascular function, and selected lipid parameters, although some findings were not running-specific. Potential concerns associated with high-volume endurance training included atrial fibrillation, coronary artery calcification, and transient cardiac biomarker elevations after marathons. Their clinical significance and long-term consequences remain uncertain. Conclusions: Regular recreational running is associated with substantial cardiovascular benefits and may support cardiovascular disease prevention. High training volumes are not necessary to obtain health benefits, while the long-term effects of extreme endurance running remain less certain. Training should be adapted to individual health status, fitness, and exercise tolerance.
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Krzyżaniak et al. (2026) conducted a review in Cardiovascular health and disease prevention. Running (recreational, competitive, marathon, or ultramarathon) vs. Non-runners or physical inactivity was evaluated on Cardiovascular adaptations, morbidity, and mortality. Regular recreational running is associated with improved cardiorespiratory fitness and up to a 33% to 56% lower risk of cardiovascular mortality compared with non-running.
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