Yesterday, we witnessed some ABSOLUTELY SUPERHUMAN performances by Sebastian Sawe and Yomif Kejelcha, as both men RAN SUB-2 HOURS at the London Marathon. And to put this in perspective (and with the Disclaimer that “Nothing I say is Medical Advice”) I feel I’m immune to the lawsuits that would inevitably result if anyone tries the “Kejelcha Challenge” that I’m about to describe. (I feel like the least I can do is name this challenge after the “loser” who still ran a sub-2 hour marathon…Sawe gets his Gold Medal Glory).
Most treadmills at your local gym only go up to 12 mph, which is a 5-minute mile. That’s pretty quick for your average person, but it’s a mere warmup for elite athletes like Sawe and Kejelcha. But if you can find a treadmill that goes 13.1 mph, which is 4:33 mile pace, see how long you can hang. THAT’S THE AVERAGE PACE THAT these guys RAN FOR 26.2 miles…you probably can’t even make it 0.2, quite honestly, and that’s not a personal slight. It’s reality.
AND STILL, there has been criticism about the environment (a perfect day with a convenient tail-wind at various stretches of the race), modern and sophisticated training methods, and the equipment (customized carbon-fiber Super Shoes) that enabled these runners to pull of this otherworldly feat. But guess what? THEY STILL RAN THE FULL DISTANCE OF A MARATHON IN UNDER 2 HOURS.
Similarly, people often criticize both drug trials and people who employ pharmacological treatments to either improve their Home Security Systems or move to safer Lipid Neighborhoods. They will say things like, “Oh, that person lost weight and got healthy, but they had to use an incretin medication.” Good for them! They still lost the weight and got healthy…they just used a potent tool in the available toolbox to catalyze the process. And guess what? Life is a MARATHON, not a sprint, and if you are in need of some proverbial Super Shoes to run your best in Life’s Marathon, your time still counts. And it may even improve the time you’ve been allotted in the process when it comes to quality of those years.
Additionally, one of the limitations of cardiovascular clinical trials is that when a pre-specified number of clinical events (like heart attacks or strokes) are reached, the trial terminates. Consequently, the trial treats all participants, whether they were in the treatment group or the placebo group, like they died the moment the trial ended, which doesn’t give a realistic view of Life’s Marathon. This becomes particularly relevant if the person would have otherwise dropped out of the proverbial race without the pharmacologic “Super Shoes” given to them in the trial.
Now don’t get me wrong…not everyone needs medications to minimize cardiovascular risk across the lifespan. If you picked the right parents and pull the right levers from a lifestyle perspective, then you may very well be able to run your life’s race without the assistance of any prescription medications. But please don’t look down on people who may benefit from one of the many tools in our therapeutic toolbox that have proven effective at reducing heart attacks and strokes. Possessing an understanding of how these tools work and who might benefit is a key to effective preventive cardiology practice.
