Oscar Wilde once said, ‘Moderation is a fatal thing. Nothing succeeds like excess’. Some would say that, for elite athletes, ignoring this aphorism can only lead to failure. With the stoichiometric rise in the number of veteran athletes taking part in ultra-endurance exercise, it is apparent that a growing number of athletes are adopting Wilde's maxim with some impressive results. The winner of the 2011 Virgin London Marathon male 60–64 year age group clocked 3 h 3 min 25 s, while the 2010 New York Marathon male 70–74 year group winner ran 3 h 18 min 45 s! In support of the endurance obsession, we have recently published a case study of a 68-year-old male runner who had accurately recorded a total distance of 148 561 miles throughout 43 years of daily running.1 While we are assured that moderate intensity, duration and frequency exercise are positive for ciovascular health, can we be sure that running 7 min 30 s repeatedly over 3 h at 70 years of age or 150 000 miles throughout a 70-year lifetime is not damaging to the myocium? In essence, can one have too much of a good thing?

Ageing is associated with changes to the ciovascular system that reduce functional capacity. Regular endurance exercise training appears to slow this progressive decline, however; do such benefits apply …