High Risk of Sudden Cardiac Death in Male Bodybuilders, Especially Competitors

Recent research highlights a concerning pattern of sudden cardiac deaths among male bodybuilders worldwide, with the highest incidence observed in professional athletes. The study, published in the European Heart Journal, examined over 20,000 male bodybuilders who participated in official competitions from 2005 to 2020. The findings revealed 121 deaths, averaging 45 years of age, with sudden cardiac death accounting for 38% of these cases.

Sudden cardiac death refers to an unexpected loss of heart function leading to death, often linked to underlying heart conditions. While rare in healthy young individuals, it becomes more prevalent among those engaged in high-intensity sports and extreme physical practices.

The study was led by Dr. Marco Vecchiato of the University of Padova, Italy. He notes that although bodybuilding promotes fitness and discipline, it also involves practices that may jeopardize heart health. These include intense strength training, rapid weight loss via severe dieting and dehydration, and the widespread use of anabolic steroids and other performance-enhancing substances. Such activities place significant stress on the cardiovascular system, potentially causing heart thickening, enlargement, and coronary artery issues.

Analysis of autopsy reports from some cases indicated structural heart changes and signs of substance abuse. Importantly, findings indicated a more than five-fold increased risk of sudden cardiac death among professional bodybuilders compared to amateurs.

Dr. Vecchiato emphasizes that the increased risk tied to professional competition may stem from prolonged engagement in risky practices and higher performance pressures. He advocates for greater awareness, safer training methods, routine medical supervision, and policies to discourage the use of harmful substances.

The research also warns against equating muscular physique with health, warning that extreme body modification can mask underlying health dangers. About 15% of deaths were due to trauma, suicides, or overdoses, suggesting a need to address mental health and substance abuse issues within the bodybuilding community.

Overall, the study calls for proactive cardiovascular screening and a cultural shift towards safer practices, enhanced education, and stricter anti-doping measures in bodybuilding. This approach aims to protect athletes' health without discouraging the benefits of regular physical activity and strength training.

Source: https://medicalxpress.com/news/2025-05-male-bodybuilders-high-sudden-cardiac.html