Bodybuilders have a higher risk of experiencing sudden cardiac death

NEW YORK (HealthDay News)—Bodybuilders spend countless hours in the gym to create killer physiques. But their efforts put their own hearts at risk of stopping, according to a recent journal study.

Sudden cardiac death is responsible for an unusually high proportion of deaths in male bodybuilders, researchers reported in the European Heart Journal.

Furthermore, professional bodybuilders are five times more likely to die from cardiac arrest than amateurs, the results show.

“The risk of death among male bodybuilders is considerably higher,” lead researcher Dr. Marco Vecchiato, a sports medicine specialist at the University of Padua, said in a press release.

“Professional athletes had a markedly higher incidence of sudden cardiac death, suggesting that the level of competition may contribute to this increased risk,” he warned.

The investigation was prompted by “an increasing number of reports of premature deaths among people involved in bodybuilding and fitness,” including many reports of cardiac arrest.

The most recent case

In a recent case, retired bodybuilder José Mateus Correia Silva suffered a cardiac arrest while working out at a gym in Aguas Claras, Brazil, in November 2024, according to The New York Post.

Friends took Silva to a local fire station, but more than an hour of CPR failed to revive the 28-year-old, according to NDTV.

“I want to thank the entire team that tried to save his life,” his brother Tiago said in a statement, also noting that Silva had no pre-existing health conditions. “Everyone was very professional and provided full support.”

In the study, researchers identified 20,300 athletes who participated in International Federation of Bodybuilding and Fitness competitions between 2005 and 2020. The IFBB is the governing body of bodybuilding competition and oversees major international championships.

The team tracked the athletes' health until July 2023, for an average duration of eight years. During the study period, 121 bodybuilders died.

Nearly two in five bodybuilders (38%) died from sudden cardiac death, a condition in which the heart stops abruptly. Disturbingly, 11 of those sudden cardiac deaths occurred in competing athletes with an average age of just under 35, the results show.

Sudden cardiac death can occur even in apparently young, healthy people with no known heart disease, although such cases are rare, the researchers noted in background notes.

“Bodybuilding involves several practices that could have an impact on health, such as extreme strength training, rapid weight-loss strategies that include severe dietary restrictions and dehydration, and the widespread use of various performance-enhancing substances,” Vecchiato noted.

“These methods can put significant stress on the cardiovascular system, increase the risk of irregular heart rhythms, and could lead to structural heart changes over time,” Vecchiato said.

In fact, autopsies of five bodybuilders found that four suffered from an enlarged heart and thickening of the heart muscle, conditions that make heart failure more likely.

“The risk may be higher for professional bodybuilders because they are more likely to engage in these practices intensively for extended periods and may experience greater competitive pressure to achieve extreme physiques,” Vecchiato said.

“For bodybuilders, the message is clear: While striving for physical excellence is admirable, the pursuit of extreme body transformation at any cost can carry significant health risks, especially for your heart,” he added.

The study also found that about 15 percent of bodybuilder deaths were classified as “sudden traumatic deaths” and included car accidents, suicides, murders, and overdoses.

“These findings underscore the need to address the psychological impact of bodybuilding,” Vecchiato said. “These mental health issues are sometimes exacerbated by substance abuse and can increase the risk of impulsive or self-destructive behaviors.”

The team is now working on a similar study focused on female bodybuilders.

“More broadly, the research challenges the idea that appearance alone is an indicator of health and highlights the hidden risks that can exist behind even the most sculpted physiques,” Vecchiato said.

“But our findings aren't an indictment of strength training or fitness culture in general,” Vecchiato added. “On the contrary, regular physical activity and strength training can be extremely beneficial for health, quality of life, and mortality risk.”