A new study published in the European Heart Journal reveals that male bodybuilders, particularly those competing professionally, face a significantly higher risk of sudden cardiac death (SCD). Led by Dr. Marco Vecchiato of the University of Padova, Italy, the research investigated mortality among over 20,000 male bodybuilders who competed in International Fitness and Bodybuilding Federation (IFBB) events between 2005 and 2020.
Researchers identified 121 deaths among these athletes, with the average age of death being just 45 years. Notably, 38% of these were attributed to sudden cardiac death, a condition where individuals die unexpectedly due to heart-related issues. Professional bodybuilders had more than a fivefold increased risk of SCD compared to amateurs.
Autopsy reports and toxicology data revealed frequent findings of heart enlargement, coronary artery disease, and the use of anabolic substances. The researchers pointed to various bodybuilding practices—such as extreme strength training, strict dieting, dehydration, and performance-enhancing drug use—as major contributors to cardiovascular stress and structural heart changes over time.
Dr. Vecchiato emphasized that while bodybuilding promotes fitness and self-discipline, the competitive nature of professional bodybuilding can lead to unhealthy extremes. The pressure to achieve and maintain extreme physiques often drives athletes toward risky behaviors that can severely impact heart health.
The study also highlighted that 15% of deaths were due to sudden traumatic causes, including suicides, overdoses, and accidents—indicating potential psychological strain within the bodybuilding community. These findings suggest a need to address mental health alongside physical risks.
The authors call for urgent action from clinicians, sports organizations, and policymakers. Recommendations include enhanced cardiovascular screening, mental health support, education on drug-related risks, and stricter anti-doping measures. Dr. Vecchiato stressed the importance of shifting cultural norms in bodybuilding to prioritize long-term health over appearance.
The research team plans to expand their work by analyzing female bodybuilders and tracking trends over time. Ultimately, the findings serve as a warning that aesthetic appearance doesn’t always reflect internal health, especially in sports that push the body to extremes.
