By Dennis Thompson HealthDay , May 27, 2025 (HealthDay News) — Bodybuilders spend countless hours in the gym to create a heart-stopping physique.
Sudden cardiac death is responsible for an unusually high proportion of deaths in male bodybuilders, researchers reported today in the European Heart Journal.
Further, professional bodybuilders are five times more likely to fall dead from cardiac arrest than amateurs, results show.
“The risk of death among male bodybuilders is considerably high,” lead researcher Dr. Marco Vecchiato, a sports medicine specialist at the University of Padova in Italy, said in a news release. “Professional athletes had a markedly higher incidence of sudden cardiac death, suggesting that the level of competition might contribute to this increased risk.”
The research was prompted by “a growing number of reports of premature deaths among people involved in bodybuilding and fitness,” including many reports of cardiac arrest, Vecchiato said.
In a recent case, retired bodybuilder José Mateus Correia Silva went into cardiac arrest while working out at a gym in Aguas Claras, Brazil in November 2024, according to the New York Post.
Friends rushed Silva to a local fire station, but more than an hour of CPR failed to resuscitate 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 prior health conditions. “They were all very professional and provided all the support.”
For 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 for bodybuilding competition and oversees major international championships.
The team tracked the athletes’ health through July 2023, with an average follow up of more than eight years. During the study period, 121 bodybuilders died.
Nearly 2 in 5 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, results show.
Sudden cardiac death can occur even in apparently young and healthy people with no known heart disease, although such cases are rare, researchers said in background notes.
“Bodybuilding involves several practices that could have an impact on health, such as extreme strength training, rapid weight loss strategies including severe dietary restrictions and dehydration, as well as the widespread use of different performance-enhancing substances,” Vecchiato said.
“These approaches can place significant strain on the cardiovascular system, increase the risk of irregular heart rhythm, and may lead to structural heart changes over time,” he continued.
Indeed, 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.
Results also showed that professional bodybuilders had 5.2 times higher risk of sudden cardiac death than amateurs.
“The risk may be greater for professional bodybuilders because they are more likely to engage intensively in these practices over prolonged periods and may experience higher 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, particularly for the heart,” he added.
The study also found that about 15% of bodybuilder deaths were categorized as “sudden traumatic deaths,” including car crashes, suicides, murders and overdoses.
“These findings underline the need to address the psychological impact of bodybuilding culture,” Vecchiato said. “These mental health challenges sometimes worsen with substance abuse and can elevate 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.
“However, our findings are not an indictment of strength training or the 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.”
