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 BODYBUILDING AND HEART RISKS





Professional male bodybuilders face a much higher risk of sudden cardiac death than you might expect, according to research published in the European Heart Journal in May 2025. The study, led by Dr. Marco Vecchiato from the University of Padova, Italy, found that heart-related deaths are alarmingly common among bodybuilders, especially those at the pro level. In fact, their risk is more than five times higher than that of amateurs.

Sudden cardiac death—an unexpected fatal heart malfunction—is rare in healthy-looking young adults. But in the world of bodybuilding, it happens too often. The research team compiled a list of over 20,000 male competitors from International Fitness and Bodybuilding Federation events between 2005 and 2020, then tracked deaths using news articles, forums, and social media, verifying each case with medical experts.

They found 121 deaths, with the average age just 45. Nearly 40% of these were sudden cardiac deaths. The causes? Often, a combination of heart enlargement, thickened heart walls, coronary artery disease, and, in many cases, evidence of anabolic steroid abuse. Professionals were far more affected than amateurs, likely because they’re more exposed to extreme training, harsh diets, dehydration, and performance-enhancing drugs—all of which put huge stress on the heart.

Dr. Vecchiato doesn’t want to demonize bodybuilding. The pursuit of physical excellence is admirable, but the drive for extreme, competitive physiques can come at a real cost. He says the sport needs a shift: a culture that values health over appearance, with safer training routines, stricter medical oversight, and zero tolerance for performance-enhancing drugs.

So, how do we make bodybuilding safer? Here are a few ideas:

  • Mandatory cardiac screenings for all competitors, not just the pros. Early detection of underlying heart conditions could save lives.

  • Regular drug testing and much harsher penalties for performance-enhancing drug use, combined with better education about the real risks.

  • Health-focused judging criteria at competitions—rewarding athletes for symmetry, proportion, and overall well-being, not just size and definition.

  • Stronger mental health support inside the sport, since about 15% of the deaths in the study were due to accidents, suicides, overdoses, or violence—often tied to the psychological toll of the bodybuilding lifestyle.

  • Ongoing research tracking both male and female bodybuilders, since practices and risks change over time.

The lesson is clear: a muscular body doesn’t always mean a healthy heart. Even the fittest-looking athletes can be at serious risk if the culture around them encourages dangerous extremes. While bodybuilding and strength training are still great for long-term health when done safely, the community—and the industry—need to take a hard look at the pressures and practices that put lives at stake.

By shifting the focus to health, prevention, and smarter rules, bodybuilding can honor its roots in strength and discipline while protecting the athletes who push its limits.

 

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