Caution is needed when it comes to bodybuilding – Photo: PA
Recent studies have noted a worrying risk of sudden death in the bodybuilding community, particularly among professional athletes. For regular gym-goers, the warning signs are concentrated in the group using muscle-building supplements.
High risk for both professional and amateur bodybuilders.
A recent study published in the European Heart Journal surveyed 20,286 male athletes who had competed in competitions under the International Federation of Bodybuilding and Fitness (IFBB) over the past 20 years. During this period, the research team recorded 121 deaths, of which 46 were classified as sudden cardiac death, accounting for 38%.
The rate of sudden cardiac death among professional athletes is 193.63 cases per 100,000 athletes per year, compared to 11.84 in amateur athletes.
Notably, the 11 individuals who died suddenly from heart attacks while still competing had an average age of 34.7. This is the age of the deceased group, not the average life expectancy in bodybuilding. Some cases occurred during training or close to competition.
Dr. Marco Vecchiato, a sports medicine expert at the University of Padova, Italy, and the lead researcher, pointed out practices that can be dangerous: extreme strength training, strict dieting, rapid weight loss, dehydration, and the use of performance-enhancing substances.
“These practices can put significant stress on the cardiovascular system,” he told the European Society of Cardiology. He added that professional athletes may be exposed to these practices for longer periods, under pressure to achieve extreme physical fitness.
The risk also exists in women. A subsequent study by the Padova group, published online in October 2025, surveyed 9,447 female athletes and recorded 32 deaths, including 10 cases of sudden cardiac death.
The rate among professional female athletes is 53.98 cases per 100,000 athletes per year, compared to 2.48 in the amateur group. However, the low number of cases makes the estimate highly uncertain.
The cause is due to medication.
In searching for the cause of this alarmingly high rate of sudden death, the data focused on individuals using anabolic androgenic steroids, commonly known as AAS, to increase muscle mass. The 2024 JAMA study tracked 1,189 men found to be using AAS at Danish fitness centers, compared to 59,450 control subjects.
After about 11 years, the risk of death in the group using AAS was 2.81 times higher, suggesting that this drug may be one of the “culprits” leading to the high risk for bodybuilders.
Many bodybuilders pay the price for AAS – Illustration.
In 2025, a study in Circulation analyzed cardiovascular disease in the same Danish population. AAS users had a 3 times higher risk of myocardial infarction, a 2.26 times higher risk of arrhythmias, an 8.9 times higher risk of cardiomyopathy, and a 3.63 times higher risk of heart failure compared to the control group, after statistical adjustments.
Another study in JAMA Network Open in 2025 surveyed 164 recreational athletes, including current, former, and non-current AAS users.
Accordingly, those using AAS had more muscle and less fat, but the rate of carrying uncalcified coronary atherosclerotic plaques was 23.8%, compared to 10.3% in the non-using group. Longer cumulative use was associated with poorer heart function, suggesting that a toned physique may mask underlying abnormalities.
Risks associated with bodybuilding – Graphic: HUY DANG
The potential for recovery is still being studied. A 2025 study in Open Heart followed 32 AAS users and 13 strength training participants who did not use AAS and noted improvements in heart structure and function in those who stopped using it. However, the small sample size does not allow us to conclude that all damage is reversible.
Sudden death statistics also need to be interpreted cautiously. Athlete studies rely on publicly available death data, which may miss lesser-known individuals; limited autopsy records mean that some causes must be categorized indirectly.
For the average person, the American Heart Association affirms that appropriate strength training is beneficial for blood pressure, blood sugar, and blood lipids. A 2023 scientific statement, by expert Amanda Paluch of the University of Massachusetts Amherst and her colleagues, emphasizes gradually increasing exercise levels and assessing health when related medical conditions are present.
Dr. Vecchiato suggested increasing cardiovascular screening and counseling within the bodybuilding community, including young, healthy-looking individuals; and increasing education and control over performance-enhancing substances.
Source: https://tuoitre.vn/la-mon-tap-cho-khoe-nhung-the-hinh-co-ti-le-dot-tu-cao-den-dang-so-100261008100039967.htm
