Abstract

Sudden Cardiac Death (SCD) is the leading non-traumatic cause of death in young athletes. Bodybuilding is a sport discipline that exposes the athlete to a series of health risks, including SCD, although studies investigating the associated mortality risk are lacking.The objective of this study was to analyze mortality data in a large worldwide population of male bodybuilders.Male athletes who performed in competitions of the International Federation of Bodybuilding and Fitness (IFBB) between 2005 and 2020 were identified by an unofficial but extensive database as well as the event-results of the official IFBB website. A standardized web search tailored to detect deaths was performed for each athlete with specific keywords, providing a follow-up analysis through July 2023.A total of 19'411 athletes were identified. During the study period, 121 deaths were reported. The leading cause of death was from cardiovascular diseases, with 35 (29 presumed or confirmed SCD detected. The incidence of SCD was 21 cases per 100'000 athletes per year (AY). Although master athletes (gt;40 years) had a higher mortality rate than younger athletes (119 vs 60 per 100'000 AY; p=0.001), no differences in incidence rate of SCD were shown (21 vs 22 per 100'000 AY; p=0.912). Professional bodybuilders had a higher risk of SCD than amateurs (180 vs 11 per 100'000 AY; plt;0.001).The risk of SCD is considerably high in bodybuilding athletes, particularly when compared with other sport specific mortality rates. The outcomes obtained from this study should alert the bodybuilding but also medical community, leading to a collective "call for action" to implement and improve preventive measures for the promotion of safe sport participation. Table 1  Figure 1