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Yale-New Haven Hospital news release
Release date: July 18, 2006
Media contact: Mark D'Antonio, (203) 688-2493

Yale-New Haven surgeons link cardiac hazard with weight lifting, strength training

NEW HAVEN, Conn. — Cardiothoracic surgeons at Yale-New Haven Hospital, (YNHH) have determined that increased blood pressure due to heavy weightlifting can raise aortic wall stress to a level that produces a devastating cardiac event called aortic dissection in individuals who are susceptible because of pre-existing mild to moderate aortic enlargement. The study appears in the July on-line issue of the journal Cardiology.

The Yale-New Haven study is a follow-up to a 2003 study in which the YNHH team had identified five healthy young individuals who had suffered "aortic dissection" during weight lifting or strength training. Doctors discovered that during weight training, blood pressure, which is normally about 120/80, rose to as high as 300 during heavy lifting. The team concluded that the dramatic rise in blood pressure from intense training can rupture the internal wall of the aorta. Aortic dissection involves the splitting of the wall of the aorta, the largest blood vessel in the body, allowing blood under pressure to enter between the layers of the wall. The condition is lethal unless immediate diagnosis and surgery is carried out.

The most recent study examined 31 cases of aortic dissection related to weight lifting — all males between the ages of 19-76, with 21 of the 31 cases under the age of 50. The activities leading to aortic dissection were weight-lifting for strength training as well as heavy lifting in non-exercise settings.

John A. Elefteriades, M.D., chief of cardiothoracic surgery at Yale-New Haven Hospital, professor and chief, section of cardiothoracic surgery at the Yale University School of Medicine, spearheaded both the initial study, which appeared in the Dec. 3, 2003 issue of the Journal of the American Medical Association (JAMA), as well as the most recent follow-up study.

"The identification of these new 31 patient cases in which acute aortic dissection occurred during heavy weight lifting or other extreme exertion strengthens the causative association between these events. In the majority of these cases, the individuals affected were relatively young (mean age 47 years) and had no known prior history of cardiac disease," said Dr. Elefteriades. "We feel that pre-existing silent enlargement of the aorta is a prerequisite for the phenomenon of weightlifting related aortic dissection to occur. We found that wall stress in the aorta increases to dangerously high levels as the aorta enlarges."

However, added Elefteriades, "While we now feel we have firmer evidence to show the association between aortic dissection and heavy weightlifting, this is not a reason to avoid weightlifting and strength training, which can be healthy and beneficial."

The study recommends that greater care be taken by those who lift weights and have a history of aneurisms in the family, as well as individuals over the age of 40, whose blood vessels are less elastic and are unable to accommodate the strain weightlifting places. Most importantly, the team recommends that individuals engaging in heavy strength training undergo a painless, minimally invasive cardiac echo exam to rule out silent aneurysm. "In that way, the tragic loss of young lives can be prevented," Dr. Elefteriades said.

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Last revised: July 18, 2006 (dh)

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All information is intended for your general knowledge and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.