Hi Austin!
Hope you are doing well, I am 36 years old and I was wondering if Powerlifting and long distance running (like marathon) can increase heart-thickness in a dangerous way or on dangerous level like Hypertrophic Cardiomyopathy (HCM) or Heartfibrosis even if one has been natural in their entire life?
Thank You and Kind Regards, Imran
Hey Imran,
I’m not Austin, but this is a good question, and the short answer is no, not really.
Hypertrophic cardiomyopathy is primarily a genetic disease caused by inherited mutations. Exercise doesn’t give you HCM. While training does thicken the heart somewhat, and in rare cases that adaptation can look enough like mild HCM to complicate imaging, the training isn’t creating the disease. If HCM runs in your family, that’s a screening question for a cardiologist about something you were born with. .
The fear about heart thickening from lifting is old, and mostly related to the telephone game gone wrong. In the 1970s researchers saw thicker heart walls in strength athletes and figured the blood pressure spikes under a heavy bar were thickening the heart the way chronic high blood pressure does. It was a reasonable guess built on crude ultrasound. The lead author, Morganroth, actually warned against overinterpreting cardiac imaging of athletes because they might look ‘weird’. Anyway, when cardiac MRI finally tested it properly, resistance training didn’t change the heart much at all. Endurance training remodels it more, and harmlessly.
So for a natural 36-year-old doing both, there’s not really a meaningful risk of dangerous thickening or of causing HCM or fibrosis. The heart changes you’d get are the benign, expected kind. We did a whole episode on this if you want the full discussion.
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