For most of us, preventing heart disease depends largely on our lifestyle, which means there's much that's in our power to maintain cardiovascular health while bodybuilding.
Despite fit looking physiques being portrayed as examples of optimized health, the reality is that bodybuilding is one of the most unhealthy things you can do from a cardiac perspective.
Therefore, I highly suggest you take extreme precautions to monitor your cardiovascular health while bodybuilding so you are fully aware of when your health markers become suboptimal, or even dangerous, and how to minimize the chances of that occurring.
When it comes to bodybuilding, even if you take a bunch of performance enhancing drugs, if your blood pressure and your cardiovascular system is maintained, it's actually relatively difficult to really screw yourself up via other things.
Cardiovascular health is the main thing you need to worry about in bodybuilding.
To be clear, I'm not saying that other things aren't important.
I'm just saying that, in general, the thing that's going to get you in bodybuilding is heart disease.
Steroids, HGH, eating a ton of food, increasing your body weight and having much more muscle than the average human are all things that will put a massive strain on your heart, consequently enlarging it and thickening its walls.
Cardiovascular health is the main concern here.
There are a handful of tests I believe are absolutely mandatory to maintain cardiovascular health while bodybuilding, and I highly recommend you get them all done fairly regularly.
Table of Contents
This is the most basic of health assessments.
Unfortunately, most bodybuilders don't even get this done regularly.
Blood work is an absolute no brainer and I highly recommend you get my recommended blood panel done via Private MD Labs at least a couple times per year.
Ideally, you would get this more frequently, especially if you are cycling on and off of harmful performance enhancing drugs.
You want to see what your state of health is like on-cycle, as well as off-cycle.
The more you can see your blood work, the more of a complete picture of your state of health you will get on average throughout the year.
Blood pressure is extremely important.
Weighing more than you should will already negatively influence your blood pressure, but adding heavily aromatizing drugs into the mix that cause severe water retention will commonly spike your blood pressure through the roof.
When I was younger and didn't understand Estrogen management, I would literally get nose bleeds at work as a bouncer downtown just standing in one spot because my blood pressure was so high.
You want your blood pressure to be no higher than 120/80 at all times, year-round.
Anytime you're getting over 130-139/80-89, you're in stage one hypertension, and at that point, you're hurting your kidneys.
That's how guys down the line end up with renal failure and are stuck on dialysis forever to survive.
Most bodybuilders will brush off blood pressure readings slightly above 120/80 that aren't considered hypertensive, when they shouldn't.
Anything above 120/80 puts stress on your cardiovascular system, and will encourage clotting, heart attacks, and strokes.
Check your blood pressure constantly, especially if you are on cycle and aren't sure if the compounds you are using are compatible with your body or not.
Buy a high quality blood pressure monitor and check your blood pressure literally every day like you check your weight on the scale until you have a comprehensive understanding of what your blood pressure is like in response to your different lifestyle factors.
If the cuff is too small for your arm, buy a larger cuff to go with the monitor to ensure you get an accurate reading.
The one I linked will fit your arm if it is between 9-17 inches in circumference unflexed.
Resting Heart Rate And Tachycardia
You also want to be checking your resting heart rate.
A lot of guys are walking around with borderline tachycardia (resting heart rates over 100), which is super unhealthy.
Many argue that heart rate is not important as long as you are under 100 beats per minute, but the reality is that the lower your resting heart rate is, the better indicator it is of your health.
I don't think it's a coincidence that marathon runners, cyclists and people who have really great cardiovascular endurance have super low heart rates.
For example, Lance Armstrong's resting heart rate was 32 beats per minute when he was in peak condition, which is insane.
The less hard your heart has to work to pump blood and oxygen around your body, the less stress is on it, and the longer you're going to be free of cardiovascular disease.
Which Lab Tests To Get?
As far as tests you want to get done, you definitely want to get EKG at least once a year if you're a young guy, and then if you're a bit older, maybe twice a year.
An EKG records the electrical signals in your heart and is a great way to detect heart problems and arrhythmias.
These were the results from my last EKG.
I highly recommend you get an echocardiogram to check your cardiac output, assess any heart thickening and overall hypertrophy, as well as the size of your left ventricle.
Even for guys who don't take steroids, if you lift weights, in general you're probably going to have some degree of left ventricular hypertrophy.
And if it gets bad enough, you will be inhibiting the output of your heart.
You need to keep an eye on that, you need to check for heart thickening and overall size.
This is the number one test that is commonly overlooked by bodybuilders and would indicate progression towards heart failure.
There are so many bodybuilders who are health conscious but are delusional by believing that blood work and donating blood will keep them healthy, despite walking around with 100 pounds more muscle than the average male.
If these guys had echocardiograms done, they would have seen how much stress their heart was under well before it got bad enough that they had a major cardiac event.
This is something that won't be detected by a blood test.
You can have perfect blood work, blood pressure, donate blood often, but still have a heart twice as large as it should be and drop dead because you failed to get an echocardiogram.
Cardiac CT Scan
Cardiac CT scan is something I wouldn't hesitate to recommend either.
Get a scan of your heart arteries, check your blood flow to the heart, and ensure it's getting enough oxygen and overall blood flow.
This scan assesses if you have any blockages in your vessels or not.
You want to check for arrhythmias and blockages, as these are often manageable issues that can cause sudden death if they aren't addressed early.
Therapeutic Phlebotomy (If Needed)
I recommend that you get regular bloodwork and see where your red blood cell count and hematocrit levels are at.
If these are out of range, you will have thick sludgy blood which clots really easily.
This is why so many cyclists who abused EPO dropped dead from cardiac events.
Anabolic steroids will increase your red blood cell count and hematocrit in the exact same way.
While this is typically indicative of using dosages higher than one should be in a therapeutic context, there are some individuals who can't maintain healthy levels even on legitimate therapeutic dosages of TRT.
It would be wise to explore whether or not blood removal via therapeutic phlebotomy is something you could benefit from to thin out your blood and decrease the viscosity of the blood itself.
These bodybuilders did their bloodwork, they checked their blood pressure, they would go donate blood every eight weeks, and they thought they were covering their bases and staying healthy.
But something that is often overlooked is that if you are walking around with 260+ pounds of muscle, your heart has to work so much harder to pump blood and oxygen to all that muscle tissue.
This puts enormous amounts of stress on the heart, and increases the size of it.
The less hard your heart has to work, the better.
The more weight on your body, the harder your heart has to work.
Believe it or not, the heart is actually more stressed in a 300 pound bodybuilder who is lean than in a 300 pound fat guy, because muscle requires more blood and oxygen than fat tissue.
Get A Cardiologist Who Has Experience With Bodybuilders
I recommend that you find a cardiologist who works with athletes, and ideally bodybuilders too.
These doctors will know how to interpret tests with much greater accuracy for your specific needs, and are also much more likely knowledgeable of what tests you will need done in the first place.
Most general doctors will shame you for bodybuilding and will refuse to even check your health markers until you stop bodybuilding.
You should find a doctor who works with bodybuilders and is willing to work with you regardless of your lifestyle choices.
Get Health Insurance
If you don't have it, definitely get health insurance.
Especially if you're bodybuilding, if you have a cardiac event the last thing you want to think about is if you should go to the hospital or not because it's going to cost you a lot of money.
This is not something you want to have to worry about.
You want to be able to get any health concerned addressed as quickly as possible.
I literally have heard of guys avoiding going to the hospital with infections from injections because they didn't want to pay the bill for the visit.
If you have an infection, you need to get on antibiotics as soon as possible, not be staying home hoping it heals itself because you don't want to pay for a hospital visit.
If you can't afford health insurance or proper health care, then you shouldn't be bodybuilding in the first place in my opinion, as it is far too risky.
Health Supplements I Use And Recommend
Citrus Bergamot improves cholesterol levels and has shown to increase high-density lipoproteins (HDL, AKA the “good” cholesterol) while lowering low-density lipoproteins (LDL, AKA the “bad” cholesterol).
I use 1500 mg of Jarrow Formulas Citrus Bergamot per day.
When you're on gear, even if you're just on TRT, it's quite likely that you have suboptimal lipid profile.
Steroids will tank your HDL, it is nearly unavoidable, even on TRT.
Anything anabolic will very likely hinder your lipid profile to some extent, even SARMs.
I highly recommend Citrus Bergamot.
I get about 10 to 15 grams of fiber in the psyllium husk itself.
You can adjust the dose depending on how much fiber you get in your diet, but mine's pretty deficient.
Psyllium husk provides a combination of insoluble and soluble fiber, which is very beneficial for gut health and optimal digestion.
Not only does it improve your digestion so you can process nutrients better, but it also sweeps bad cholesterol from the digestive tract, which will lead to improved cardiovascular health.
Maintaining an optimal lipid profile is critical to cardiovascular health while bodybuilding.
It also helps you feel full longer if you're dieting, which is a fringe benefit.
Curcumin is the main active ingredient in turmeric.
It's a really powerful anti-inflammatory and a strong antioxidant.
It reduces the risk of high cholesterol, chronic joint pain, and other inflammation-related issues.
I'm not going to make a scientific claim here, but there's evidence showing that it can lower cancer risk by quite a bit.
In East Indian culture, they have a lot of food with turmeric on it, and the people who eat those foods a lot have been found to have very low cancer rates.
They credit it to turmeric itself.
I take 2 Doctor's Best Curcumin from Turmeric Root pills every single day.
One thing to note about turmeric/curcumin, you want to make sure it comes with Bioperine in it, which is black pepper extract.
It enhances the bioavailability of curcumin by 2,000% [R].
I can't underplay how important digestion is, and this is something I didn't take seriously when I first started bodybuilding.
Probiotics help your digestive system work properly by aiding in the digestion of fats and complex carbs.
I don't know how common it is, but some people have such bad gut health that they can't even lose fat in a calorie deficit simply due to the environment of their digestive system.
Often, this scenario can be improved by adding in a fiber supplement and a good probiotic supplement.
Keep in mind that these needs can also be fulfilled via whole foods.
Most individuals just won't do that though and prefer to go the supplement route.
I use 1 capsule per day of the probiotic supplement NOW Probiotic-10.
It is known by many bodybuilders and athletes that omega-3 fatty acids can help you gain muscle, lose body fat, and prevent injuries.
But don't opt for whatever you can find, you want to look at the concentration of EPA and DHA and find the highest one possible.
You also want to avoid brands that are notorious for selling rancid old omega-3's.
I make sure I get at least 4 grams of high quality fresh omega-3 fatty acids in per day.
I usually opt for Nordic Naturals ProOmega.
Omega-3 keeps your blood thinner as well, and for somebody who needs to maintain cardiovascular health while bodybuilding having a hardy dose of EPA and DHA every day can be a major key for keeping your blood viscosity at a healthier level.
Ubiquinol (Not Coenzyme Q10)
Coenzyme Q10 (CoQ10) is an antioxidant naturally made in the body.
A deficiency in it can lead to heart failure, chest pain and high blood pressure.
As you get older, the levels in your body decrease, and supplementation becomes a necessity.
This is fine when you're younger, but as you get older, your body doesn't convert CoQ10 into Ubiquinol as easily, which is the end stage antioxidant that actually matters.
This is why I highly recommend that you opt for Ubiquinol instead of CoQ10.
I have 400 milligrams of Jarrow Formulas Ubiquinol per day.
I used to take 200 mg per day, but I heard a story of a bodybuilder who was on a heart transplant list who mega-dosed Ubiquinol at 1500 mg per day and actually got himself off the heart transplant list and significantly reversed his heart damage.
After hearing that story, I bumped my daily dosage up to 400 mg per day.
Hawthorn Berry Extract
I take 2 Now Hawthorn Berry Extract capsules per day because it has shown to be useful in combatting heart damage.
It is primarily used to treat ailments related to the heart and blood vessels, and it has been shown to have a positive effect on heart health and blood circulation.
It is a preventative measure for people with impaired cardiac function and has shown to be really useful for people in early-stage heart failure.
Several double-blind studies have shown patients with early stages of cardiovascular disorders experiencing increased physical endurance and improved cardiac function after using standardized hawthorn berry extract for a few weeks.
It has shown to also be useful in angina prevention.
This is a bit more obscure of a supplement, but its benefits align perfectly with what we need to maintain cardiovascular health while bodybuilding, hence why I use it daily.
A quality Multivitamin is literally the bare minimum you should be taking if you don't want to get any of the other stuff.
Usually, brands you find in grocery stores are not the best ones.
They're mainstream marketed and typically do not feature efficacious dosages.
Some supplement companies actually have really good multivitamin formulas, you just need to look around and know what your needs are.
So far, Nutrex Research Vitadapt has been my favorite.
It is extremely comprehensive, uses efficacious dosages, and also features the highest quality standardizations of each specific vitamin and mineral in the formula.
I take 3 tablets per day, and make sure every one in my family does the same.
With that being said, I believe that most of the other supplements I mention in this article should not be overlooked, and can be critical in sustaining cardiovascular health while bodybuilding.
Numerous studies have shown that Vitamin K2 has unique positive effects on cardiovascular and bone health.
The reason I use it is because I do not get enough of it in my diet (most don't) and it is crucial for arterial calcification prevention.
Vitamin K2 has shown to help prevent coronary artery calcification, as well as even reverse it.
I take 1 Jarrow Formulas K-Right softgel per day right now.
Astragalus has many effects on the cardiovascular system.
It has the ability to reduce blood pressure.
It also reduces hardening of the arteries, cholesterol absorption and plaque build up.
These are all major factors that increase your risk of stroke and heart disease, and should be kept in check to maintain optimal cardiovascular health while bodybuilding.
It is also possible that it improves cardiac contractions, generally strengthening your heart and its ability to pump.
The reason I use it is because Astragalus is virtually the only compound that research shows can regenerate Kidneys, as well as greatly lower creatinine and raise GFR
Two studies have shown that various people in kidney failure were able to get out of kidney failure by using a high dose of it.
Astragalus has also shown amazing potential in an anti-aging capacity through its ability to activate telomerase activity in human T cells.
I take four capsules in the morning, and four capsules at night to get 4 grams in per day.
Vitamin D-3 is key for the development and maintenance of healthy bones.
It also has many positive effects on the immune system, endocrine glands, and the cardiovascular system.
A new study suggests that Vitamin D-3 may also improve muscle strength.
In addition, Vitamin D-3 has shown to stimulate expression of androgen receptor in human skeletal muscle, making it an absolutely critical vitamin to ensure you are not deficient in as someone who not only cares about maintaining cardiovascular health while bodybuilding, but also maximizing your muscle growth potential.
I take 1 NOW Supplements Vitamin D-3 5000 IU soft gel per day.
Pomegranate Juice (100% Juice Not From Concentrate)
Research has shown that pomegranate juice can prevent the hardening of arteries by reducing blood vessel damage, as well as reverse the progression of arterial hardening via its rich antioxidant profile.
Pomegranate juice and Vitamin K2 I feel are critical to have in your daily regimen for cardiovascular health maintenance.
Pomegranate juice literally scavenges existing plaque from the arteries.
You want to make sure you get 100% pure Pomegranate juice NOT from concentrate.
I drink 4 ounces of Lakewood Organic Pomegranate Juice per day.
Carditone is another good remedy for high blood pressure.
I don't take this anymore, but when I was younger and blasted heavily aromatizing drugs like Dbol it was a godsend.
It can lower your systolic and diastolic by 10 to 15 points, respectively.
And it's natural, which is pretty cool because it won't require you going to a doctor and getting a beta blocker or something like that.
Obviously, if you take all possible precautions and you still have high blood pressure, you need to be getting on whatever it is to mitigate your issue.
However, blood pressure is almost always manageable via lifestyle changes, whether that be via decreasing water retention, avoiding certain compounds, lowering your body weight, changing your diet, fixing your water, potassium and sodium intake, or natural supplementation, it is usually something that can be kept in the very healthy range with basic practices.
If you have increased blood pressure as a result of the drugs you're taking, get off those drugs.
For example, if you can't avoid high blood pressure and getting nosebleeds because your blood pressure is so high from Dbol, don't take Dbol.
Whatever drugs give you the least side effects are the ones you want to try and implement into your regimen.