Fears Mount Over Dangers
Of Pumping Iron

By KEVIN HELLIKER
Staff Reporter of THE WALL STREET JOURNAL
March 13, 2003

As a fitness trainer and health fanatic, Michael Logan knew that weight lifting could strengthen his bones and protect his heart.

What he didn't know was that it could be lethal. Mr. Logan had a bulge in his primary artery, the aorta. Knowledge of that bulge, or aneurysm, would have prompted doctors to allow only light-weight lifting. But like the vast majority of people with aneurysms, Mr. Logan didn't know he had one.

So he continued heavy-weight lifting -- until an aortic aneurysm killed him last June at age 46. "It's very surprising that something he did for his health might have hurt him," says Mike Logan, the late Chicago trainer's son.

In a nation obsessed with looks and fitness, weight lifting is the latest workout craze. Recent studies have shown that lifting can lower blood pressure, combat diabetes and strengthen bones. Bookstore shelves are teeming with new fitness tomes touting weight lifting. Over the three years ended in 2001, participation in weight lifting in the U.S. has risen 12% -- while aerobic exercise declined 2%, according to American Sports Data Inc.

Now, however, a small but growing number of researchers are raising concerns about the safety of lifting heavy weights. Such lifting can trigger strokes and aneurysms, and perhaps even cause a highly fatal arterial disease called dissection, believe doctors at prominent health centers such as Yale University School of Medicine and the Stanford University Medical Center.

Aneurysms alone kill 32,000 Americans a year, making them as big a killer as prostate cancer, and a more common killer than brain cancer or AIDS. Especially vulnerable to aneurysm and other arterial conditions are senior citizens -- a group that has been urged to take advantage of the bone-strengthening effects of weight lifting.

Aneurysm experts express little concern about moderate to light-weight lifting. Some define light as an amount that can be lifted 60 times, in four sets of 15. A leading aneurysm research and surgeon, John Elefteriades of the Yale University School of Medicine, recommends that people over 40 years old bench-press no more than half their body weight. Equally important is breathing regularly during exercise to minimize spikes in blood pressure.

Aneurysms aren't the only concern for heavy-weight lifters. Vascular experts say it can induce stroke, as well as dissection, in which the inner lining of the aortic artery separates from the outer walls.

Heavy-weight lifting can spike blood pressure to dangerous heights. In maximum-effort lifting, which pits a participant against the most weight he can hoist one time, studies have shown that blood pressure rises to as high as 370/360 from a resting rate of 130/80. Conventional blood-pressure monitors can't even measure levels above 300. "At that level, nobody would be surprised if you had a stroke," says Franz Messerli, a hypertension specialist at the Ochsner Clinic Foundation in New Orleans.

John Robertson witnessed just such an event one day when he was lifting weights as a medical student. Lifting beside Dr. Robertson was a fellow medical student who suddenly keeled over backward. A vessel in his brain had ruptured. He was rushed to the hospital, and survived. "During the time that you're lifting, the pressure on the artery wall is intense," says Dr. Robertson, chief of thoracic and cardiovascular surgery at St. John's Health Center in Santa Monica, Calif.

Doctors have long suspected that the steep blood-pressure spikes arising from heavy-weight lifting could trigger ruptures of already weakened vessels. Now, suspicion is growing that such lifting can damage healthy vessels. Yale's Dr. Elefteriades has shown in a lab experiment that intense pressure can induce dissection, often requiring emergency open-heart surgery.

Dissection typically occurs in older adults, or those who have a family history or who suffer from a syndrome called Marfan's disease. Yet Dr. Elefteriades has treated two young dissection victims who had none of the traditional risk factors, but who were heavy-weight lifters. Similarly, a study conducted at Los Angeles County Harbor-UCLA Medical Center profiled four young men who entered the emergency room suffering dissection -- all heavy-weight lifters. Steriod use may increase the risk.

One option for anyone over 60 or with a family history of aneurysms or dissection is to get scanned before starting a lifting program. Most aneurysms and dissections can be detected by CT scans. Also, an inexpensive ultrasound test can detect the abdominal aortic aneurysm, which ranks as the nation's 13th-leading cause of death.

The latest trend in resistance training is called slow lifting, in which the participant takes 10 seconds to raise a light to moderate amount of weight and 10 seconds to lower it. Proponents tout it as a safer and more effective alternative to both regular lifting and aerobic exercise.

But the authors of two books on slow lifting concede they haven't measured its blood-pressure spikes, which is arguably the most crucial safety issue. The two authors, Adam Zickerman and Michael Eades, say that slow lifting produces smaller spikes than regular lifting.

Other doctors and fitness experts disagree. They say that one cause of blood-pressure spikes during weight lifting is the contraction of the effected muscle. During slow lifting, a muscle may be contracted for more than 60 seconds compared with two or three seconds in regular speed lifting. For anyone concerned about stroke, aneurysm or dissection, or for the vast number of Americans with uncontrolled hypertension, "I would not recommend slow lifting," says Wayne Westcott, a slow-lifting proponent who is director of research at the South Shore YMCA in Quincy, Mass.

(Copyright (c) 2003, Dow Jones & Company, Inc.)