Lifting with a dilated ascending aorta

[Martin Shenfield]

I don't think you can do anything that will be of benefit to you strength-wise without a degree of straining.

You will have to quit any form of training and just do exercise. Maybe Pilates.

Don't do any yard work either.

[Jdcuth]

I did pay for them. A coronary CT scan is about $150, and used to measure if you have calcium in your vessels. I heard about it from a podcast, advocating that anyone over 40 should get one done.

I'm thankful I proactively did this because it showed a slightly dilated aorta and not yet a full blown aneurysm. So therefore, I can hopefully make lifestyle adjustments to stop it from growing. Once a dilation turns to an aneurysm you need open heart surgery to replace that part of the aorta with a man made tube. If it's in your descending aorta, you may be eligible for a stent. They call aortic aneurysms the silent killer or ticking time bombs, because quite often you have zero symptoms until it dissects or ruptures.

My doctors are not telling me to "stay on the couch" and are encouraging exercise, just modifying the way I do it. They even described a study involving mice with aneurysms. The ones that were allowed to go on the wheel had better outcomes than the sedentary ones.

Is there any evidence that strength training (or if we are more specific the SS method) increases risk from a slightly dilated aorta to an aneurysm (I can answer that - there definitely isn’t) and mice models are irrelevant because their cardiac and vascular physiology is totally different. The issue is properly performed strength training has innumerable other benefits related to aging (read the Barbell Prescription) such that excluding it needs properly justifying. And I know doctors are loathe to say ANYTHING is safe because if our name is put to that advice, we’re liable. It’s interesting that doctors will advise long slow distance when this seems to me to contribute to sarcopenia and joint injuries and frailness but has a better reputation than those grunty deadlifts and squats done by hairy men in singlets. This is despite the startling reversals to the sick aging phenotype and frailty we see videos of on the SS website on a regular basis. I just feel it’s worth you hearing this to make an informed decision.

[Jason Donaldson]

The issue is properly performed strength training has innumerable other benefits related to aging (read the Barbell Prescription) such that excluding it needs properly justifying.

This right here is the heart of the principle. NOT doing the healthy thing is what needs the justification, not the converse.

(I'm speaking generally here, not to the OP's specific situation. I'm well out of my depth on that.)

[RayK]

If Travis G (the original post) is still on the thread, I would like to speak with him. I have sent him a friend request. I just discovered the same thing and the same way. Routine CAC screening revealed a 4.1 cm ectasia. When I was a child, our pediatrician was concerned that I might have Marfans since I looked like a Marfans kid. (Tall, gangly long limbs, sunken chest, allergies, nearsighted) I grew up just fine, and concluded that I did not have Marfans since I was still alive. I will now get the genetic testing done at the age of 61. There are medications that often help. Lostartan has been used for at least a decade. Telmisartan, and Irbesartan may also be used along with beta blockers. It is interesting that these ARB meds may be doing more than just lower blood pressure. There may be an affect on TGF-Beta, and the actual repair function in the arteries. If you need surgery or diagnostic work, the Mayo Clinic is surprisingly affordable.

I have no idea what to think regarding strength training. I do know that 20 rep squats are brutal! I have never tried 20 reps of the deadlift. A half mile sprint on a bicycle zooms my heart rate up to over 180 beats a minute if I hammer it, so I am skeptical that bike riding is completely safe. Telmisartan has been used as a mostly legal performance enhancing drug by some cyclists, and it is thought that Telmisartan may reduce the risk of atrial fibrillation in older athletes who train hard. Any exercise that pushes the trainee is going to cause the heart and aorta to stretch a bit and pump much more volume per stroke as well as beat faster. I am no doctor, but I would expect a heavy set of three on the squat to be much less damaging to the aorta than a lighter set of 20 if both sets are taken anywhere close to failure. I've worn a heart rate monitor while lifting, and while cycling. If heart rate means anything, it is interesting that it does not climb astronomically on the very first rep of the deadlift, but it does continue to climb a bit even after the fifth rep when you set the bar down. My heart rate never gets above 150 bpm from deadlifting, and that is nowhere near what it gets to during a bike ride. Of course that may not matter at all since what we care about is stretching the aorta beyond what it can bear.