Dear Dr. Roach: I am a 62-year-old male. My aortic valve was replaced with a Carpentier-Edwards bovine tissue valve, and my ascending aorta was replaced in 2005. My question is about competitive power-lifting.
I compete in the bench press. I lift and train with between 50 percent and 100 percent of my max lift three to four times a week. How high does blood pressure go when lifting to the max on the bench press? Does it reach dangerous levels? Is the risk of damaging the valve slight, moderate or severe? Is there a risk of developing a second aneurysm? I want to compete, and Im willing to accept some risks. What are your thoughts? S.M.R.
Answer: Maintaining an active lifestyle can help prevent many diseases, and its useful as treatment for many more. The side effects generally are small. However, there are some exceptions, and this is one of them.
In powerlifting, many parts of the body are pushed to their physiological limits. In a maximum lift, part of the pressure of the weight is transmitted throughout the chest, which forces the heart to increase its pressure in order to continue blood flow. Measurements of elite-level lifters show that blood pressure can reach or exceed 300 mmHg (!) during a maximal lift. It is not uncommon to see bleeding from the nose or another body part as blood vessels burst under the pressure. Powerlifters are at increased risk for some kinds of heart damage and stroke during these lifts, but the risk for young, healthy lifters is not large, and bad outcomes are rare.
In your case, you have two potential weaknesses. The first is the prosthetic aortic valve, but the Carpentier-Edwards valve in particular has a reputation for strength. I think it is unlikely that you would damage the valve. Its the abdominal aneurysm that concerns me.
Although the diseased part of the aorta has been replaced with a very strong graft, the attachment where the graft is sewn onto your blood vessels is a point of weakness. Also, it is possible that you have weaknesses in other blood vessels. I cant recommend powerlifting for you, competitive or not, as I think the risk is too great.
