New Study Reveals Higher Upper-Body Muscle Quality Reduces Heart Attack and Death Risk

Participants with below-average upper-body muscle density had an 85% higher risk of death and a 58% higher risk of a heart attack over the 10-year follow-up, based on 1,722 adults from the Scottish Computed Tomography of the Heart trial.
During the 10-year follow-up, 133 participants died and 106 experienced a fatal or non-fatal heart attack.
Muscle quality was quantified as skeletal muscle attenuation on coronary CT angiogram scans, with lower attenuation indicating greater fatty infiltration and poorer muscle quality.
The study highlighted that AI could assess muscle density in minutes, a rapid approach compared to manual analysis.
Experts suggest that improving upper-body muscle density through activities such as bent-over rows and chest presses may support heart health, while noting that more research is needed to understand causality.
People with stronger, denser chest and back muscles are significantly less likely to have a heart attack or die early, according to a major new study published June 30 in the journal *Radiology*. Researchers analyzed heart scans from 1,722 adults and found that those with below-average muscle density faced an 85% higher risk of death and a 58% higher risk of a heart attack over a 10-year period, according to The Herald.
The study, funded by the British Heart Foundation and led by the University of Edinburgh, used artificial intelligence to measure muscle quality in minutes from routine CT scans. Crucially, it was muscle quality — not size — that predicted heart risk. Even slim people can have fatty, low-quality muscle that signals danger, Newsy Today reported.
The researchers drew from the Scottish Computed Tomography of the Heart (SCOT-HEART) trial, a landmark study that ran from 2010 to 2015. It recruited patients with stable chest pain and gave them coronary CT angiogram scans — detailed X-ray images of the heart and surrounding tissue. Those scans also captured the chest and back muscles. Until now, analyzing that muscle data manually was too slow for clinical use.
AI changed that. The software measured "skeletal muscle attenuation" — essentially how bright the muscle appears on a CT scan. Brighter muscle means less fat inside the tissue. Darker, fatty muscle is a sign of poorer health. The Mirror reported that AI can complete this analysis in minutes, compared to hours of manual work. Professor Bryan Williams of the British Heart Foundation said: "Artificial intelligence can rapidly reveal information buried in scan results which provides a more detailed picture of our health than ever before."
Over the 10-year follow-up, 133 participants died and 106 suffered a fatal or non-fatal heart attack. But the risk was not spread evenly. Those with the lowest muscle density drove most of those outcomes. For every 10-point increase in muscle density — measured in Hounsfield units, the standard CT measurement scale — participants were 31% less likely to have a heart attack and 39% less likely to die, according to The Mirror.
The findings held even after researchers accounted for age, sex, and arterial calcification — a buildup of calcium in artery walls that is a known heart risk factor. That means muscle density appears to carry its own independent warning signal, separate from the usual risk markers doctors already track, The Herald reported.
The lead author, Professor Michelle Williams of the University of Edinburgh, said the findings changed her own habits. "It is fascinating that people's skeletal muscle could be linked to their risk of having a heart attack," she said, adding that she is "now personally interested in exercises like cycling, planks, and Pilates," according to The Herald. Other experts pointed to bent-over rows and chest presses as targeted upper-body moves.
Still, researchers are careful not to overstate the finding. Williams stressed that we do not yet know if building muscle directly causes a lower heart risk, or if high-quality muscle simply reflects an already active lifestyle. "We need far more research to better understand how exercise may affect muscle density," she said, per Yahoo Health. The bottom line for now: regular movement and a healthy diet remain the clearest paths to a healthier heart.
One of the study's biggest implications is for preventive medicine. Around 350,000 coronary CT scans are performed each year in the UK. If AI software is deployed on those existing scans, patients could receive a "muscle health score" at no extra cost and with no extra radiation, according to Newsy Today. The British Heart Foundation calls this "opportunistic screening" — squeezing more value out of tests already being done.
Patients flagged with low muscle density could then be prioritized for closer monitoring or more aggressive preventive treatment — even if their cholesterol levels look borderline acceptable. That shift could help doctors identify high-risk individuals who currently slip through standard risk-scoring systems, The Mirror reported.
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