anabolic steroids and cardiovascular effects

Last reviewed 10/2022

Cardiovascular:

• effects of anabolic androgenic steroids (AAS) include:
  
  
  • anecdotal reports have linked AAS to myocardial infarction and sudden death
    
    
    • these cases have generally occurred in young men (using high doses of multiple androgens) without any previous cardiac history and normal coronary arteries on autopsy. A common autopsy finding are the hypercontracted, deeply eosinophilic cardiac myocytes with disruption of myofibrillar structure
      
      
  • use of AAS has also been associated with septal and left ventricular hypertrophy and cardiac arrhythmias
    
    
  • both systolic and diastolic dysfunction that was directly related to the dose and duration of AAS use
    
    
  • use of AAS, not unexpectedly, has been associated with polycythemia and adverse changes in clotting factors
    
    
  • one of the most commonly seen undesirable effects of androgens, particularly nonaromatizable androgens, is a significant decrease in high-density lipoprotein cholesterol
    • nonaromatizable androgens like stanozolol can decrease plasma high-density lipoprotein by more than 30%
    • decline is significantly less with use of aromatizable androgens such as testosterone
    • AAS also increase hepatic lipase activity, thereby contributing to dyslipidemia. All these pathways by which AAS influence cardiovascular risk make cardiovascular disease a serious consequence of AAS

Reference:

• 1) Basaria S.Androgen abuse in athletes: detection and consequences. J Clin Endocrinol Metab. 2010 Apr;95(4):1533-43