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

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