Technische Universität München

The Entrepreneurial University

The cardiovascular side effects of androgenic-anabolic steroids (AAS) are manifold and unclear, mainly because it is difficult to distinguish the side effects of the drugs used. Myocardial infarction and sudden cardiac death are the most serious complications. Other common cardiovascular disorders are arterial hypertension, heart failure, cardiomyopathy, arrhythmias, thrombosis etc.

Many studies have demonstrated that AAS abuse in combination with resistance training cause concentric hypertrophy of the left ventricular wall. However, not only contractible but also non-contractible elements are increased. Generalized and focal fibrosis and myofibrillar disarray are also found in autopsy of athletes consuming large amounts of AAS. Furthermore, it is reported that AASs use may lead to diastolic dysfunction and to dysrhythmias. AASs are found to affect the cardiac sympathetic nervous system and also electrolyte concentrations, which may lead to atrial or ventricular fibrillation. Sudden cardiac arrest related to adrenergic stress and documented by an extensive myocardial necrosis is also found in young athletes abusing AAS.    

Use of AASs is found to lead to a significant decrease in high-density lipoprotein cholesterol and an increase in low-density lipoprotein cholesterol. Decreased fibrinolytic activity and increased clotting factors have also been reported. It is also supported that AAS and particularly androgens may increase either systolic or diastolic blood pressure.