Anabolic steroids tied to irreversible heart damage

By Lisa Rapaport

(Reuters Health) - Male weight lifters who use illicit anabolic steroids are more likely to have heart damage than men with similar workout habits who don’t use these drugs, a recent study suggests.

Researchers tested cardiovascular function among 86 current or former steroid users and 54 men who had never used steroids. Compared to the non-users, the steroid users had higher rates of both systolic and diastolic myocardial dysfunction, as well as coronary atherosclerosis.

“Our findings confirm that steroid abuse impairs heart muscle function,” said lead study author Dr. Aaron Baggish of Harvard medical School and Massachusetts General Hospital in Boston.

“This paper, however, is the first report documenting a link between illicit steroid use and premature coronary disease,” Baggish said by email.

Illegal use of anabolic androgenic steroids became widespread in the U.S. in the 1980s and most current users today are young or approaching middle age, researchers noted May 22 online in Circulation. As many as 4 million people in the U.S., mostly men, have used these drugs to gain muscle mass or improve their appearance and about 1 million of them have chronically used steroids for years.

While previous research has linked steroid use to cardiovascular disease, the current study offers a fresh look at what can happen to the body after just a couple years of chronic use and how much damage may be reversed when steroid use stops.

All of the study participants were weight lifters who responded to ads in gyms seeking men 34 to 55 years old who could bench-press 275 pounds.

Among the steroid users in the study, 58 were currently using the drugs and 28 had previously used steroids. Both groups had at least two years of cumulative lifetime use.

Compared with nonusers, steroid users had reduced left ventricular ejection fraction (LVEF; mean 52% versus 63%; P<0.001) and diastolic function (early relaxation velocity 9.3 versus 11.1 cm/second; P<0.001).

Current users had significantly reduced LVEF (49% versus 58%; P<0.001) and diastolic function (early relaxation velocity 8.9 versus 10.1 cm/second; P=0.035) compared with former users.

Steroid users had higher coronary artery plaque volume than nonusers (median 3 versus 0 mL3; P=0.012). Lifetime steroid dose was strongly associated with coronary atherosclerotic burden, with an increase of 0.60 SD units in rank of plaque volume for each 10-year increase in cumulative duration of use (P=0.008).

“Our data suggest that systolic function is substantially impaired while one is using anabolic androgenic steroids, but appears to return to normal, or almost normal, after one stops,” said senior study author Dr. Harrison Pope of Harvard Medical School in Boston.

“However, our data suggest that diastolic function may not fully recover, and that some residual impairment may persist even long after one has stopped using anabolic androgenic steroids,” Pope said by email.

The study wasn’t a controlled experiment designed to prove steroids directly cause heart damage.

It’s also possible that because all of the participants were weight lifters, some of the results might be explained at least in part by the sport rather than by steroid use, the authors note.

Even so, the findings confirm that these steroids can affect the heart even among younger men, said Dr. Richard Becker of the University of Cincinnati College of Medicine.

“Anabolic and androgenic steroids used in high doses for as little as two years have detrimental effects on the heart muscle and blood vessels serving the heart that begin at a young age,” Becker, who wasn’t involved in the study, said by email. “Shorter term use, particularly at very high doses may also be detrimental.”

SOURCE: http://bit.ly/2rPLpto

Circulation 2017.

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