It has long been known that anabolic androgenic steroid (AAS) use can bring about a number of unpleasant side effects. Now, a new study presented at the European Society of Cardiology (ESC) Congress 2019 suggests that this might be a silent killer.
In recent years, a number of studies have shown that AAS pose significant risks to heart health. Some medical experts already suspected this before it was shown in clinical studies.
Researchers were able to show in this new study that long-term use of AAS has unfavorable effects on the structure of the heart as well as its function.
They made their findings after examining dozens of weightlifters who used these banned substances to enhance performance and results.
“Our study found that illicit steroid use is associated with a number of worrying effects on the heart,” said researcher Rang Abdullah, a year-three medical student at the University of Oslo. “We demonstrated that AAS-using weightlifters have a thicker heart muscle and reduced ability to contract the ventricular chambers of the heart during a cardiac cycle.”
This inability to contract properly is linked to higher mortality, Abdullah said.
The research is part of a bigger multidisciplinary study probing effects of the use of anabolic androgenic steroids.
Changing structure and function
To make their findings, the researchers enlisted 100 weightlifters, who were all male. A group of 58 consisted of those that have used steroids cumulatively for more than a year. The second group comprised 42 weightlifters who did not use the illicit substances.
There was no significant age or body mass index (BMI) difference between the two groups of subjects.
The researchers made use of echocardiography to assess the size, mass, thickness and function of the heart of the weightlifters. This method utilizes sound waves to determine the amount of blood that is pumped out with each contraction of the left ventricle.
It was observed that weightlifters who took AAS had thicker heart muscle. The interventricular septum, the wall separating the heart’s lower chambers, became 2mm thicker on average. Also, the left ventricular posterior wall showed a 1.2mm average increase in thickness.
What’s more? The ability of the ventricular chambers to contract during a cardiac cycle was reduced in the steroid group.
There was also decrease in ejection fraction as well as in ventricular global strain among steroid users, compared to subjects not exposed to the substances. Ejection fraction and ventricular global strain are new measures of systolic function.
A ‘silent killer’
What was arguably scarier about the findings in this study was that weightlifters who used AAS were often not aware of these unpleasant effects. Only a handful of steroid users noticed cardiovascular symptoms connected to the illegal compounds.
This, according to Abdullah, explains why some weightlifters die without warning due to their use of these substances.
“Continuous, long-term use of AAS might prove to be a ‘silent killer’ but it is too early to tell,” Abdullah said.
He noted there are numerous case-studies of weightlifters who used steroids dying or being hospitalized as a result of heart attack or severe cardiac arrhythmias. This raises urgent need for observational trials on the subject, according to him.