Increased blood pressure and aortic stiffness among abusers of anabolic androgenic steroids

Rasmussen, Jeppe Nørgaard; Schou, Morten; Madsen, Per; Selmer, Christian; Johansen, Marie Louise; Hovind, Peter; Ulriksen, Peter; Faber, Jens; Gustafsson, Finn; Kistorp, Caroline

doi:10.1097/hjh.0000000000001546

Cited by 59 publications

(60 citation statements)

References 30 publications

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“…However, the prevailing opinion is that AAS abuse in general causes a dosedependent increase in blood pressure that returns to baseline levels months after discontinuing drug use. 43,45,58,59 Increasing low-density lipoprotein (LDL) and decreasing high-density lipoprotein (HDL) are widely accepted to be associated with an increased cardiovascular risk. The association between AAS abuse and lipids has also been thoroughly studied and it has been persistently reported that AAS abuse is associated with slightly elevated levels of LDL cholesterol and decreased levels of HDL cholesterol.…”

Section: Aas Abuse Thrombosis and Cardiovascular Risk Markersmentioning

confidence: 99%

Anabolic Androgenic Steroid Abuse: The Effects on Thrombosis Risk, Coagulation, and Fibrinolysis

Chang

Münster

Gram

et al. 2018

Semin Thromb Hemost

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Anabolic androgenic steroid (AAS) abuse surged during the 1980s and is seen in approximately 1 in 20 of all males today. A wide spectrum of AAS compounds and abuse regimens are applied and AAS abuse has been associated with an unfavorable cardiovascular profile. The aim of this review is to critique the collected data concerning effects of AAS abuse on thrombosis risk through presentation of condensed evidence from studies investigating AAS-induced changes in coagulation, fibrinolysis, and cardiovascular risk markers. AAS abuse inflicts a procoagulant distribution of cardiovascular risk markers including dyslipidemia and atherosclerosis proneness. AAS abuse overall stimulates synthesis of coagulation factors, inhibitors, and fibrinolytic proteins resulting in both increased global coagulation and stimulation of fibrinolysis. Overall, supported by many case reports and some epidemiological studies, AAS abuse is associated with an increased risk of thrombosis. However, to provide clear evidence for a causal relationship between AAS abuse and thrombosis risk, future studies need to address a range of potential biases, insufficient methodology, and other shortcomings of the current literature as highlighted in this review.

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Section: Aas Abuse Thrombosis and Cardiovascular Risk Markersmentioning

confidence: 99%

Anabolic Androgenic Steroid Abuse: The Effects on Thrombosis Risk, Coagulation, and Fibrinolysis

Chang

Münster

Gram

et al. 2018

Semin Thromb Hemost

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“…In line with this, Rasmussen et al . found that current AAS use was associated with increased 24‐h blood pressure and increased aortic stiffness, which are known risk factors for cardiovascular events and death. Furthermore, AAS use has been associated with a decrease in HDL cholesterol and an increase in LDL cholesterol and secondary erythrocytosis.…”

Section: Discussionmentioning

confidence: 99%

“…Androgenic anabolic steroids (AAS) provide an efficient route to achieve muscle growth and have been used by bodybuilders and elite athletes for decades [1][2][3]. Unfortunately, these drugs are not without side effects and have been associated with, amongst other conditions, hormonal disturbances, gynaecomastia, testicular dysfunction, infertility and cardiomyopathy [4][5][6]. The lifetime prevalence of AAS abuse is estimated to be around 6% in men; therefore, the harm related to these drugs is a public health concern [2].…”

Section: Introductionmentioning

confidence: 99%

Health consequences of androgenic anabolic steroid use

2018

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Background The lifetime prevalence of androgenic anabolic steroid abuse is estimated to be around 6% for men, but there is limited knowledge about the side effects of these drugs. Objective To investigate mortality and morbidity amongst users of androgenic anabolic steroids (AAS). Methods In this retrospective matched cohort study, 545 male subjects tested positive for AAS in Danish fitness centres during the period 3 January 2006 to 1 March 2018. Subjects were matched with 5450 male controls. In addition, 644 men who were sanctioned because they refused to submit to a doping test and 6440 controls were included as a replication cohort. Results Mortality was three times higher amongst users of AAS than amongst nonuser controls (hazard ratio 3.0, 95% CI 1.3–7.0). The median annual number of hospital contacts was 0.81 in the cohort of AAS users and 0.36 in the control cohort (P < 0.0001). Acne, gynaecomastia and erectile dysfunction affected more than 10% of the androgenic anabolic steroid users, and the prevalence of these disorders was significantly higher than in the control group (P < 0.0001). The results could be replicated in a similar cohort. Conclusion Androgenic anabolic steroid users have an increased risk of dying and significantly more hospital admissions than their nonuser peers. Side effects of AAS and their metabolites were highly prevalent. Given the high rate of androgenic anabolic steroid abuse, these side effects are of public health concern.

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“…The significant adverse effects of pseudo-endogenous and synthetic anabolic-androgenic steroid (AAS) misuse have been reported extensively in the past and continue to result in case reports of cardiovascular, renal, and hepatic issues plausibly correlated to AAS administration. [40][41][42] Nevertheless, also in 2017, findings of AAS were toplisted in statistics regarding AAFs 43 being one the most frequent reasons of drug-related anti-doping rule violations (ADRVs). At the level of recreational athletes, the issue of AAS misuse has not been contained.…”

Section: Anabolic-androgenic Steroidsmentioning

confidence: 99%

Annual banned‐substance review: Analytical approaches in human sports drug testing

Thevis

Kuuranne

Geyer

2019

Drug Testing and Analysis

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A number of high profile revelations concerning anti‐doping rule violations over the past 12 months have outlined the importance of tackling prevailing challenges and reducing the limitations of the current anti‐doping system. At this time, the necessity to enhance, expand, and improve analytical test methods in response to the substances outlined in the World Anti‐Doping Agency (WADA) Prohibited List represents an increasingly crucial task for modern sports drug testing programs. The ability to improve analytical testing methods often relies on the expedient application of novel information regarding superior target analytes for sports drug testing assays, drug elimination profiles, and alternative sample matrices, together with recent advances in instrumental developments. This annual banned‐substance review evaluates literature published between October 2017 and September 2018 offering an in‐depth evaluation of developments in these arenas and their potential application to substances reported in WADA's 2018 Prohibited List.

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Increased blood pressure and aortic stiffness among abusers of anabolic androgenic steroids

Abstract: Current AAS abusers displayed increased 24-h systolic BP and decreased plasma MR-proANP. Both current and former AAS abusers exhibited higher aortic stiffness.

Cited by 59 publications

References 30 publications

Anabolic Androgenic Steroid Abuse: The Effects on Thrombosis Risk, Coagulation, and Fibrinolysis

Anabolic Androgenic Steroid Abuse: The Effects on Thrombosis Risk, Coagulation, and Fibrinolysis

Health consequences of androgenic anabolic steroid use

Annual banned‐substance review: Analytical approaches in human sports drug testing

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