Effects of Anabolic-Androgenic Steroids on the Cardiovascular System.

I gained particular interest in studying the effects of anabolic steroids on the cardiovascular system as Don spoke about them frequently in lecture when reminiscing about his favorite football, baseball, and biking athletes who all shared one thing in common; juicing. He was sure to highlight the negative impacts that these drugs have and so I decided to look deeper into the subject. The course objectives that my steam project relates to are, “Explain the structure and function of the heart” and “Know the path of blood through the heart and circulatory system”. I conducted my research from three primary peer reviewed articles and meta-analysis on the cardiovascular effects of androgenic-anabolic steroids (AAS for short) all of which are cited in my references page below. My medium was drawing the anatomical differences caused by prolonged AAS usage.

One of the most prominent effects that AAS have on the cardiovascular system is called cardiac hypertrophy. Just like any other muscle in the body, the heart is susceptible to growth, also known as hypertrophy. Cardiac hypertrophy is a condition associated with prolonged AAS usage and is quite dangerous. Anabolic steroids increase protein synthesis which leads to muscle growth (Liu and Wu 2019) indiscriminately, which includes both skeletal muscle (generally the target of AAS usage) and cardiac muscle. Anabolic-androgenic steroids and cardiovascular risk also states that AAS significantly increases collagen production and myocardial fibroblastic growth (Liu and Wu 2019).These effects are commonly observed in athletes who have used AAS for extended periods. When combined with high-intensity training, which is typical for these athletes, AAS use has a cumulative impact on cardiac hypertrophy, potentially leading to cardiac dysfunction and even heart failure (Liu and Wu 2019). AAS mimics the effects of testosterone by binding to androgen receptors in various tissues including cardiac tissues. This stimulates the production and synthesis of proteins therefore increasing cardiac muscle mass.The anatomical result of this is increased left ventricular thickness which I drew a comparison between a normal and an affected heart in my first drawing. The left ventricle pumps oxygenated blood throughout the entire body, which requires it to overcome greater resistance compared to the part of the heart responsible for pumping blood to the lungs. Because of this, the left ventricle increases in thickness significantly more than the right. It is also important to note that while on AAS, a person’s body mass may increase rapidly, further increasing the resistance needed to be overcome by the left ventricle. The increase in heart size is maladaptive in nature and can cause heart arrhythmias, cardiomyopathy, reduced diastolic function, and eventually heart failure if left untreated (Kindermann 2006)(Paul Vanberg and Dan Atar 2010).

The second effect that I researched was atherosclerosis. Atherosclerosis is a condition where the arteries narrow due to plaque buildup, and lipid metabolism disorders serve as the underlying cause of this disease. AAS have been linked with lipid metabolism disruption leading to reduced levels of high-density-lipoprotein (HDL) and increased levels of low-density-lipoprotein (LDL)(Paul Vanberg and Dan Atar 2010). This significantly increases the risk of coronary artery disease (Liu and Wu 2019) which I drew in my second drawing. Physical exercise can raise HDL levels and significantly reduce LDL and triglyceride levels, mitigating some of the harmful effects of AAS on the body. It is important to note that after the discontinuation of AAS usage, lipoprotein levels returned to normal within a few weeks to months (Liu and Wu 2019). Moreover, it is suggested that long-term AAS abuse leads to sustained increases in blood homocysteine levels, causing hyperhomocysteinemia, which is a known risk factor for coronary atherosclerosis and increases the likelihood of developing coronary artery disease (Liu and Wu 2019).

Androgenic-anabolic steroids are commonly used as performance enhancing drugs among athletes to improve muscle mass, strength, and for cosmetic reasons, however, they are linked to a plethora of potentially life threatening side effects. For this reason, it is important that the negative side effects of AAS should be as equally as known as their benefits. Side effects such as ventricular hypertrophy, coronary artery disease, arrhythmias, and other circulatory defects should not be overlooked, as they can lead to long-term cardiovascular complications and increased mortality risk. Greater awareness, education, and monitoring are essential to ensure that individuals make informed decisions regarding AAS use and understand the full scope of their impact on health.