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Anabolic Steroids and Cardiovascular Risk

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Abstract

Recent reports from needle exchange programmes and other public health initiatives have suggested growing use of anabolic steroids (AS) in the UK and other countries. Data indicate that AS use is not confined to bodybuilders or high-level sportsmen. Use has spread to professionals working in emergency services, casual fitness enthusiasts and subelite sportsmen and women. Although the precise health consequences of AS use is largely undefined, AS use represents a growing public health concern. Data regarding the consequences of AS use on cardiovascular health are limited to case studies and a modest number of small cohort studies. Numerous case studies have linked AS use with a variety of cardiovascular disease (CVD) events or endpoints, including myocardial infarction, stroke and death. Large-scale epidemiological studies to support these links are absent. Consequently, the impact of AS use upon known CVD risk factors has been studied in relatively small, case-series studies. Data relating AS use to elevated blood pressure, altered lipid profiles and ECG abnormalities have been reported, but are often limited in scope, and other studies have often produced equivocal outcomes. The use of AS has been linked to the appearance of concentric left ventricular hypertrophy as well as endothelial dysfunction but the data again remains controversial. The mechanisms responsible for the negative effect of AS on cardiovascular health are poorly understood, especially in humans. Possibilities include direct effects on myocytes and endothelial cells, reduced intracellular Ca2+ levels, increased release of apoptogenic factors, as well as increased collagen crosslinks between myocytes. New data relating AS use to cardiovascular health risks are emerging, as novel technologies are developed (especially in non-invasive imaging) that can assess physiological structure and function. Continued efforts to fully document the cardiovascular health consequences of AS use is important to provide a clear, accurate, public health message to the many groups now using AS for performance and image enhancement.

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References

  1. McVeigh J, Beynon C, Bellis MA. New challenges for agency based syringe exchange schemes: analysis of 11 years of data(1991-2001) in Merseyside and Cheshire, United Kingdom. Int J Drug Policy 2003; 14 (5-6): 399–405

    Article  Google Scholar 

  2. Yesalis CE, Bahrke MS. Doping among adolescent athletes. Best Pract Res Clin Endocrinol Metab 2000; 14 (1):25–35

    Article  CAS  Google Scholar 

  3. Bahrke MS, Yesalis CE. Abuse of anabolic androgenic steroids and related substances in sport and exercise. CurrOpin Pharmacol 2004; 4 (6): 614–20

    Article  PubMed  CAS  Google Scholar 

  4. Korkia P, Stimson GV. Indications of prevalence, practice and effects of anabolic steroid use in Great Britain. IntJ Sports Med 1997; 18 (7): 557–62

    Article  CAS  Google Scholar 

  5. Ong PJ, Patrizi G, Chong WC, et al. Testosterone enhances flow-mediated brachial artery reactivity in men with coronaryartery disease. Am J Cardiol 2000; 85 (2): 269–72

    Article  PubMed  CAS  Google Scholar 

  6. Melchert RB, Welder AA. Cardiovascular effects of androgenic-anabolic steroids. Med Sci Sports Exerc 1995;27 (9): 1252–62

    PubMed  CAS  Google Scholar 

  7. LeGros T, McConnell D, Murry T, et al. The effects of 17 alpha-methyltestosterone on myocardial function in vitro.Med Sci Sports Exerc 2000; 32 (5): 897–903

    Google Scholar 

  8. Belhani D, Fanton L, Vaillant F, et al. Cardiac lesions induced by testosterone: protective effects of dexrazoxaneand trimetazidine. Cardiovasc Toxicol 2009; 9 (2): 64–9

    Article  PubMed  CAS  Google Scholar 

  9. Morris JN, Heady JA, Raffle PA, et al. Coronary heartdisease and physical activity of work. Lancet 1953; 265 (6796): 1111–20

    Article  PubMed  CAS  Google Scholar 

  10. Paffenbarger RS, Hale WE. Work activity and coronary heart mortality.N Engl J Med 1975 Mar 13; 292 (11): 545–50

    Article  PubMed  CAS  Google Scholar 

  11. Pipe A, Hebert PC. Doping, sport and the community. CMAJ 2008; 179 (4): 303–5

    PubMed  Google Scholar 

  12. Salonen JT, Salonen R. Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation 1993; 87 (3 Suppl.): II56–65

    PubMed  CAS  Google Scholar 

  13. Bots ML, Dijk JM, Oren A, et al. Carotid intima-media thickness, arterial stiffness and risk of cardiovascular disease:current evidence. J Hypertens 2002; 20 (12): 2317–25

    Article  PubMed  CAS  Google Scholar 

  14. Sader MA, Griffiths KA, McCredie RJ, et al. Androgenic anabolic steroids and arterial structure and function inmale bodybuilders. J Am Coll Cardiol 2001; 37 (1): 224–30

    Article  PubMed  CAS  Google Scholar 

  15. Hartgens F, Kuipers H. Effects of androgenic-anabolic steroids in athletes. Sports Med 2004; 34 (8): 513–54

    Article  PubMed  Google Scholar 

  16. Frankle MA, Eichberg R, Zachariah SB. Anabolic androgenic steroids and a stroke in an athlete: case report. ArchPhys Med Rehabil 1988; 69 (8): 632–3

    PubMed  CAS  Google Scholar 

  17. Mochizuki RM, Richter KJ. Cardiomyopathy and cerebrovascular accident associated with anabolic-androgenicsteroid use. Phys Sportsmed 1988; 16 (11): 109–11, 114

    Google Scholar 

  18. Kennedy MC, Corrigan AB, Pilbeam ST. Myocardial infarction and cerebral haemorrhage in a young body builder taking anabolic steroids. Aust N Z JMed 1993; 23 (6): 713

    Article  CAS  Google Scholar 

  19. Akhter J, Hyder S, Ahmed M. Cerebrovascular accident associated with anabolic steroid use in a young man.Neurology 1994; 44 (12): 2405–6

    Article  PubMed  CAS  Google Scholar 

  20. Sahraian MA, Mottamedi M, Azimi AR, et al. Androgeninduced cerebral venous sinus thrombosis in a young body builder [case report]. BMC Neurol 2004; 4 (1):22

    Article  PubMed  Google Scholar 

  21. Santamarina RD, Besocke AG, Romano LM, et al. Ischemic stroke related to anabolic abuse. Clin Neuropharmacol 2008; 31 (2): 80–5

    Article  PubMed  Google Scholar 

  22. McNutt RA, Ferenchick GS, Kirlin PC, et al. Acute myocardial infarction in a 22-year-old world class weight lifter using anabolic steroids. Am J Cardiol 1988; 62 (1): 164

    Article  PubMed  CAS  Google Scholar 

  23. Bowman S. Anabolic steroids and infarction. BMJ 1990; 300 (6726): 750

    Article  PubMed  CAS  Google Scholar 

  24. Ferenchick GS, Adelman S. Myocardial infarction associated with anabolic steroid use in a previously healthy 37-year-old weight lifter. Am Heart J 1992; 124 (2): 507–8

    Article  PubMed  CAS  Google Scholar 

  25. Kennedy C. Myocardial infarction in association with misuse of anabolic steroids. Ulster Med J 1993; 62 (2): 174–6

    PubMed  CAS  Google Scholar 

  26. Appleby M, Fisher M, Martin M. Myocardial infarction, hyperkalaemia and ventricular tachycardia in a youngmale body-builder. Int J Cardiol 1994; 44 (2): 171–4

    Article  PubMed  CAS  Google Scholar 

  27. Huie MJ.An acute myocardial infarction occurring in an anabolic steroid user. Med Sci Sports Exerc 1994; 26 (4): 408–13

    PubMed  CAS  Google Scholar 

  28. Fisher M, Appleby M, Rittoo D, et al. Myocardial infarction with extensive intracoronary thrombus induced by anabolic steroids. Br J Clin Pract 1996; 50 (4): 222–3

    PubMed  CAS  Google Scholar 

  29. Goldstein DR, Dobbs T, Krull B, et al. Clenbuterol and anabolic steroids: a previously unreported cause of myocardialinfarction with normal coronary arteriograms.South Med J 1998; 91 (8): 780–4

    Article  PubMed  CAS  Google Scholar 

  30. Fineschi V, Baroldi G, Monciotti F, et al. Anabolic steroid abuse and cardiac sudden death: a pathologic study. ArchPathol Lab Med 2001; 125 (2): 253–5

    PubMed  CAS  Google Scholar 

  31. Gunes Y, Erbas C, Okuyan E, et al. Myocardial infarction with intracoronary thrombus induced by anabolic steroids.Anadolu Kardiyol Derg 2004; 4 (4): 357–8

    PubMed  Google Scholar 

  32. Angelilli A, Katz ES, Goldenberg RM. Cardiac arrest following anaesthetic induction in a world-class body builder.Acta Cardiol 2005; 60 (4): 443–4

    Article  PubMed  Google Scholar 

  33. Wysoczanski M, Rachko M, Bergmann SR. Acute myocardial infarction in a young man using anabolic steroids.Angiology 2008; 59(3): 376–8

    Article  PubMed  Google Scholar 

  34. Lunghetti S, Zaca V, Maffei S, et al. Cardiogenic shock complicating myocardial infarction in a doped athlete.Acute Card Care 2009; 11 (4): 250–1

    Article  PubMed  Google Scholar 

  35. Luke JL, Farb A, Virmani R, et al. Sudden cardiac death during exercise in a weight lifter using anabolic androgenic steroids: pathological and toxicological findings J Forensic Sci 1990; 35 (6): 1441–7

    PubMed  CAS  Google Scholar 

  36. Campbell SE, Farb A, Weber KT. Pathologic remodeling of the myocardium in a weightlifter taking anabolic steroids.Blood Press 1993; 2 (3): 213–6

    Article  PubMed  CAS  Google Scholar 

  37. Hausmann R, Hammer S, Betz P. Performance enhancing drugs (doping agents) and sudden death: a case reportand review of the literature. Int J Legal Med 1998; 111 (5):261–4

    Article  PubMed  CAS  Google Scholar 

  38. Madea B, Grellner W. Long-term cardiovascular effects of anabolic steroids. Lancet 1998; 352 (9121): 33

    Article  PubMed  CAS  Google Scholar 

  39. Fineschi V, Riezzo I, Centini F, et al. Sudden cardiac death during anabolic steroid abuse: morphologic and toxicologic findings in two fatal cases of body builders. Int J Legal Med 2007; 121 (1): 48–53

    Article  PubMed  Google Scholar 

  40. Laroche GP. Steroid anabolic drugs and arterial complications in an athlete: a case history. Angiology 1990

    Google Scholar 

  41. Gaede JT, Montine TJ. Massive pulmonary embolus andanabolic steroid abuse. JAMA 1992; 267 (17):2328–9

    PubMed  CAS  Google Scholar 

  42. Jaillard AS, Hommel M, Mallaret M. Venous sinus thrombosis associated with androgens in a healthy youngman. Stroke 1994; 25 (1): 212–3

    Article  PubMed  CAS  Google Scholar 

  43. Mewis C, Spyridopoulos I, Kuhlkamp V, et al. Manifestation of severe coronary heart disease after anabolic drugabuse. Clin Cardiol 1996; 19 (2): 153–5

    Article  PubMed  CAS  Google Scholar 

  44. Nieminen MS, Ramo MP, Viitasalo M, et al. Serious cardiovascular side effects of large doses of anabolic steroids in weight lifters. Eur Heart J 1996; 17 (10): 1576–83

    Article  PubMed  CAS  Google Scholar 

  45. Palfi S, Ungurean A, Vecsei L. Basilar artery occlusion associated with anabolic steroid abuse in a 17-year-old body builder. Eur Neurol 1997; 37 (3): 190–1

    Article  PubMed  CAS  Google Scholar 

  46. Falkenberg M, Karlsson J, Ortenwall P. Peripheral arterial thrombos is in two young men using anabolic steroids. EurJ Vasc Endovasc Surg 1997; 13 (2): 223–6

    Article  CAS  Google Scholar 

  47. Hourigan LA, Rainbird AJ, Dooris M. Intracoronary stenting for acute myocardial infarction (AMI) in a 24-year old man using anabolic androgenic steroids. Aust N Z J Med 1998; 28 (6): 838–9

    Article  PubMed  CAS  Google Scholar 

  48. McCarthy K, Tang AT, Dalrymple-Hay MJ, et al. Ventricular thrombosis and systemic embolism in body builders: etiology and management. Ann Thorac Surg2000; 70 (2): 658–60

    Google Scholar 

  49. Ment J, Ludman PF. Coronary thrombus in a 23 year old anabolic steroid user. Heart 2002; 88 (4): 342

    Article  PubMed  CAS  Google Scholar 

  50. Alhadad A, Acosta S, Sarabi L, et al. Pulmonary embolism associated with protein C deficiency and abuse of anabolic-androgen steroids Clin Appl Thromb Hemost 2010;16 (2): 228–31

    Article  Google Scholar 

  51. Liljeqvist S, Hellden A, Bergman U, et al. Pulmonary embolism associated with the use of anabolic steroids. EurJ Intern Med 2008; 19 (3): 214–5

    Article  Google Scholar 

  52. Frogel JK, Weiss SJ, Kohl BA. Transesophageal echocardiography diagnosis of coronary sinus thrombosis.Anesth Analg 2009; 108 (2): 441–2

    Article  PubMed  Google Scholar 

  53. Mark PB, Watkins S, Dargie HJ. Cardiomyopathy induced by performance enhancing drugs in a competitive body builder.Heart 2005; 91 (7): 888

    Article  PubMed  CAS  Google Scholar 

  54. Ahlgrim C, Guglin M. Anabolics and cardiomyopathy in a body builder: case report and literature review. J Card Fail 2009; 15 (6): 496–500

    Article  PubMed  Google Scholar 

  55. Bispo M, Valente A, Maldonado R, et al.Anabolic steroid induced cardio myopathy underlying acute liver failure ina young body builder. World J Gastroenterol 2009; 15 (23):2920–2

    Article  PubMed  Google Scholar 

  56. Sullivan ML, Martinez CM, Gallagher EJ. Atrial fibrillation and anabolic steroids. J Emerg Med 1999; 17 (5): 851–7

    Article  PubMed  CAS  Google Scholar 

  57. Clark BM, Schofield RS. Dilated cardiomyopathy and acute liver injury associated with combined use of ephedra,gamma-hydroxybutyrate, and anabolic steroids.Pharmacotherapy 2005; 25 (5): 756–61

    Article  PubMed  Google Scholar 

  58. Alaraj AM, Chamoun RB, Dahdaleh NS, et al. Spontaneous subdural haematoma in anabolic steroids dependent weight lifters: reports of two cases and review of literature.Acta Neurochir (Wien) 2005; 147 (1): 85–7; discussion 7-8

    Article  CAS  Google Scholar 

  59. Lau DH, Stiles MK, John B, et al. Atrial fibrillation and anabolic steroid abuse. Int J Cardiol 2007; 117 (2): e86–7

    Article  PubMed  Google Scholar 

  60. Murai MH, Pecci M, Laursen M. Student Focus left ventricular hypertrophy in a rugby player on anabolicsteroids: a case study. Athl Ther Today 2005; 10 (6): 25–7

    Google Scholar 

  61. Ridker PM, Rifai N, Rose L, et al. Comparison of Creactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events.N Engl J Med 2002; 347 (20): 1557–65

    Article  PubMed  CAS  Google Scholar 

  62. Freed DL, Banks AJ, Longson D, et al. Anabolic steroids in athelics: crossover double-blind trial on weight lifters.Br Med J 1975; 2(5969): 471–3

    Article  PubMed  CAS  Google Scholar 

  63. Kuipers H, Wijnen JA, Hartgens F, et al. Influence of anabolic steroids on body composition, blood pressure,lipid profile and liver functions in body builders Int JSports Med 1991; 12 (4): 413–8

    Article  CAS  Google Scholar 

  64. Riebe D, Fernhall B, Thompson PD. The blood pressure response to exercise in anabolic steroid users. Med SciSports Exerc 1992; 24 (6): 633–7

    PubMed  CAS  Google Scholar 

  65. Lane HA, Grace F, Smith JC, et al. Impaired vasore activity in body builders using androgenic anabolic steroids. Eur JClin Invest 2006; 36 (7): 483–8

    Article  CAS  Google Scholar 

  66. Baldo-Enzi G, Giada F, Zuliani G, et al. Lipid and apoprotein modifications in body builders during and after self-administration of anabolic steroids. Metabolism1990; 39 (2): 203–8

    Article  PubMed  CAS  Google Scholar 

  67. Zmuda JM, Fahrenbach MC, Younkin BT, et al. The effect of testosterone aromatization on high-density lipoprotein cholesterol level and postheparin lipolytic activity. Metabolism1993; 42 (4):446–50

    Article  PubMed  CAS  Google Scholar 

  68. Hartgens F, Rietjens G, Keizer HA, et al. Effects of androgenic- anabolic steroids on a polipoproteins and lipoprotein(a). Br J Sports Med 2004; 38 (3): 253–9

    Article  PubMed  CAS  Google Scholar 

  69. Grace FM, Davies B. Raised concentrations of C reactive protein in anabolic steroid using body builders. Br J Sports Med 2004; 38 (1): 97–8

    Article  PubMed  CAS  Google Scholar 

  70. Zmuda JM, Bausserman LL, Maceroni D, et al. The effect of supraphysiologic doses of testosterone on fasting total homocysteine levels in normal men Atherosclerosis 1997;130 (1-2): 199–202

    Article  PubMed  CAS  Google Scholar 

  71. Graham MR, Grace FM, Boobier W, et al. Homocysteine induced cardiovascular events: a consequence of long termanabolic-androgenic steroid (AAS) abuse. Br J Sports Med 2006; 40 (7): 644–8

    Article  PubMed  CAS  Google Scholar 

  72. Alén M. Androgenic steroid effects on liver and red cells Br J Sports Med 1985; 19 (1): 15–20

    Article  PubMed  Google Scholar 

  73. Dawber TR, Moore FE, Mann GV. Coronary heart disease in the Framingham study. Am J Public Health Nations Health 1957; 47 (4 Pt 2): 4–24

    Article  PubMed  CAS  Google Scholar 

  74. Chaney RH, Eyman RK. Blood pressure at rest and during maximal dynamic and isometric exercise as predictorsof systemic hypertension. Am J Cardiol 1988; 62 (16):1058–61

    Article  PubMed  CAS  Google Scholar 

  75. Kawano H, Tanimoto M, Yamamoto K, et al. Resistance training in men is associated with increased arterial stiffness and blood pressure but does not adversely affect endothelial function as measured by arterial reactivity to thecold pressor test. Exp Physiol 2008; 93 (2): 296–302

    Article  PubMed  Google Scholar 

  76. Kasikcioglu E, Oflaz H, Arslan A, et al. Aortic elastic properties in athletes using anabolic-androgenic steroids.Int J Cardiol 2007; 114 (1): 132–4

    Article  PubMed  Google Scholar 

  77. Robinson JG, Wang S, Smith BJ, et al. Meta-analysis of the relationship between non-high-density lipoprotein cholesterol reduction and coronary heart disease risk. J AmColl Cardiol 2009; 53 (4): 316–22

    Article  PubMed  CAS  Google Scholar 

  78. Applebaum-Bowden D, Haffner SM, Hazzard WR. The dyslipoproteinemia of anabolic steroid therapy: increasein hepatic triglyceride lipase precedes the decrease in highdensity lipoprotein 2 cholesterol. Metabolism 1987; 36 (10):949–52

    Article  PubMed  CAS  Google Scholar 

  79. Boushey CJ, Beresford SA, Omenn GS, et al. A quantitative assessment of plasma homocysteine as a risk factorfor vascular disease: probable benefits of increasing folicacid intakes. JAMA 1995; 274 (13): 1049–57

    Article  PubMed  CAS  Google Scholar 

  80. McCully KS. Hyperhomocysteinemia and arteriosclerosis: historical perspectives. Clin Chem Lab Med 2005; 43 (10):980–6

    Google Scholar 

  81. Hartgens F, Hamulyak K, Pernot C, editors. Effects of high doses androgenic-anabolic steroids on haematologic parameters in body builders [abstract]. 8th FIMS European Sports Medicine Congress 1995: 23–7

    Google Scholar 

  82. Savage DD, Levy D, Dannenberg AL, et al. Association of echocardiographic left ventricular mass with body size,blood pressure and physical activity (the FraminghamStudy). Am J Cardiol 1990; 65 (5): 371–6

    Article  PubMed  CAS  Google Scholar 

  83. Yeboah J, Crouse JR, Hsu FC, et al. Brachial flow mediated dilation predicts incident cardiovascular events in older adults: the Cardiovascular Health Study. Circulation 2007; 115 (18): 2390–7

    Article  PubMed  Google Scholar 

  84. Bidoggia H, Maciel JP, Capalozza N, et al. Sex differences on the electrocardiographic pattern of cardiac repolarization:possible role of testosterone. Am Heart J 2000;140 (4): 678–83

    Article  PubMed  CAS  Google Scholar 

  85. Fulop L, Banyasz T, Szabo G, et al. Effects of sex hormones on ECG parameters and expression of cardiac ion channelsin dogs. Acta Physiol (Oxf) 2006; 188 (3-4): 163–71

    Article  CAS  Google Scholar 

  86. Stolt A, Karila T, Viitasalo M, et al. QT interval and QT dispersion in endurance athletes and in power athletes using large doses of anabolic steroids. Am J Cardiol 1999;84 (3): 364–6, A9

    Article  PubMed  CAS  Google Scholar 

  87. Bigi MA, Aslani A. Short QT interval: a novel predictor of androgen abuse in strength trained athletes. Ann Non invasive Electrocardiol 2009; 14 (1): 35–9

    Article  Google Scholar 

  88. Liu XK, Katchman A, Whitfield BH, et al. In vivo androgen treatment shortens the QT interval and increases the densities of inward and delayed rectifier potassium currents in orchiectomized male rabbits. Cardiovasc Res 2003; 57 (1): 28–36

    Article  PubMed  CAS  Google Scholar 

  89. Urhausen A, Holpes R, Kindermann W. One- and two dimensional echo cardiography in body builders using anabolic steroids. Eur J Appl Physiol Occup Physiol 1989;58 (6): 633–40

    Article  PubMed  CAS  Google Scholar 

  90. Sachtleben TR, Berg KE, Elias BA, et al. The effects of anabolic steroids on myocardial structure and cardiovascular fitness. Med Sci Sports Exerc 1993; 25 (11): 1240–5

    PubMed  CAS  Google Scholar 

  91. Dickerman RD, Schaller F, McConathy WJ. Left ventricular wall thickening does occur in elite power athletes with or without anabolic steroid use. Cardiology 1998; 90(2): 145–8

    Article  PubMed  CAS  Google Scholar 

  92. Hartgens F, Cheriex EC, Kuipers H. Prospective echocardiographic assessment of androgenic-anabolic steroids effects on cardiac structure and function in strength athletes.Int J Sports Med 2003; 24 (5): 344–51

    Article  PubMed  CAS  Google Scholar 

  93. Nottin S, Nguyen LD, Terbah M, et al. Cardiovascular effects of androgenic anabolic steroids in male body builders determined by tissue Doppler imaging. AmJ Cardiol 2006; 97 (6): 912–5

    Article  CAS  Google Scholar 

  94. D’Andrea A, Caso P, Salerno G, et al. Left ventricular early myocardial dysfunction after chronic misuse of anabolic androgenic steroids: a Doppler myocardial and strain imaging analysis. Br J Sports Med 2007; 41 (3): 149–55

    Article  PubMed  Google Scholar 

  95. Kasikcioglu E, Oflaz H, Umman B, et al. Androgenic anabolic steroids also impair right ventricular function. Int J Cardiol 2009; 134 (1): 123–5

    Article  PubMed  Google Scholar 

  96. Baggish AL, Weiner RB, Kanayama G, et al. Long-term anabolic-androgenic steroid use is associated with left ventricular dysfunction. Circ Heart Fail 2010; 3 (4): 472–6

    Article  PubMed  Google Scholar 

  97. Krieg A, Scharhag J, Albers T, et al. Cardiac tissue Doppler in steroid users. Int J Sports Med 2007; 28 (8): 638–43

    Article  PubMed  CAS  Google Scholar 

  98. Langeland S, D’Hooge J, Wouters PF, et al. Experimental validation of a new ultrasound method for the simultaneous assessment of radial and longitudinal myocardial deformation independent of insonation angle. Circulation 2005; 112 (14): 2157–62

    Article  PubMed  Google Scholar 

  99. Marsh JD, Lehmann MH, Ritchie RH, et al. Androgen receptors mediate hypertrophy in cardiac myocytes. Circulation 1998; 98 (3): 256–61

    Article  PubMed  CAS  Google Scholar 

  100. Krieg A, Scharhag J, Kindermann W, et al. Cardiac tissue Doppler imaging in sports medicine. Sports Med 2007;37 (1): 15–30

    Article  PubMed  Google Scholar 

  101. Lieberherr M, Grosse B. Androgens increase intracellular calcium concentration and inositol 1, 4, 5-trisphosphateand diacylglycerol formation via a pertussis toxin sensitive G-protein. J Biol Chem 1994; 269 (10): 7217–223

    PubMed  CAS  Google Scholar 

  102. Zaugg M, Jamali NZ, Lucchinetti E, et al. Anabolic androgenic steroids induce apoptotic cell death in adult rat ventricular myocytes. J Cell Physiol 2001; 187 (1): 90–5

    Article  PubMed  CAS  Google Scholar 

  103. Takase B, Uehata A, Akima T, et al. Endotheliumdependent flow-mediated vasodilation in coronary and brachial arteries in suspected coronary artery disease. AmJ Cardiol 1998; 82 (12): 1535–9, A7-8

    Article  CAS  Google Scholar 

  104. Takase B, Hamabe A, Satomura K, et al. Close relationship between the vasodilator response to acetylcholine in the brachial and coronary artery in suspected coronaryartery disease. Int J Cardiol 2005; 105 (1): 58–66

    Article  PubMed  Google Scholar 

  105. Green DJ, Cable NT, Rankin JM, et al. Anabolic steroids and vascular responses. Lancet 1993; 342 (8875): 863

    Article  PubMed  CAS  Google Scholar 

  106. Gokce N, Keaney Jr JF, Hunter LM, et al. Predictive value of noninvasively determined endothelial dysfunction for long-term cardiovascular events in patients with peripheral vascular disease. J Am Coll Cardiol 2003; 41 (10):1769–75

    Article  PubMed  Google Scholar 

  107. Ebenbichler CF, Sturm W, Ganzer H, et al. Flowmediated, endothelium-dependent vasodilatation is impaired in male body builders taking anabolic-androgenic steroids. Atherosclerosis 2001; 158 (2): 483–90

    Article  PubMed  CAS  Google Scholar 

  108. Miyachi M, Kawano H, Sugawara J, et al. Unfavorable effects of resistance training on central arterial compliance a randomized intervention study. Circulation 2004; 110 (18): 2858–63

    Article  PubMed  Google Scholar 

  109. Rakobowchuk M, McGowan CL, de Groot PC, et al. Endothelial function of young healthy males following whole body resistance training. J Appl Physiol 2005; 98 (6):2185–90

    Article  PubMed  CAS  Google Scholar 

  110. McCredie RJ, McCrohon JA, Turner L, et al. Vascular reactivity is impaired in genetic females taking high-dose androgens. J Am Coll Cardiol 1998; 32 (5): 1331–5

    Article  Google Scholar 

  111. D’Ascenzo S, Millimaggi D, Di Massimo C, et al. Detrimental effects of anabolic steroids on human endothelialcells. Toxicol Lett 2007; 169 (2): 129–36

    Article  PubMed  CAS  Google Scholar 

  112. Ammar EM, Said SA, Hassan MS. Enhanced vasoconstriction and reduced vasorelaxation induced by testosterone and nandrolone in hypercholesterolemic rabbits.Pharmacol Res 2004; 50 (3): 253–9

    Article  PubMed  CAS  Google Scholar 

  113. McCrohon JA, Jessup W, Handelsman DJ, et al. Androgen exposure increases human monocyte adhesion to vascular endothelium and endothelial cell expression of vascularcell adhesion molecule-1. Circulation 1999; 99 (17):2317–22

    Article  Google Scholar 

  114. Welder AA, Robertson JW, Melchert RB. Toxic effects of anabolic-androgenic steroids in primary rat hepatic cell cultures. J Pharmacol Toxicol Methods 1995; 33 (4): 187–95

    Article  PubMed  CAS  Google Scholar 

  115. Welder AA, Robertson JW, Fugate RD, et al. Anabolicandrogenic steroid-induced toxicity in primary neo natal rat myocardial cell cultures. Toxicol Appl Pharmacol1995; 133 (2): 328–42

    Article  PubMed  CAS  Google Scholar 

  116. O’Sullivan AJ, Kennedy MC, Casey JH, et al. Anabolicandrogenic steroids: medical assessment of present, past and potential users. Med J Aust 2000; 173 (6): 323–7

    PubMed  Google Scholar 

  117. Thevis M, Schrader Y, Thomas A, et al. Analysis of confiscated black market drugs using chromatographic and mass spectrometric approaches. J Anal Toxicol 2008; 32 (3): 232–40

    PubMed  CAS  Google Scholar 

  118. Evans-Brown M, Dawson R, McVeigh J. The dire consequences of doping [letter] Lancet 2008; 372 (9649): 1544

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool, L3 3AF, UK

    Peter Angell, Neil Chester, Danny Green, Greg Whyte & Keith George

  2. School of Sport Science, Exercise and Health, The University of Western Australia, Nedlands, WA, Australia

    Danny Green

  3. Cardiology Department, Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Chester, Cheshire, UK

    John Somauroo

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  1. Peter Angell
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Correspondence to Peter Angell.

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Angell, P., Chester, N., Green, D. et al. Anabolic Steroids and Cardiovascular Risk. Sports Med 42, 119–134 (2012). https://doi.org/10.2165/11598060-000000000-00000

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