CARDIOVASCULAR EFFECTS OF ANDROGENIC-ANABOLIC STEROIDS

Evidence has accumulated over the past several years which associates androgenic-anabolic steroid (AAS) use with sudden cardiac death, myoca rdial infarction, altered serum lipoproteins, and cardiac hypertrophy in humans who habitually use these drugs. Even though some experimenta l data obtained from animals correlate well with the human findings, t he adverse cardiovascular effects of AAS use are poorly understood. Th e evidence presented in this review suggests that there are at least f our hypothetical models of AAS-induced adverse cardiovascular effects: 1) an atherogenic model involving the effects of AAS on lipoprotein c oncentrations; 2) a thrombosis model involving the effects of AAS on c lotting factors and platelets; 3) a vasospasm model involving the effe cts of AAS on the vascular nitric oxide system; and 4) a direct myocar dial injury model involving the effects of AAS on individual myocardia l cells. Future studies should be directed at determining the exact me chanisms responsible for AAS-induced adverse cardiovascular effects, a t determining the relative contribution of each of these models, and a t identifying other possible contributing factors such as metabolism o f these steroids and the effects of potential metabolites on various t arget organs.