Androgenic anabolic steroids and arterial structure and function in male bodybuilders

OBJECTIVES The study examined arterial and cardiac structure and function i n bodybuilders using androgenic anabolic steroids (AAS), compared to non-st eroid-using bodybuilder controls. BACKGROUND Adverse cardiovascular events have been reported in bodybuilders taking anabolic steroids. The cardiovascular effects of AAS, however, have not been investigated in detail. METHODS We recruited 20 male bodybuilders (aged 35 +/- 3 years), 10 activel y using AAS and 10 who denied ever using steroids. Serum lipid and hormone levels, carotid intima-media thickness (IMT), arterial reactivity, and left ventricular (LV) dimensions were measured. Vessel diameter was measured by ultrasound at rest, during reactive hyperemia tan endothelium-dependent re sponse, leading to flow-mediated dilation, FMD), and after sublingual nitro glycerin (GTN, an endothelium-independent dilator). Arterial reactivity was also measured in 10 age-matched non-bodybuilding sedentary controls. RESULTS Use of AAS was associated with significant decreases in high densit y lipoprotein cholesterol, sex hormone binding globulin, testosterone and g onadotrophin levels, and significant increases in LV mass and self-reported physical strength (p < 0.05). Carotid IMT (0.60 +/- 0.04 mm vs. 0.63 +/- 0 .07 mm), arterial FMD (4.7 +/- 1.4% vs. 4.1 +/- 0.7%) and GTN responses (11 .0 +/- 1.9% vs. 14.4 +/- 1.7%) were similar in both bodybuilding groups (p > 0.2). The GTN responses were significantly lower and carotid IMT signific antly higher in both bodybuilding groups, however, compared with the non-bo dybuilding sedentary controls (p = 0.01). CONCLUSIONS Although high-level bodybuilding is associated with impaired va scular reactivity and increased arterial thickening, the use of AAS per se is not associated with significant abnormalities of arterial structure or f unction. (J Am Coil Cardiol 2001;37:224-30) (C) 2001 by the American Colleg e of Cardiology.