EFFECTS OF ANABOLIC STEROID ABUSE ON THE DEVELOPMENT OF HEART FAILURE AND CARDIOVASCULAR INCIDENTS

Dariusz Szołtys; Katarzyna Oberska; Sandra Olewińska; Aleksandra Lisowska; Hanna Grygorcewicz; Pola Sitek; Karolina Zygoń Komendarczyk; Michalina Adamczyk; Tola Kotkiewicz; Yelyzaveta Petrenko

doi:10.31435/ijitss.2(50).2026.5222

Authors

Dariusz Szołtys Municipal Hospital in Siemianowice Śląskie, Siemianowice Śląskie, Poland https://orcid.org/0009-0000-2687-3123
Katarzyna Oberska Municipal Hospital in Siemianowice Śląskie, Siemianowice Śląskie, Poland https://orcid.org/0009-0004-6701-7584
Sandra Olewińska Municipal Hospital in Siemianowice Śląskie, Siemianowice Śląskie, Poland https://orcid.org/0009-0003-7018-8440
Aleksandra Lisowska Municipal Hospital in Siemianowice Śląskie, Siemianowice Śląskie, Poland https://orcid.org/0009-0008-4917-821X
Hanna Grygorcewicz University Clinical Hospital No. 2 of the Pomeranian Medical University in Szczecin, Poland https://orcid.org/0009-0009-1260-8308
Pola Sitek Municipal Hospital in Siemianowice Śląskie, Siemianowice Śląskie, Poland https://orcid.org/0009-0009-2631-8846
Karolina Zygoń Komendarczyk Municipal Hospital in Siemianowice Śląskie, Siemianowice Śląskie, Poland https://orcid.org/0009-0005-9916-0972
Michalina Adamczyk Municipal Hospital in Siemianowice Śląskie, Siemianowice Śląskie, Poland https://orcid.org/0009-0002-6325-8298
Tola Kotkiewicz Municipal Hospital in Siemianowice Śląskie, Siemianowice Śląskie, Poland https://orcid.org/0009-0001-6578-3910
Yelyzaveta Petrenko Municipal Hospital Complex in Chorzów, Chorzów, Poland https://orcid.org/0009-0005-9481-472X

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5222

Keywords:

Anabolic Androgenic Steroids, Cardiovascular Disease, Cardiomyopathy, Heart Failure, Steroid Misuse

Abstract

Anabolic androgenic steroids (AASs) are synthetic derivatives of testosterone primarily indicated for the treatment of androgenic deficiency states. Non-clinical use of these agents has increased in recent years, particularly among athletes and individuals seeking rapid muscle hypertrophy and enhanced physical performance. Supraphysiological, off-label dosing is associated with significant systemic adverse effects. Elevated steroid levels disrupt endocrine homeostasis by suppressing the hypothalamic-pituitary-gonadal (HPG) axis. Furthermore, AAS misuse has been linked to dyslipidemia, activation of the renin-angiotensin-aldosterone system (RAAS), vascular remodeling, oxidative stress, and left ventricular hypertrophy. These mechanisms collectively add to structural remodeling of the myocardium and blood vessels, thereby increasing the risk of cardiovascular disease (CVD). Emerging evidence also indicates a higher prevalence of cardiomyopathy, arrhythmias, and premature atherosclerosis among chronic AAS users. Recent studies have associated AAS misuse with left ventricular dilation, reduced ejection fraction, and mitral regurgitation.

This narrative review compiles current human-based research on the cardiovascular consequences of anabolic androgenic steroids misuse, explains the pathophysiology of CVD in this population, and highlights recommended clinical evaluations. A comprehensive literature search was executed using PubMed, Scopus, and Web of Science, focusing on original clinical cardiovascular imaging and translational studies published between 2000 and 2025.

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