Long-term use of anabolic steroids damages the heart more than researchers previously believed and could be setting up many users for heart disease and death, researchers reported Tuesday. The drugs, which include testosterone and related hormones, are taken by weight lifters and other athletes to boost muscle mass. Research reported in the journal Circulation: Heart Failure shows that they can severely impair the heart's ability to pump blood throughout the body.
Previously known side effects of the drugs include liver tumors, jaundice, high blood pressure, shrinkage of the testicles, reduced sperm count, development of breasts, paranoid jealousy, extreme irritability and impaired judgment.
Because some studies have also suggested an effect on the heart, Dr. Aaron L. Baggish of Massachusetts General Hospital in Boston and his colleagues decided to study the effects more carefully. They recruited 12 male weight lifters, average age 40, who reported taking about 675 milligrams of steroids per week for nine years. They were compared with seven closely matched weight lifters who had not taken the drugs.
The researchers used echocardiography to measure the so-called ejection fraction, the proportion of blood in the left ventricle forced out of the heart with each contraction. In healthy people, the ejection fraction is normally somewhere between 55% and 70%. In the steroid-taking group, the average ejection fraction was about 50%, compared to 59% in the group that did not take drugs. Such low ejection fractions are associated with an increased risk of heart disease and heart failure. The steroid users also had significantly impaired diastolic function, impeding the ventricle's ability to relax and fill with blood.
Previous studies have not found such clear-cut problems, Baggish said. That may be in part because they were conducted in Europe and athletes may have been taking different drugs. Also, most previous studies have looked at professional athletes, who might be expected to be healthier, while this one focused on recreational athletes.
"What we hope is that people start recognizing steroid use as a potential cause of heart disease and a cause of otherwise unexplained heart dysfunction in young people," Baggish said in a statement.
-- Thomas H. Maugh II
Photo: Weight lifters who take anabolic steroids to increase their muscle mass run the risk of damaging their heart's ability to pump blood. Credit: EPA / Anatoly Maltsev