"Steroid abuse has been associated with cardiovascular diseases (CVD), including heart attacks and strokes, even in athletes younger than 30. Steroids contribute to the development of CVD, partly by changing the levels of lipoproteins that carry cholesterol in the blood. Steroids, particularly the oral types, increase the level of low-density lipoprotein (LDL) and decrease the level of high-density lipoprotein (HDL). High LDL and low HDL levels increase the risk of atherosclerosis, a condition in which fatty substances are deposited inside arteries and disrupt blood flow. If blood is prevented from reaching the heart, the result can be a heart attack. If blood is prevented from reaching the brain, the result can be a stroke.
Steroids also increase the risk that blood clots will form in blood vessels, potentially disrupting blood flow and damaging the heart muscle so that it does not pump blood effectively.
The most serious complication of Anabolic Androgenic Steroids (AAS) use is an increased risk for heart disease and sudden death.
Anabolic steroids decrease HDL cholesterol and increase cardiac size. Myocardial fibrosis can occur, similar to cardiomyopathy.
Hypertension induced by Anabolic Androgenic Steroids (AAS) further increases heart size.
These effects may persist even after use of Anabolic Androgenic Steroids (AAS) has been stopped, increasing the risk for morbidity and mortality.
Anabolic steroids have been shown to enhance the coronary artery response to catecholamines released during periods of stress, and this may play a role in the sudden cardiac deaths reported with their use.
Contraction band necrosis, indicative of ischemia, has been observed in such deaths.
. Heart with hypertrophy, gross.
. Heart with myocardial contraction band necrosis, trichrome stain, microscopic.
. Testicular atrophy, gross.
. Testicular atrophy, microscopic.
. Gynecomastia, gross."
Carter N, Rutty GN, Milroy CM, Forrest AR. Deaths associated with MBDB misuse. Int J Legal Med. 2000;113:168-170.
Christophersen AS. Amphetamine designer drugs - an overview and epidemiology. Toxicol Lett. 2000;112-113:127-131.
Fineschi V, Baroldi G, Monciotti F, Reattelli LP, Turillazzi E. Anabolic steroid abuse and cardiac sudden death. Arch Pathol Lab Med. 2001;125:253-255.
Fineschi V, Centini F, Mazzeo E, Turillazzi E. Adam (MDMA) and Eve (MDEA) misuse: an immunohistochemical study on three fatal cases. Forensic Sci Int. 1999;104:65-74.
McGuire P. Long term psychiatric and cognitive effects of MDMA use. Toxicol Lett. 2000;112-113:153-156.
Olmedo R, Hoffman RS. Withdrawl syndromes. Emerg Med Clin North Am. 2000;18:273-288.
Scully RE, Mark EJ, McNeely WF, et al. Case 6-2001: Case records of the Massachusetts General Hospital. New Engl J Med. 2001;344:591-599.
Timby N, Eriksson A, Bostrom K. Gamma-hydroxybutyrate associated deaths. Am J Med. 2000;108:518-519.