Long-term use of anabolic-androgenic steroids causes persistent thickening of the heart’s left ventricle and impairs pumping function among male weightlifters, according to a nearly 10-year follow-up study published in the European Heart Journal Cardiovascular Imaging. However, complete discontinuation of the drugs can reverse these severe cardiovascular changes.
Ten Years of Following Weightlifters Reveals Persistent Heart Damage
For nearly a decade, researchers at Oslo University Hospital in Norway tracked male strength athletes to understand how long-term anabolic-androgenic steroid use alters the cardiovascular system.
The investigation builds on an earlier study conducted between 2017 and 2019. Out of the original participants, 70 steroid users and 35 non-using controls re-enrolled for the follow-up. Among the previous users, 35 continued taking anabolic steroids, 15 had stopped completely, 14 maintained abstinence, and six had relapsed.
Scientists gathered data through questionnaires and clinical interviews, collected blood and urine samples to measure hormone levels, and performed echocardiography to examine heart structure and function. Researchers additionally accounted for variables such as exercise habits, drinking, tobacco use, substance intake, heart-related complaints, and management for high blood pressure.
“We found that continued use of anabolic steroids among adult and middle-aged male strength athletes, even at lower dosages, was associated with a persistent thickening of the heart muscle, impaired contractions and worsening of the heart’s ability to relax. As many as 17% of those who continued using AAS had severely reduced heart function. However, this could be reversed if the men stopped using anabolic steroids and continued to abstain from them over the long term.”
Dr Vibeke M. Almaas
Why Dosage Reductions Failed While Total Cessation Reversed Damage
According to data gathered through questionnaires and clinical interviews, lowering the dose yielded no beneficial effects or improvement in heart condition for the weightlifters’ hearts.
Real recovery required stopping entirely. The 15 men who completely discontinued anabolic-androgenic steroids showed a significant reduction in heart muscle thickness at follow-up compared to entry baseline measurements.
Their left ventricular ejection fraction in participants who stopped taking steroids also increased from 48% to 54%. At the same time, it remained at 60% in the control group.
How Antihypertensive Therapy Affects Active Users
Participants who kept taking the substances experienced an 11% boost in ejection fraction when receiving high blood pressure management, though this did not decrease their heart muscle thickness.
The researchers acknowledged multiple constraints in their work, such as a limited cohort size where dropout occurred, reliance on memory for past anabolic-androgenic steroid intake which introduces recall bias, blood pressure treatment records existing exclusively for the final evaluation, and potential confounding influences from lifestyle habits, stimulant consumption, hypertension, or alternative medical conditions.
