[Cardiovascular alterations associated with doping]

Area of Science:

• Sports Medicine
• Toxicology
• Cardiology

Context:

• Anabolic-androgenic steroid (AAS) abuse extends beyond professional athletes, prevalent in amateur and recreational sports.
• High-dose AAS use, common in bodybuilding and powerlifting, is linked to significant cardiovascular and endocrine side effects.
• Forensic investigations and user self-declarations reveal weekly AAS dosages from 300-2000 mg, often accompanied by medications for side effect management.

Purpose:

• To investigate the correlation between AAS abuse and self-treatment of associated side effects, particularly cardiovascular issues.
• To analyze the types of medications used by AAS users for managing adverse effects.
• To highlight the severe, potentially lethal, consequences of excessive AAS misuse.

Summary:

• AAS misuse is widespread, with users self-medicating for side effects like erectile dysfunction, estrogenic issues, and cardiovascular problems using various drug classes.
• Confiscated medications in doping cases include antihypertensives (beta-blockers, diuretics, ARBs, CCBs, ACE inhibitors), confirming self-treatment practices.
• Case studies of bodybuilder fatalities illustrate severe AAS side effects, including cardiac infarction and thrombotic events, underscoring the risks.

Impact:

• Clinicians should consider potential AAS abuse in patients with unexplained constitutional changes and adverse effects.
• Awareness of common self-medications used by AAS consumers is crucial for effective therapeutic interventions.
• This research emphasizes the critical need for monitoring and addressing AAS abuse and its health consequences in diverse athletic populations.