How Substance Use Patterns Shape Perceived Cardiac Concern Among An International Sample of Men Who Use...

Area of Science:

• Cardiovascular Health
• Pharmacology
• Public Health

Background:

• Cardiovascular side effects are a known risk for anabolic-androgenic steroid (AAS) users.
• Factors contributing to these risks, such as administration route and concurrent substance use, are not well understood.

Purpose of the Study:

• To investigate the association between route of administration (ROA), image-and performance-enhancing drug (IPED) polypharmacy, and licit substance use with cardiovascular concerns in AAS users.
• To identify specific predictors of self-reported cardiovascular-related concerns among AAS consumers.

Main Methods:

• Analysis of data from 1167 males (≥16 years) who used AAS in the past 12 months from the 2024 Global Drug Survey (GDS2024).
• Exploration of associations using chi-square tests and multivariable binary logistic regression.
• Investigation of substance interactions using pairwise models.

Main Results:

• 35.7% of AAS consumers reported cardiovascular concerns.
• Injectable AAS use (OR=10.57) and oral AAS use (OR=1.92) were strongly associated with cardiovascular concerns.
• Clenbuterol use (OR=1.44) was also associated with increased cardiovascular concerns, particularly in combination with other substances.

Conclusions:

• Oral AAS use and the use of substances like clenbuterol are most strongly linked to negative cardiovascular health outcomes in AAS consumers.
• Route of administration and patterns of concurrent substance use are critical factors influencing cardiovascular risk in this population.