Anabolic steroid users may face heart trouble

NEW YORK (Reuters Health) - Bulking up with anabolic steroids appears to damage and weaken the heart, a new study shows, in principle increasing the odds of heart failure.

While it’s nothing new that steroids have bad health effects, the new findings show they may be more harmful than previously thought. In heart failure, a weakened heart can’t pump enough blood around the body.

The study did not find heart failure itself, just the signs of it, but in severe cases, the condition creates a backlog of blood in the lungs that makes breathing difficult, and may be fatal.

“What makes this scary is that the full magnitude of the problem may not declare itself until after 20 or 30 years,” said Dr. Harrison G. Pope of Harvard University, who worked on the new study, published in the journal Circulation.

Pope, who has studied anabolic steroids for over 20 years, said the drugs began to crop up in gyms around the country in the 1980s, and quickly flourished. Today, as many as two million Americans may have abused the controlled substances at one point or another.

“We may be seeing just the beginning of something that could become a huge public health problem,” Pope said.

With his colleagues, he advertised for weightlifters who could bench more than 275 pounds. That way, he got both steroid users and “clean” bodybuilders without having to disclose the study’s purpose, which could have biased the results.

The researchers measured the recruits’ heart function using ultrasound. Among the 12 steroid users, 10 turned out to have hearts that pumped less blood into the body than they should. In contrast, only one of the seven non-users had this problem.

“That is a stunning statistical difference, far greater that could possibly be explained by chance,” Pope told Reuters Health. “The heart becomes more flappy and cannot contract with the same force as it usually does, and it also becomes less flexible.”

“There have been case reports of athletes collapsing on the floor,” Dr. Nora Volkow, director of the National Institute on Drug Abuse in Bethesda, Maryland, told Reuters Health. “If I was a cardiologist, I would be very concerned.”

But she added that because the study is small, it is still too early to predict what will happen to the large group of steroid users now moving into middle age.

In addition to boosting muscle growth, anabolic steroids -- which mimic testosterone, the male sexual hormone -- also affect the brain in unpredictable ways: In some people, they produce aggression, in others depression.

With prolonged use, steroids also limit natural testosterone production in the testicles, which can make men more feminine.

While law enforcement has cracked down on illegal production of steroids in the U.S., the drugs are sold over-the-counter in some countries and can be purchased easily on the internet.

Pope, himself a psychiatrist, said the behavioral effects are worrisome, but that his biggest concern is the heart. Heart failure is already a major killer in developed nations. How much steroids will be adding to that death toll is still unclear.

“It is very hard for the (Drug Enforcement Administration) to intercept this stuff, it just pours into the country,” said Pope. “We need to get more data and we need it fast.”

SOURCE: here Circulation, online April 27, 2010.