Metabolic & Cardiometabolic
anabolic-androgenic steroids increases cardiovascular disease risk
In plain terms: Do anabolic steroids increase cardiovascular disease risk?
Part of: 💊 anabolic-androgenic steroids
Yes — a nationwide cohort and imaging studies show steroid users have more coronary plaque, worse heart function and adverse lipids; long-term cardiovascular risk is clearly raised (short courses may not show acute changes).
Evidence ladder
How far up the ladder this claim has climbed. A high consensus on a low rung means "consistent so far," not "proven in people."
Top evidence so far: Population patterns (Observational)
How the studies fall
The evidence (12)
| Source | Grade | Stance | Quality | Finding |
|---|---|---|---|---|
| de Souza 2022 · Int J Sports Med | observational | supports | moderate | Strength-trained AAS users showed impaired myocardial contractility (reduced strain) and higher LV mass by cardiac MRI versus non-users. |
| Vasilaki 2016 · Toxicol Lett | animal | supports | moderate | Long-term nandrolone in rabbits caused focal myocardial fibrosis, oxidative stress and diastolic impairment. |
| Di Fazio 2025 · Front Cardiovasc Med | observational | supports | moderate | Systematic review of AAS-related deaths found LV hypertrophy, myocardial fibrosis and sudden cardiac death even without coronary disease. |
| Hartgens 2003 · Int J Sports Med | RCT | tested-null | high | Short-term (up to 16 weeks) AAS/nandrolone administration produced no detectable echocardiographic changes in heart structure or function. |
| Baggish 2017 · Circulation | observational | supports | high | AAS users had reduced LV systolic/diastolic function and markedly higher coronary atherosclerotic plaque volume than non-using weightlifters. |
| Celik 2024 · Medicina | observational | supports | low | Bodybuilders showed altered paraoxonase/arylesterase activity and lipid profiles associated with a pro-atherosclerotic pattern. |
| D'Andrea 2022 · Eur J Prev Cardiol | observational | supports | moderate | AAS-abusing athletes showed biventricular dysfunction and lung congestion on speckle-tracking and stress echocardiography. |
| Vanberg 2010 · Handb Exp Pharmacol | observational | supports | moderate | Review concludes AAS raise LDL and lower HDL, induce a prothrombotic state and hypertrophy, increasing cardiovascular disease risk. |
| Ilic 2014 · Hellenic J Cardiol | observational | supports | moderate | AAS-using athletes showed adverse LV remodeling and diastolic function changes versus non-using athletes. |
| Windfeld-Mathiasen 2025 · Circulation | observational | supports | high | Nationwide cohort of male AAS users showed substantially higher incidence of cardiovascular disease than age/sex-matched general-population controls. |
| Barbosa Neto 2018 · Clin Auton Res | observational | supports | moderate | Male bodybuilder AAS users had higher blood pressure, altered cardiac dimensions and cardiac autonomic dysfunction. |
| Urhausen 2004 · J Sports Med Phys Fitness | observational | mixed | moderate | Some adverse cardiac effects (hypertrophy, diastolic changes) persisted while others partly reversed after AAS cessation in strength athletes. |
Disagree, or know a study we missed?
We grade by evidence, not opinions. The way to weigh in is to point us to a study we haven't cited (check the evidence table above first), or to flag a problem with one we have. Every submission is reviewed; if it holds up, the grade updates and shows in Science Changes Its Mind.
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Educational only, not medical advice. Grades and scores reflect published evidence weighted by study design and quality; see the methodology.