by Justin Jackson , Medical Xpress

Credit: Unsplash/CC0 Public Domain

Hospital-based researchers from Denmark have reported a substantial increase in cardiovascular disease risk among male users of anabolic androgenic steroids (AAS). Long-term health outcomes for AAS users show extreme increases in heart-related health risks.

AAS are synthetic derivatives of testosterone that enhance muscle mass and strength. While prohibited in competitive sports, they are widely used for body enhancement and recreational fitness. AAS use has been associated with increased mortality rates, yet the long-term epidemiology of cardiovascular disease in this population remains underexplored.

In the study titled “Cardiovascular Disease in Anabolic Androgenic Steroid Users,” published in Circulation, researchers examined a cohort of 1,189 men who had been sanctioned for AAS use in Danish fitness centers between 2006 and 2018.

These participants were matched with 59,450 male controls from the general Danish population based on age and sex. Researchers assessed the incidence of acute myocardial infarction, percutaneous coronary intervention or coronary artery bypass graft, venous thromboembolism, ischemic stroke, arrhythmia, cardiomyopathy, heart failure, and cardiac arrest.

It is unclear from the study whether AAS users quit or continued use after being sanctioned, nor does it specify dosage or AAS type. Still, the AAS user group demonstrated much higher incidences of several cardiovascular outcomes over an average follow-up of 11 years.

Time to cardiovascular events for users of anabolic androgenic steroids and controls. The numbers below the graphs show individuals at risk. Users of anabolic androgenic steroids are presented in red. Controls are presented in blue. To ensure anonymity, incident individuals at risk at baseline are not tabulated. Credit: Circulation (2025). DOI: 10.1161/CIRCULATIONAHA.124.071117

Hazard ratios showed a risk three times higher of acute myocardial infarction (HR 3.00) and percutaneous coronary intervention or coronary artery bypass graft (HR 2.95).

Venous thromboembolism risk was higher (HR 2.42), and arrhythmias occurred at 2.3 times the rate of the general population (HR 2.26).

Heart failure was only 3.6 times higher (HR 3.63), which is surprising considering that cardiomyopathy risk was nearly nine times higher in this group (HR 8.90).

Researchers concluded that AAS use is significantly associated with an elevated risk of several major cardiovascular diseases, with risks persisting during long-term follow-up.

More information: Josefine Windfeld-Mathiasen et al, Cardiovascular Disease in Anabolic Androgenic Steroid Users, Circulation (2025). DOI: 10.1161/CIRCULATIONAHA.124.071117

Journal information:Circulation

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