Anabolic steroids and cardiovascular risk: A national population-based cohort study.
Level 3 - non-randomized controlled study
Non-randomized national register-linked cohort study
PubMed 26005042 · doi:10.1016/j.drugalcdep.2015.04.013
What was done
A Swedish national population-based cohort study enrolled 2,013 men between 2002 and 2009 on the date of their first test for anabolic androgenic steroids (AAS). Subsequent morbidity and mortality data were tracked via national registries, comparing AAS-positive individuals (n = 409) against AAS-negative individuals (n = 1,604) and benchmarking both groups against the general Swedish male population.
What was found
Men testing positive for AAS (20%) had twice the rate of cardiovascular morbidity and mortality compared to AAS-negative controls (adjusted hazard ratio [aHR] 2.0; 95% CI 1.2–3.3). Compared to the general Swedish population, all tested individuals had elevated rates of premature all-cause mortality, though it was markedly higher in the AAS-positive group (standardized mortality ratio [SMR] 19.3; 95% CI 12.4–30.0) than the AAS-negative group (SMR 8.3; 95% CI 6.1–11.0).
Why it matters
This study provides population-level longitudinal evidence that non-therapeutic AAS use is independently associated with doubled cardiovascular morbidity and mortality and substantially increased premature death.
Limits
The study included only men tested for AAS, a high-risk group that already had an 8-fold higher baseline mortality than the general public. Specific steroid regimens, dosages, duration of exposure, and concurrent substance use or lifestyle confounders were not detailed in the abstract.
Cited by
- context Using anabolic steroids for muscle mass is associated with a 15-fold increased risk of premature heart failure and a 122-fold increased risk of cardiac death.