How do steroids affect the heart?
Steroids significantly affect the cardiovascular system. The use of steroids is linked with an increased cardiovascular risk. The higher the dosage of steroids, the higher the risk for cardiovascular diseases. One of the reasons for this is that steroids can lead to anatomical and functional changes in the heart [1].
The steroids cause the heart to beat in an irregular, slower, or faster rhythm [1]. These changes in the heart rate lead to heart palpitations.
Also, steroids can lead to heart muscle dysfunction, decreasing blood pumping effectiveness [1].
Furthermore, steroids can lead to atherosclerosis in the coronary arteries. The changes in the arteries lead to a buildup of plaque that can obstruct the blood flow. The presence of atherosclerotic plaques significantly increases the risk of heart attacks [1].
The formation of atherosclerosis while taking steroids is supported by another effect. Steroids increase the levels of LDL cholesterol. The higher the amount of this molecule, the faster the development of the plaque [1].
The use of steroids can also result in hypertension. Increased blood pressure also increases the risk of cardiovascular disease [1].
Another impact that steroids can have on the heart is the creation of blood clots. A blood clot can travel into the coronary circulation and cause a myocardial infarction [1].
Additionally, steroids can change the anatomy of the heart. They can increase the size of the ventricles and the atriums [1].
The changes of the heart can reverse after steroid therapy ends. However, prolonged treatment and the high dose of the drug decrease the chances of a full recovery [1].
Can steroids cause cardiac arrest?
The connection between cardiac arrest and steroids is not fully understood.
However, when used in high doses or misused, steroids can contribute to cardiac arrest [2, 3, 4, 5].
Steroids increase the risk of cardiovascular diseases like heart attacks and arrhythmia [1]. This condition, when not treated, can lead to heart arrest.
On the other hand, some studies indicate that taking steroids after or during and heart arrest increases the chances of survival [6, 7].
Do steroids increase blood pressure?
Yes, steroids increase blood pressure. The effect of higher blood pressure occurs during physical activity and at rest [8, 9].
However, the exact increase in blood pressure also depends on the individual health state and predispositions.
For example, adrenocorticotrophin and adrenocortical steroids cause an increase in fluid volumes in the body and cardiac output [8].
Also, anabolic steroids used by weightlifters and synthetic glucocorticoids increase blood pressure [10, 9].
How to control high blood pressure on steroids?
Control of high blood pressure while on steroids involves a multifactorial approach. It demands, in addition to blood pressure medication, lifestyle changes, and regular monitoring.
The medication that can be used for high blood pressure depends on your doctor. A good choice might be a mineralocorticoid receptor antagonist, like spironolactone [11, 12].
Among the lifestyle changes that are recommended for the management of high blood pressure are:
- a balanced diet,
- regular physical exercise,
- reduction of caffeine and alcohol,
- quitting smoking [11, 12].
Regular monitoring is a great way to see if the changes and medication work. To monitor blood pressure, one needs a blood pressure measuring device and a way to record the results. Some devices have an automatic digital measurement history linked to an app. However, a paper notebook is equally good.
It is crucial to measure the blood pressure regularly, every day at a similar time. Every measurement should be recorded with a date. When the measurement is performed after coffee, smoking, or physical activity, it has to be noted.
Why are steroids contraindicated in heart failure?
Steroids are contraindicated in heart failure as they worsen the heart's function. In heart failure, when the heart is insufficiently pumping blood, taking steroids would only increase the failure.
For example, steroids like testosterone and boldenone can lead to severe heart failure. Using them in cases of present heart failure would lead to fast deterioration and possible death [13].
Also, steroids like aldosterone can worsen heart failure. Aldosterone leads to the remodeling of the ventricles. Its influence changes the size and function of the heart [14].
The use of steroids in heart failure is still under investigation. There are hopes that steroids could help against the inflammatory changes in the heart. However, until now, the findings do not support taking steroids for heart failure [15].
Can steroids cause blood clots?
Yes, particularly the anabolic-androgenic steroids, which can lead to blood clots.
Steroids have the potential to create a pro-thrombotic state. This state leads to the formation of blood clots, especially in predisposed individuals to thrombosis [16].
Additionally, in some cases, steroids can cause an accelerated activation of the clotting process. This is caused by the fact that steroids lead to a hypercoagulation state. In this state, the coagulation-promoting molecules in blood are more prominent [17].
However, the link between steroids and coagulation is not well understood. Some studies show no findings of hypercoagulation in steroid users [18].
Do steroids make cancer grow faster?
The connection between steroids and cancer is complex. The effect steroids have on the proliferation of cancer depends on many factors. The most crucial factors include the type of steroid, its dose, and the duration of use. Also, not all steroids make all cancer types grow faster.
The interaction is more specific. For example, estrogen (17 beta-estradiol) in high doses shows the potential to stimulate androgen-dependent tumors, such as prostate cancer. However, the experiment was done on mouse tissue, so there is no confirmation it will work the same on human cells [19].
Anabolic steroids have also been linked to cancer growth. These steroids increase the risk of liver tumors [20].
Additionally, steroid use lowers the survival chances of cancer [21].
How to tell if someone is using steroids?
Identifying steroid use is not easy. However, there are a few signs that can indicate that a person is using steroids.
Among the most common physical and behavioral signs of someone using steroids are:
- rapid muscle growth in a short period [22],
- sudden appearance of acne, particularly in adults [23],
- changes in fat distribution and breast enlargement in men [24],
- often mood swings and increased irritability and aggression [23],
- temporary changes in libido [24],
- changes in laboratory markers like lower levels of LH and FSH, increased hematocrit, and higher γ-glutamyl transpeptidase levels [23].