Effect of large doses of anabolic steroids on the diurnal blood pressure profile

To assess the effect of the self-administration of large doses of anabolic steroids (AS) on 24-hr blood pressure (BP) and cardiac structure and function, 10 body-builders using AS and 14 control body builders were studied with ambulatory BP monitoring and echocardiography. Age was 28±5 years in the former and 27±8 years in the latter. AS users were studied at the end of a steroid cycle (8.4 weeks) and after a period of withdrawal (11 weeks). Gonadotropins (LH and FSH) were significantly lower in the AS users than the controls (p=.001 and .03). In the former they further decreased after the AS cycle (p<.001 and <.001 vs controls). Average 24-hr BP was similar in the two groups of subjects. However, the 24-hr systolic BP pattern was altered in AS users, due to a smaller BP reduction during sleep (−9.7±4.1 mmHg vs −17.3±5.0 mmHg in non users;p=.04). This finding was more evident at the end of the AS cycle (−8.6±8.5 mmHg;p=.02 vs non users). Differences in diastolic BP were smaller and non significant. Interventricular septum thickness was greater in AS users than non users (p=.05), while the other dimensional parameters and left ventricular systolic and diastolic function did not differ between the two groups. In AS users the day-night BP difference was inversely correlated to interventricular septal thickness (r=−0.71) and relative wall thickness (−0.76) (both p<.05). This held true when the AS users and controls were grouped together (r=−0.71 and −0.68; p<.01). In conclusion, the present results show that chronic AS intake is associated with a flattened 24-hr BP profile. This could contribute to the left ventricular remodeling exhibited by AS users.