Treatment‐seeking behavior and cardiovascular morbidity among men with anabolic‐androgenic steroid use: A cross‐sectional study.

Aims: To determine associations between anabolic‐androgenic steroid (AAS) use‐related morbidity including cardiovascular disease (CVD) and engagement to health services. Methods: In this cross‐sectional study, 90 males with at least 12 months cumulative current or former use of AAS were included. The participants were divided into a treatment‐seeking group (TSG) and a non‐treatment seeking group (non‐TSG) based on their responses to a self‐report web questionnaire. All participants were screened for symptoms that could be indicative of CVD through a clinical interview, and examined with blood samples, blood pressure measurements and transthoracic echocardiography. Results: In the total sample (n = 90), mean age was 39 ± 11 years with cumulative AAS use of 12 ± 9 years. Among men in the TSG with current use there were higher prevalence of dyspnoea (50% vs 7%) and reduced left ventricular ejection fraction (LVEF) in conjunction with left ventricular hypertrophy (LVH) (36 vs. 9%) and/or high blood pressure (55% vs. 19%) compared to men in the non‐TSG. Among men with current AAS use and established LVEF <50% (n = 25) or LVH (n = 21), 44% (11) and 43% (9) respectively, had never engaged health services due to AAS‐related adverse effects. Deviant liver‐ and kidney parameters were frequently observed in the total sample but without between‐group differences. Conclusions: Treatment‐seeking behavior among current AAS users may be associated with increased levels of dyspnoea and established CVD. Despite objective signs of severe CVD among a substantial amount of study participants, it is of great concern that the majority had never sought treatment for AAS‐related concerns. [ABSTRACT FROM AUTHOR]