Anabolic androgenic steroid users: a tilt test study with young adult men

Introduction
Anabolic androgenic steroids (AASs) can induce cardiac dysautonomia, which is related to arrhythmias, vasovagal syncope (VVS) and sudden death. The aim of this study was to determine whether the use of AASs increases the susceptibility for VVS or autonomic dysfunction in AAS users by the head-up tilt test (HUTT).

Material and methods
Cross-sectional observational study conducted with physically active young men, users (AAS group; n = 10) and non-users (Control group, n = 13) of AAS. The history of physical activity and age of each participant were recorded and the following examinations were performed: physical, biochemical, hormonal, electrocardiogram (ECG), 24-hour Holter recorder equipment. The 24-hour Holter and HUTT were conducted to detect the presence of arrhythmias/heart rate variability, and VVS/dysautonomia, respectively. Of the 28 participants recruited, 5 were excluded for not having completed the examinations.

Results
Compared with non-users, users of AAS showed an increase in aspartate aminotransferase (Control: 29.7 ±1.8; AAS: 49.9 ±9.0 UI/l; p < 0.05), in ventricular extrasystoles (Control: 2.5 ±2.3; AAS: 14.9 ±11.2, p < 0.05), and reduction in the pNN50 index of Holter (Control: 24.3 ±4.0%; AAS: 14.8 ±4.0%, p < 0.05). The HUTT showed that the maximum value of diastolic blood pressure was increased in the AAS user group (Control: 78.3 ±2.1; AAS: 90.0 ±5.4 mm Hg, p < 0.05).

Conclusions
The study showed that the use of AAS is able to promote an autonomic dysfunction, with a ventricular arrhythmia. In addition it was found that among AAS users there was a positive result for the HUTT.