Saturday, May 7, 2011

Anabolic androgenic steroids and heart disease

     Anabolic androgenic steroid (AAS) abuse is widespread in competitive sports.  It has been estimated that close to 3% of American adults have used AAS. (1)  In one study 29% of college football players and 21% of male track and field athletes reported use. (2)  Self admitted use of AAS in elite power lifters was 55% in another study. (3)

Brian Pillman
     Prevalence of AAS use among American professional wrestlers is unknown.  Data is limited because many past and current users are reluctant to admit usage of performance enhancing drugs.  Self reporting is known to yield inaccurate information.  This is especially true since 1990 when AAS were classified as a Schedule III drug of misuse.  Under oath Terry Bollea (Hulk Hogan) estimated 75-80% of WWE wrestlers were using AAS during 1982-83. (4)    While it is believed current use if down, no data are available.

     For over two decades there has been an epidemic of American professional wrestlers dying young.  Keith Pinckard, M.D., Ph.D, a forensic pathologist in Dallas, Texas who has followed deaths in professional wrestling estimated that professional wrestlers are 12 times more likely to die of heart disease than other individuals ages 25 to 44. (5)  That AAS can cause heart disease has been well known for a number of years. 

Eddie Guerrero
     A non-fatal heart attack was first reported in the medical literature in a 22 year old weightlifter who used AAS for only six weeks. (6)  The first fatal heart attack was reported in a college athlete. (7)  Other cardiac fatalities due to heart attacks have subsequently been reported. (8,9)

     There have also been reports of cardiomyopathy occurring in AAS users. (10, 11)  There are studies that show AAS can cause abnormal enlargement of the left heart ventricle that can persist even after stopping drug use. (12)  Such changes to the heart function can cause heart failure (13) and even sudden death. (14)

     Other specific complications that have been reported in AAS users include pulmonary embolism (15), hypertension (16), adverse cholesterol profiles (17), and lethal heart rhythms (18).

David Smith
    Many well know American professional wrestlers have died prematurely with autopsy findings supporting the use of AAS as a contributing factor.  Autopsy findings that have been described in AAS users include increased cardiac mass, features of hypertrophic cardiomyopathy, interstitial fibrosis in the myocardium, and atherosclerosis.  Acute coronary thrombosis is not always identified. (11)

     On February 27, 2006 WWE implemented a Wellness Program that included a substance abuse and drug policy. (19)  The non-medical use of AAS which include and are based on the natural steroid testosterone is prohibited.  It is too early to know what effect this new policy will have on the death rate of professional wrestlers.


  1. National Institute on Drug Abuse (NIDA) notes 2000; 15(3): 15.
  2. Clin Sports Med 1990; 2: 155.
  3. Physician Sportmed 1988; 16: 91.
  4. United States v. Vincent K. McMahon and Titan Sports, No 93-CT-1276.
  6. Am J Cardio 1988; 62: 162.
  7. N Engl J med 1990; 322: 476.
  8. Ugersk Laeger 1991; 153: 587.
  9. Am J Heart 1992; 124: 507.
  10. Physician Sportsmed 1988; 16(11): 109.
  11. Med J Aust 1993; 158: 34.
  12. Prog Cardiovasc Dis 1998; 41: 1.
  13. Eur Heart J 1996; 17: 1576.
  14. Med Sci Sports Exerc  1995; 27(9): 1252.
  15. JAMA 1992; 6: 2328.
  16. Med Toxicol Adverse Drug Exp 1989; 4: 254.
  17. Arch Intern Med 1991; 151: 1925.
  18. Am J Cardio 2000; 85 (10): 1212.

Photographs are for illustrative purposes only.  Wrestling with Death does not claim ownership.

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