Beauty, brawn, and burden: cardiovascular consequences of aesthetic AAS use

The non-medical use of androgenic anabolic steroids (AAS) for aesthetic and performance enhancement has surged globally, especially among young adults and athletes. Despite public perception of these substances as shortcuts to physical perfection, accumulating evidence reveals significant cardiovascular toxicity associated with their use. This opinion paper synthesizes recent findings from clinical and experimental studies, highlighting mechanisms of cardiovascular damage, including left ventricular hypertrophy, arrhythmias, dyslipidemia, thrombosis, and sudden cardiac death. We argue that cardiologists and physicians must be at the forefront of prevention, early detection, and multidisciplinary management of AAS-related cardiovascular complications.