Cardiovascular Risks and Mortality Associated with Hormone Use in Young Athletes: A Literature Review

Abstract

ABSTRACT
The use of hormones, especially anabolic-androgenic steroids (AAS), has become increasingly
common among young athletes and individuals who engage in physical activity for aesthetic
and performance enhancement purposes. Despite the desired anabolic effects, recent
scientific evidence points to a consistent association between the non-therapeutic use of these
substances and the development of adverse cardiovascular changes, as well as an increased
risk of mortality. The present study aims to review the scientific literature on cardiovascular
risks and mortality associated with hormone use in young athletes, highlighting the main
pathophysiological mechanisms involved and the clinical outcomes observed. This is a
narrative review of the literature, based on the analysis of observational studies, systematic
reviews, meta-analyses, clinical trials, and experimental studies published in recent years,
which address the use of AAS and testosterone, their effects on the cardiovascular system, and
their relationship with thrombotic events, cardiomyopathy, arrhythmias, heart failure, and
sudden death. The results indicate that the use of hormones in supraphysiological doses is
associated with atherogenic dyslipidemia, hypertension, endothelial dysfunction, systemic
inflammation, pathological cardiac remodeling, and a prothrombotic state, culminating in a
higher incidence of serious cardiovascular events, such as myocardial infarction, stroke, and
sudden cardiac death, even in young and physically active individuals. In contrast, hormone
replacement therapy at physiological doses and with appropriate clinical indication does not
present the same cardiovascular risk profile. It is concluded that the indiscriminate use of
hormones by young athletes represents an important public health problem, reinforcing the
need for prevention strategies, health education, and early cardiovascular surveillance.