" Anabolic androgenic steroid abuse among young people is a widespread problem, and adverse events such as sudden cardiac death and heart attack have been reported in athletes ," said Francis Ribeiro, the lead author of the study. I have added, "In Brazil, around one million people have used anabolic androgenic steroids at least once, and they are the most commonly used drug in the country."

Whether anabolic androgenic steroids related to early coronary artery disease, was examined by the study. Moreover, it also tested if reduced high-density lipoprotein (HDL) function was the mechanism that led to coronary artery disease in anabolic androgenic steroid users.

The study included 51 men with an average age of 29 years. Among these 51 men, 21 did weightlifting and had taken anabolic androgenic steroids for at least two years, 20 did weight lifting but did not take steroids, and 10 were healthy but sedentary.

To assess the presence of atherosclerosis in coronary arteries, participants underwent computed tomography coronary angiography. To confirm steroid use, a urine test was performed in all participants. Lipid levels including HDL were tested using blood samples. Cell culture was used to measure the ability of each participant's HDL to perform its normal function of removing cholesterol from macrophages .

When compared to none of the non-users and sedentary participants, 24% of steroid users had atherosclerosis in their coronary arteries. These steroid users had significantly lower HDL levels, and reduced HDL function , which could increase the risk of cardiovascular events. Greater awareness of the potential risks of these drugs needed.

"Our study suggests that anabolic androgenic steroid use may be associated with the development of coronary artery disease in apparently healthy young people." Steroids may have an impact on HDL's ability to remove cholesterol from macrophages, promoting atherosclerosis, "said Mr. Ribeiro of Souza.

He continued, "This was a small, observational study and we can not conclude that steroids cause atherosclerosis." He adds, "Larger studies with longer follow-up are needed to confirm these results."

"This study despite its small sample size is well done and calls attention to a possible important health problem in Brazil and elsewhere since it shows not only the classical lipid disturbances induced by steroids but actually associated with subclinical atherosclerosis presence, something that we are not supposed to find in young individuals, "said Dr Raul Santos.

"This is an important issue in cardiovascular prevention which deserves further study. During SBC 2017, ESC experts will highlight hot topics in prevention and other fields of cardiology that were presented at ESC Congress 2017 in Barcelona," said Professor Fausto Pinto.