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Prostate Cancer Treatment and Research / Sexual Differentiation and Disorders · Journal article
International Health Sciences Review · August 11, 2026
A consensus or society position rather than new primary data.
This narrative review distinguishes therapeutic testosterone replacement therapy, which RCT evidence (TRAVERSE, T4DM) indicates does not increase major cardiovascular events when monitored, from non-therapeutic supraphysiological AAS abuse, which observational studies associate with higher rates of acute myocardial infarction, cardiomyopathy, arrhythmias, thromboembolism, hypertension, and dyslipidemia. The authors recommend multidisciplinary clinical management with individualized cardiovascular screening and harm reduction, emphasizing that risk depends on dose, duration, and cumulative exposure.
Narrative review. Men receiving testosterone replacement therapy (therapeutic use); individuals using anabolic-androgenic steroids at supraphysiological doses (abusive use)..
Randomized trials (TRAVERSE, T4DM) indicate testosterone replacement therapy does not increase risk of major cardiovascular events when appropriately indicated and monitored Testosterone replacement therapy may be associated with arrhythmias and thromboembolic events Observational studies demonstrate abusive AAS use is associated with higher incidences of acute myocardial infarction, cardiomyopathy, arrhythmias, venous thromboembolism, hypertension, and dyslipidemia
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should distinguish supervised therapeutic testosterone replacement in hypogonadism from non-therapeutic abuse, recognizing that monitored therapeutic use does not increase major cardiovascular event risk but may carry arrhythmia and thromboembolism risk, whereas abusive use carries substantially higher cardiovascular morbidity. A multidisciplinary approach spanning cardiology, endocrinology, psychiatry, and sports medicine is recommended.
A narrative review synthesizing evidence on therapeutic versus abusive AAS use and cardiovascular risk, offering multidisciplinary clinical management recommendations rather than reporting a primary study result.
As stated by the source record.
Clinicians should distinguish supervised therapeutic testosterone replacement in hypogonadism from non-therapeutic abuse, recognizing that monitored therapeutic use does not increase major cardiovascular event risk but may carry arrhythmia and thromboembolism risk, whereas abusive use carries substantially higher cardiovascular morbidity. A multidisciplinary approach spanning cardiology, endocrinology, psychiatry, and sports medicine is recommended.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Anabolic-androgenic steroids (AAS) have established therapeutic applications, particularly testosterone replacement therapy in men with hypogonadism; however, non-therapeutic use at supraphysiological doses is associated with important cardiovascular consequences. This narrative review synthesizes recent evidence on the mechanisms, risks, and clinical implications of AAS use, emphasizing the distinction between supervised therapeutic treatment and abuse. Evidence from randomized clinical trials, including the TRAVERSE and T4DM studies, indicates that testosterone replacement therapy, when appropriately indicated and monitored, does not increase the risk of major cardiovascular events, although it may be associated with arrhythmias and thromboembolic events. In contrast, observational studies demonstrate that abusive AAS use is associated with higher incidences of acute myocardial infarction, cardiomyopathy, arrhythmias, venous thromboembolism, hypertension, and dyslipidemia. The underlying mechanisms include androgen receptor overactivation, oxidative stress, endothelial dysfunction, pathological cardiac remodeling, myocardial fibrosis, lipid abnormalities, and prothrombotic effects. The magnitude of cardiovascular damage appears to depend primarily on dose, duration, and cumulative exposure, as well as the simultaneous use of multiple compounds. Clinical management should therefore adopt a multidisciplinary approach involving cardiology, endocrinology, psychiatry, and sports medicine, with individualized strategies for cardiovascular screening, risk prevention, patient education, and harm reduction.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.