Steroids can help build muscle mass and reduce inflammation in the body. But they can also have negative cardiovascular side effects, including abnormal rhythms and possible heart attacks.

Steroids can be an effective way to treat a variety of health conditions. Doctors may prescribe steroid medications to reduce inflammation or other medical purposes.

Additionally, approximately 3 to 4 million Americans use steroids to gain muscle mass.

However, steroid use — especially over a long time or in large doses — can have negative effects on the body, including the heart.

Steroids can cause a heart attack in certain situations.

For example, when androgenic-anabolic steroids are misused or taken in large doses, they can affect the heart structurally and functionally.

The way the heart contracts and relaxes may change when you take large doses of steroids. Your heart’s chambers may even increase in size.

Steroids can affect how your heart’s blood flow and ability to clot. They may also cause a temporary rise in blood pressure and an increase in LDL (“bad”) cholesterol levels while HDL (“good”) cholesterol levels decrease. This can place people at an increased risk of coronary artery disease and a life threatening irregular heart rate.

Timing of steroid use may also increase the risk of experiencing full cardiac arrest. For example, when people attribute early warning signs of a heart attack to their workout, they may not get assistance quickly and develop more serious complications.

Even if you don’t experience a heart attack from steroid use, your heart may still experience damage.

Steroids can:

Heart damage may be reversible by stopping steroid use, but other forms of treatment may be necessary depending on the extent and duration of the steroid use.

In an American Heart Association study from 2017 examining the effect of anabolic steroids on cardiovascular health, the researchers found reduced left ventricular systolic and diastolic function as well as coronary artery disease.

If you are on steroids, you may be able to help protect your heart by:

  • not smoking
  • reducing salt intake and eating a heart-healthy diet
  • exercising
  • limiting the amount of steroids you take and the length of time you take them

There may be alternatives to steroids that are easier on your heart. Your doctor can offer different recommendations depending on your reason for using steroids.

If you’re using steroids to add muscle or improve athletic performance, you might consider using a structured exercise plan, consuming additional healthy foods, and discussing natural supplement options with a nutritionist or your doctor.

To reduce inflammation without steroids, dietary changes may be helpful. You can also try getting additional sleep as well as reducing stress and other triggers.

If you do need steroids to control a medical condition, taking steps to minimize the dosage and duration can reduce the risk of heart damage.

Before taking steroids, you may want to ask your doctor:

  • Would you recommend using something else instead of a steroid based on my goals and health history?
  • Are there any risks I should be aware of?
  • Do I have any health conditions that mean I shouldn’t take steroids? Are there any health conditions I should watch to make sure that I don’t develop while on steroids?
  • How much of the steroid would you recommend I take? Are there any limits on the amount I should take?
  • Are there any other medications or lifestyle choices that would help my body while on steroids?
  • Would you recommend I undergo any tests to check on my heart health? (If so, should I do this before or while on steroids?)

Steroids may be taken for a variety of purposes, including reducing inflammation and building muscle.

However, their effects on the body may not all be positive. Especially if they’re misused, steroids have the potential to cause heart damage.

It’s important to talk with your doctor about any health concerns you may have before you begin using steroids.