Cardiotoxic effects of cocaine and anabolic-androgenic steroids in the athlete.
Cocaine and anabolic-androgenic steroid abuse have become major drug problems in the United States. Cocaine has been designated as "the drug of greatest national health concern" while as many as 1 million Americans have used or are currently using anabolic-androgenic steroids to promote athletic performance and/or improve physical appearance. Unfavorable cardiovascular events have been linked to both cocaine and anabolic-androgenic steroid abuse in healthy, physically active individuals. Deaths of several United States athletes in 1986 focused attention on the life-threatening cardiovascular consequences of cocaine abuse. Reports of myocardial injury with anabolic-androgenic steroid abuse are anecdotal. Nevertheless, case reports have illustrated the alarming cardiotoxic potential of these steroids in athletes. Anabolic-androgenic steroids were correlated to myocardial infarction in weight lifters and cardiomyopathy in a former professional football player. From the total emergency room episodes where cocaine was mentioned in 1990, approximately 66% of these episodes occurred in young individuals 18-29 years of age. Over 500,000 of the individuals currently taking anabolic-androgenic steroids for nonmedical purposes are high-school children. Because cocaine and anabolic-androgenic steroids are used improperly, more focus needs to be paid to the toxic mechanisms of their adverse effects. Therefore, the purpose of this review is to discuss mechanisms whereby exercise and/or exercise training may alter the cardiovascular responses to these drugs. Furthermore, we would like to illustrate that contrary to the popular belief, acute and chronic abuse of cocaine and anabolic-androgenic steroids have a negative impact on exercise performance.
Welder
A A
AA
College of Pharmacy, Division of Medicinal Chemistry and Pharmacodynamics, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
Melchert
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RB
D045930:Anabolic Agents / Q000009:adverse effects*; D009202:Cardiomyopathies / Q000139:chemically induced; D003042:Cocaine / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000378:metabolism; D004300:Doping in Sports; D006331:Heart Diseases / Q000139:chemically induced* / Q000378:metabolism; D006801:Humans; D009203:Myocardial Infarction / Q000139:chemically induced; D014179:Neurotransmitter Uptake Inhibitors / Q000378:metabolism; D010807:Physical Endurance / Q000187:drug effects / Q000502:physiology; D013177:Sports
D045930:Anabolic Agents; D014179:Neurotransmitter Uptake Inhibitors; C066444:cocaethylene; D003042:Cocaine