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Cited by 122Doping in SportsHormonal and reproductive studiesPharmacological Effects and Assays

Cardiovascular Toxicities of Performance-Enhancing Substances in Sports

Dhar, Ritesh, Stout, C. William, Link, Mark S., Homoud, Munther K., Weinstock, Jonathan, Estes, N. A. Mark·2005·Mayo Clinic Proceedings
DOI 10.4065/80.10.1307
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Abstract

Athletes commonly use drugs and dietary supplements to improve athletic performance or to assist with weight loss. Some of these substances are obtainable by prescription or by illegal means; others are marketed as supplements, vitamins, or minerals. Nutritional supplements are protected from Food and Drug Administration regulation by the 1994 US Dietary Supplement Health and Education Act, and manufacturers are not required to demonstrate proof of efficacy or safety. Furthermore, the Food and Drug Administration lacks a regulatory body to evaluate such products for purity. Existing scientific data, which consist of case reports and clinical observations, describe serious cardiovascular adverse effects from use of performance-enhancing substances, including sudden death. Although mounting evidence led to the recent ban of ephedra (ma huang), other performance-enhancing substances continue to be used frequently at all levels, from elementary school children to professional athletes. Thus, although the potential for cardiovascular injury is great, few appropriately designed studies have been conducted to assess the benefits and risks of using performance-enhancing substances. We performed an exhaustive OVID MEDLINE search to Identify all existing scientific data, review articles, case reports, and clinical observations that address this subject. In this review, we examine the current evidence regarding cardiovascular risk for persons using anabolic-androgenic steroids including 2 synthetic substances, tetrahydrogestrinone and androstenedione (andro), stimulants such as ephedra, and nonsteroidal agents such as recombinant human erythropoietin, human growth hormone, creatine, and beta-hydroxy-beta-methylbutyrate.

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  • By itself, caffeine is not thought to stimulate the sympathetic nervous system enough to activate BAT.

    “By itself, caffeine is not thought to stimulate the sympathetic nervous system enough to activate BAT 138.”

    From Cellular bioenergetics as a target for obesity therapy (2010) · cites this paper as [138]

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Authors
Dhar, R., Stout, C. W., Link, M. S., Homoud, M. K., Weinstock, J., & Estes, N. A. M.
Affiliations
Tufts University (US)
Corresponding author
Dhar, Ritesh
ORCID
Venue
Mayo Clinic Proceedings
Publisher
Elsevier BV
Published
2005-10
Volume
80
Issue
10
Pages
1307-1315
ISSN
0025-6196 (ISSN-L)
DOI
10.4065/80.10.1307
OpenAlex
W1979455339
Cited by
122
References
82
Citations by year
2026: 2 · 2025: 1 · 2024: 3 · 2023: 4 · 2022: 1 · 2021: 5 · 2020: 8 · 2019: 4 · 2018: 6 · 2017: 5 · 2016: 3 · 2015: 9 · 2014: 5 · 2013: 9 · 2012: 12
FWCI
4.00
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Mayo Clinic Proceedings (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Sociology and Political Science › Doping in Sports
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Pharmacological Effects and Assays
Keywords
performance-enhancing drugs, cardiotoxicity, anabolic steroids, androstenedione, Ephedra, recombinant human erythropoietin, human growth hormone, creatine, beta-hydroxy-beta-methylbutyrate, dietary supplements, sudden death, athletes, drug regulation, Dietary Supplement Health and Education Act
MeSH terms
Central Nervous System Stimulants, Androstenedione, Caffeine, Cardiovascular System, Doping in Sports, Gestrinone, Humans, Male, Dietary Supplements, Ephedra

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