AAS and Cardiovascular/Pulmonary Function

[hurricane]

Pickering TG, Hall JE, Appel LJ, et al. Recommendations for Blood Pressure Measurement in Humans and Experimental Animals. Hypertension 2005;45(1):142-61. http://hyper.ahajournals.org/content/45/1/142

Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed.

Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements.

Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home.

There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

This is widely overlooked IMO. I will see my PC doc and get one reading. EP doc I get another. Cardiologist another. Never uniformity. One will use my forearm because they don't have the right size. One uses a normal size cuff, the other one a large size. That annoys me. I have 20" fukin arms. I need a large cuff! Readings go from 142/82- 128/60.

 

[grey]

This is widely overlooked IMO.

One of Rippetoe's regular harping point as well.

He goes as far as to say that not one GP office in 20 will do a single correct and repeatable BP reading during an average day.

 

[hurricane]

One of Rippetoe's regular harping point as well.

He goes as far as to say that not one GP office in 20 will do a single correct and repeatable BP reading during an average day.

That's fukin scary.

 

[Dr JIM]

The Role of Androgen Receptors in Atherosclerosis


Male disadvantage in cardiovascular health is well recognised!

Takov, K., J. Wu, et al. "The role of androgen receptors in atherosclerosis." Mol Cell Endocrinol. Redirecting

This is what I was referring to in my post above about “maleness”.

Perhaps the age related decline in TT levels is a protective metabolic change and Mother Nature understood maintenance of young adulthood levels would only increase the probability of ASCVD.

To that end it would seem if the
norms of a 60 year old range bt
200-400ng/dL a quest for higher levels may result in unforeseen complications

 

[Dr JIM]

Stimulants and AAS are definitely a bad combo. Learned the hard way.

And the last two articles I posted
and two of those cited by Dr Scally provide a reasonable explanation as to why.

Moreover take a real close look at the second article which discusses the ATRIAL effects of AAS !

Finally based on the evidence of late I would avoid Nandrolone like a plague
if I was a chronic cyclists or was above the age of 40!

 

[CensoredBoardsSuck]

Perhaps the age related decline in TT levels is a protective metabolic change and Mother Nature understood maintenance of young adulthood levels would only increase the probability of ASCVD.

Highly unlikely for one reason: mother nature isn't concerned with keeping a redundant organism alive. After it's reproduced and, where necessary, raised its offspring to the point where they're self-sufficient and capable of reproducing on their own, there is no longer a need for that organism from an evolutionary perspective. That makes humans redundant after about age 45 or so, which, perhaps unsurprisingly, happens to be the maximum typical lifespan of most humans throughout history.

Finally based on the evidence of late I would avoid Nandrolone like a plague
if I was a chronic cyclists or was above the age of 40!

The same could probably be said about every other synthetic AAS, it's just that nandrolone has been studied the most extensively, especially in humans. In fact, I'd be surprised if the other synthetic AAS didn't have similar, if not worse, risks than nandrolone.

 

[Dr JIM]

Highly unlikely for one reason: mother nature isn't concerned with keeping a redundant organism alive. After it's reproduced and, where necessary, raised its offspring to the point where they're self-sufficient and capable of reproducing on their own, there is no longer a need for that organism from an evolutionary perspective. That makes humans redundant after about age 45 or so, which, perhaps unsurprisingly, happens to be the maximum typical lifespan of most humans throughout history.



The same could probably be said about every other synthetic AAS, it's just that nandrolone has been studied the most extensively, especially in humans. In fact, I'd be surprised if the other synthetic AAS didn't have similar, if not worse, risks than nandrolone.

 

[Dr JIM]

To late I included my reply within the text, or “quote” parameters of your post above CBS.

Where have you been anyway, did Mother Nature awaken you from a several month hiatus

Nope it seems my reply was lost in cyberspace @Millard Baker can you
find it or is a post that exceeds the 15 min time limit “lost”?

Regs
Jim

 

[Michael Scally MD]

Andersson C, Vasan RS. Epidemiology of cardiovascular disease in young individuals. Nat Rev Cardiol. http://www.nature.com/articles/nrcardio.2017.154

In the past 2 decades, a high prevalence of risk factors for cardiovascular disease, such as obesity, physical inactivity, and poor diet, has been observed among young individuals living in developed countries.

The rate of substance abuse (opioids, cocaine, electronic cigarettes, and anabolic steroids) is also increasing among young adults, whereas cigarette smoking might be declining.

Among younger individuals (aged 18-50 years), the incidence of cardiovascular diseases over the same time period has either been steady or has increased, in contrast to the trend towards a lower incidence of cardiovascular disease in adults aged >50 years.

Current observations might, therefore, be used to forecast a potential epidemic of cardiovascular disease in the near future as the younger segment of the population ages.

In this Review, we discuss the burden of risk factors for ischaemic heart disease, heart failure, atrial fibrillation, and sudden cardiac death among young adults aged 18-45 years.

Furthermore, we discuss the prevalence, incidence, and temporal trends of various cardiovascular diseases among this young segment of the population.

 

[hurricane]

Andersson C, Vasan RS. Epidemiology of cardiovascular disease in young individuals. Nat Rev Cardiol. http://www.nature.com/articles/nrcardio.2017.154

In the past 2 decades, a high prevalence of risk factors for cardiovascular disease, such as obesity, physical inactivity, and poor diet, has been observed among young individuals living in developed countries.

The rate of substance abuse (opioids, cocaine, electronic cigarettes, and anabolic steroids) is also increasing among young adults, whereas cigarette smoking might be declining.

Among younger individuals (aged 18-50 years), the incidence of cardiovascular diseases over the same time period has either been steady or has increased, in contrast to the trend towards a lower incidence of cardiovascular disease in adults aged >50 years.

Current observations might, therefore, be used to forecast a potential epidemic of cardiovascular disease in the near future as the younger segment of the population ages.

In this Review, we discuss the burden of risk factors for ischaemic heart disease, heart failure, atrial fibrillation, and sudden cardiac death among young adults aged 18-45 years.

Furthermore, we discuss the prevalence, incidence, and temporal trends of various cardiovascular diseases among this young segment of the population.[/QUOTE very disturbing evidence that the younger population is at such a increased risk of CD. I never would of guessed that. I thought I was a rare case.

 

[hurricane]

Andersson C, Vasan RS. Epidemiology of cardiovascular disease in young individuals. Nat Rev Cardiol. Epidemiology of cardiovascular disease in young individuals

In the past 2 decades, a high prevalence of risk factors for cardiovascular disease, such as obesity, physical inactivity, and poor diet, has been observed among young individuals living in developed countries.

The rate of substance abuse (opioids, cocaine, electronic cigarettes, and anabolic steroids) is also increasing among young adults, whereas cigarette smoking might be declining.

Among younger individuals (aged 18-50 years), the incidence of cardiovascular diseases over the same time period has either been steady or has increased, in contrast to the trend towards a lower incidence of cardiovascular disease in adults aged >50 years.

Current observations might, therefore, be used to forecast a potential epidemic of cardiovascular disease in the near future as the younger segment of the population ages.

In this Review, we discuss the burden of risk factors for ischaemic heart disease, heart failure, atrial fibrillation, and sudden cardiac death among young adults aged 18-45 years.

Furthermore, we discuss the prevalence, incidence, and temporal trends of various cardiovascular diseases among this young segment of the population.

That reply didn't work. Very disturbing evidence among the younger population. I thought I was a rare case. In your opinion what's the biggest culprit. Weight or drugs??

 

[grey]

Weight or drugs??

Purely opinion, but I find that younger folks on cycle (the serious ones, not the idjits we keep getting here) are a lot more willing to eat filthy than the 50+ crowd are and are less averse to truly epic stimulant use.

 

[Dr JIM]

Purely opinion, but I find that younger folks on cycle (the serious ones, not the idjits we keep getting here) are a lot more willing to eat filthy than the 50+ crowd are and are less averse to truly epic stimulant use.

Ditto!

Yet many of these 50+ crowd are being
“forced” to modify such trash laden youthful diets, in large part bc of the development of metabolic syndrome.

 

[Michael Scally MD]

[OA] Laddu DR, Rana JS, Murillo R, et al. 25-Year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium. Mayo Clinic Proceedings. http://www.mayoclinicproceedings.org/article/S0025-6196(17)30577-3/fulltext

Objective - To evaluate 25-year physical activity (PA) trajectories from young to middle age and assess associations with the prevalence of coronary artery calcification (CAC).

Patients and Methods - This study includes 3175 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who self-reported PA by questionnaire at 8 follow-up examinations over 25 years (from March 1985-June 1986 through June 2010-May 2011). The presence of CAC (CAC>0) at year 25 was measured using computed tomography. Group-based trajectory modeling was used to identify PA trajectories with increasing age.

Results - We identified 3 distinct PA trajectories: trajectory 1, below PA guidelines (n=1813; 57.1%); trajectory 2, meeting PA guidelines (n=1094; 34.5%); and trajectory 3, 3 times PA guidelines (n=268; 8.4%). Trajectory 3 participants had higher adjusted odds of CAC>0 (adjusted odds ratio [OR], 1.27; 95% CI, 0.95-1.70) vs those in trajectory 1. Stratification by race showed that white participants who engaged in PA 3 times the guidelines had higher odds of developing CAC>0 (OR, 1.80; 95% CI, 1.21-2.67). Further stratification by sex showed higher odds for white males (OR, 1.86; 95% CI, 1.16-2.98), and similar but nonsignificant trends were noted for white females (OR, 1.71; 95% CI, 0.79-3.71). However, no such higher odds of CAC>0 for trajectory 3 were observed for black participants.

Conclusion - White individuals who participated in 3 times the recommended PA guidelines over 25 years had higher odds of developing coronary subclinical atherosclerosis by middle age. These findings warrant further exploration, especially by race, into possible biological mechanisms for CAC risk at very high levels of PA.

 

[ErikR]

The study didn't mention what type of exercise the participants were doing. Does that even matter?

 

[hurricane]

[OA] Laddu DR, Rana JS, Murillo R, et al. 25-Year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium. Mayo Clinic Proceedings. http://www.mayoclinicproceedings.org/article/S0025-6196(17)30577-3/fulltext

Objective - To evaluate 25-year physical activity (PA) trajectories from young to middle age and assess associations with the prevalence of coronary artery calcification (CAC).

Patients and Methods - This study includes 3175 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who self-reported PA by questionnaire at 8 follow-up examinations over 25 years (from March 1985-June 1986 through June 2010-May 2011). The presence of CAC (CAC>0) at year 25 was measured using computed tomography. Group-based trajectory modeling was used to identify PA trajectories with increasing age.

Results - We identified 3 distinct PA trajectories: trajectory 1, below PA guidelines (n=1813; 57.1%); trajectory 2, meeting PA guidelines (n=1094; 34.5%); and trajectory 3, 3 times PA guidelines (n=268; 8.4%). Trajectory 3 participants had higher adjusted odds of CAC>0 (adjusted odds ratio [OR], 1.27; 95% CI, 0.95-1.70) vs those in trajectory 1. Stratification by race showed that white participants who engaged in PA 3 times the guidelines had higher odds of developing CAC>0 (OR, 1.80; 95% CI, 1.21-2.67). Further stratification by sex showed higher odds for white males (OR, 1.86; 95% CI, 1.16-2.98), and similar but nonsignificant trends were noted for white females (OR, 1.71; 95% CI, 0.79-3.71). However, no such higher odds of CAC>0 for trajectory 3 were observed for black participants.

Conclusion - White individuals who participated in 3 times the recommended PA guidelines over 25 years had higher odds of developing coronary subclinical atherosclerosis by middle age. These findings warrant further exploration, especially by race, into possible biological mechanisms for CAC risk at very high levels of PA.

That study literally blows my mind. How can that be??

 

[ErikR]

That study literally blows my mind. How can that be??

It's bad enough with all the Negative AAS reports. Now too much exercise is a problem?

 

[hurricane]

It's bad enough with all the Negative AAS reports. Now too much exercise is a problem?

What are we supposed to do?? I'm fukin confused bro.

 

[Dr JIM]

The study didn't mention what type of exercise the participants were doing. Does that even matter?

The level of PA was ascertained by interviewer assisted questioner. The info obtained was further quantified as METs.

This is not the first study which has exposed the risk, or lack of benefit to VIGOROUS exercise.

Once again moderation is of paramount importance

Here's a short and relatively easy to follow synopsis of a study on CAC and it's utility in diagnosing ASYMPTOMATIC heart disease.

And since MANY of those cycling AAS experience a diminished aerobic capacity basing relative risk on the presence or absence of symptoms poses another problem ---which form of risk stratification (or "cardiac test") is most suitable for this subset of patients, as a means to an ends, preventing Sudden Cardiac Death.

To that end the use of AAS as PEDs should be included as a separate cardiac risk factor, IMO

Jim

 

[ErikR]

The level of PA was ascertained by interviewer assisted questioner. The info obtained was further quantified as METs.

This is not the first study which has exposed the risk, or lack of benefit to VIGOROUS exercise.

Once again moderation is of paramount importance

Here's a short and relatively easy to follow synopsis of a study on CAC and it's utility in diagnosing ASYMPTOMATIC heart disease.

And since MANY of those cycling AAS experience a diminished aerobic capacity basing relative risk on the presence or absence of symptoms poses another problem ---which form of risk stratification (or "cardiac test") is most suitable for this subset of patients, as a means to an ends, preventing Sudden Cardiac Death.

To that end the use of AAS as PEDs should be included as a separate cardiac risk factor, IMO

Jim

Does this apply to weight training or cardiovascular exercise?