Cardiovascular effects of doping substances, commonly prescribed medications and ergogenic aids in relation to sports: a position statement of the sport cardiology and exercise nucleus of the European Association of Preventive Cardiology.

Paolo Emilio Adami, Nikolaos Koutlianos, Aaron Baggish, Stéphane Bermon, Elena Cavarretta, Asterios Deligiannis, Francesco Furlanello, Evangelia Kouidi, Pedro Marques-Vidal, Josef Niebauer, Antonio Pelliccia, Sanjay Sharma, Erik Ekker Solberg, Mark Stuart, Michael Papadakis

Journal: European journal of preventive cardiology 2022;29(3):559-575

PMID: 35081615

Abstract

The use of substances and medications with potential cardiovascular effects among those practicing sports and physical activity has progressively increased in recent years. This is also connected to the promotion of physical activity and exercise as core aspects of a healthy lifestyle, which has led also to an increase in sport participation across all ages. In this context, three main users' categories can be identified, (i) professional and amateur athletes using substances to enhance their performance, (ii) people with chronic conditions, which include physical activity and sport in their therapeutic plan, in association with prescribed medications, and (iii) athletes and young individuals using supplements or ergogenic aids to integrate their diet or obtaining a cognitive enhancement effect. All the substances used for these purposes have been reported to have side effects, among whom the cardiovascular consequences are the most dangerous and could lead to cardiac events. The cardiovascular effect depends on the type of substance, the amount, the duration of use, and the individual response to the substances, considering the great variability in responses. This Position Paper reviews the recent literature and represents an update to the previously published Position Paper published in 2006. The objective is to inform physicians, athletes, coaches, and those participating in sport for a health enhancement purpose, about the adverse cardiovascular effects of doping substances, commonly prescribed medications and ergogenic aids, when associated with sport and exercise.

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2022. For permissions, please email: [email protected].

Address: Health and Science Department, World Athletics, 6-8 Quai Antoine 1er, Monaco 98000, Monaco.; Sports Medicine Laboratory, Aristotle University of Thessaloniki, Thermi, AUTH DPESS, 54124, Thessaloniki, Greece.; Cardiovascular Performance Program, Massachusetts General Hospital, 55 Fruit Street Boston, MA 02114, USA.; Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica, 79 - 04100 - Latina (LT), Italy.; Mediterranea Cardiocentro, Via Orazio, 2, 80122, Napoli (NA), Italy.; Aritmologia Clinica e Sportiva, IRCCS Gruppo MultiMedica Elettrofisiologia, Via Milanese 300, 20099, Sesto San Giovanni(MI), Italy.; Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland.; Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria.; Sports Medicine and Science Institute, CONI, Largo Piero Gabrielli, 1, 00197, Rome, Italy.; Cardiovascular Clinical Academic Group, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK.; Diakonhjemmet Hospital, Diakonveien 12, 0370 Oslo, Norway.; International Testing Agency-ITA, Av. de Rhodanie 58, 1007 Lausanne, Switzerland.
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