Caminiti's Death Puts Spotlight on Steroids
By E.J. Mundell, HealthDay Reporter
MONDAY, Oct. 11 (HealthDayNews) -- The sudden heart attack death of former baseball star Ken Caminiti, 41, highlights the potential link between substance abuse among pro athletes and its dangerous effects on health, according to experts.
Caminiti, who died Sunday in New York City, had admitted in the past to abusing both cocaine and performance-enhancing steroids.
"For males in the U.S., heart disease is the number one cause of death, and steroid abuse makes heart disease even worse," stressed Dr. Linn Goldberg, a professor at Oregon Health Sciences University, and an expert on steroid abuse.
Caminiti was voted the National League's Most Valuable Player in 1996 after hitting a career-high .326 and leading the San Diego Padres to the National League pennant. He also belted 40 home runs, drove in 130 runs, and won the second of three consecutive Gold Glove awards for his work at third base that year.
But a darker side to Caminiti's brilliance on the field emerged in May 2002, when he told Sports Illustrated he had used steroids to maximize his performance during that winning season.
Anabolic steroids help build muscle tissue and increase body mass by acting like the body's natural male hormone, testosterone.
More recently, Caminiti was admitted to a Texas drug-treatment facility in February 2003, after testing positive for cocaine use, leading state prosecutors to revoke his probation from a previous drug conviction.
And just last Tuesday, Caminiti admitted in a Houston court that he had violated his probation again after testing positive for cocaine use in September.
A spokeswoman for the New York City medical examiner's office said an autopsy would be performed Monday, The New York Times reported.
The exact causes and contributing factors to Caminiti's heart attack remain unknown. But Dr. Nieca Goldberg, a spokeswoman for the American Heart Association, said steroids raise nearly all heart disease risk factors.
"One, steroid use raises blood pressure," she said. "Two, it can also alter your sugar metabolism, so you have an increased risk of diabetes. Three, it makes the arteries vulnerable since, because of elevated cholesterol, you get cholesterol plaque buildup."
Steroid abuse can also cause a dangerous thickening of heart muscle called hypertrophy --- the same kind of heart-muscle enlargement seen in patients with congestive heart failure, experts warn.
"By revving the heart up with steroids, making it grow bigger, and then taking those steroids away, you end up with a heart muscle that's enlarging and then contracting. It's like putting [pitching great] Roger Clemens' arm in a sling and then telling him to pitch," explained Dr. Eric Braverman, a New York City doctor who has counseled numerous pro athletes on steroid abuse and other medical issues.
Braverman believes athletes take steroids for the mental boost, too. "They get addicted to the high -- the testosterone high and the mood elevation that goes along with that performance edge," he said.
Caminiti's recent cocaine convictions mean his cardiovascular system was facing yet another challenge, the AHA's Goldberg said.
"Cocaine increases your risk for heart attack," she said. "It can cause a direct spasm of the blood vessels, closing off the blood supply to heart muscle. It can also cause a life-threatening arrhythmia."
Braverman believes steroids and cocaine act on similar mechanisms, causing some people to "cross-addict" to both drugs.
"Steroids have a kind of amphetamine effect, similar to cocaine," he said. In the case of cocaine, "it gives people a thrill -- your heart races and there's that edge. But sooner or later your heart goes off the deep end and collapses."
Caminiti's death has shifted the focus yet again to recurrent scandals of drug-abuse and steroid abuse among professional athletes.
The exact number of pro baseball players -- and other world-class athletes -- taking steroids remains unknown. But OHSU's Goldberg said the results of Major League Baseball testing efforts suggest it may be as high as one in every six players.
In his 2002 interview with Sports Illustrated, Caminiti estimated that half of all pro baseball players were using the supplements.
Linn Goldberg (no relation to Nieca Goldberg) said his biggest concern remains the health of America's teenagers, who are increasingly influenced by the behaviors of their favorite sports stars.
"These are very dangerous drugs, and their effects on children are even greater than on adults because they affect all their biological systems," he said. "It's a shock to their body, because the hormones are so powerful."
Goldberg has long pushed for passage of a "Steroids Bill" that would educate children about the dangers of steroid abuse while limiting the over-the-counter sale of so-called "pro-hormones" -- nonsteroidal compounds that are transformed into steroid hormones once ingested. That bill was just passed by both the U.S. House of Representatives and the Senate, Goldberg said, and now awaits President Bush's signature.
More information
To learn more about steroid dangers, go to the American Pediatric Association (www.aap.org ). 
SOURCES: Linn Goldberg, M.D., professor of medicine, and head, division of Health Promotion and Sports Medicine, Oregon Health Sciences University, Portland; Nieca Goldberg, M.D., chief, women's cardiac care, Lenox Hill Hospital, New York City, and spokeswoman, American Heart Association; Eric Braverman, M.D., director, PATH Medical, New York City, author, The Edge Effect; Oct. 11, 2004, The New York Times
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