New Delhi: The growing obsession with muscular physiques and rapid body transformations among urban youth in India is fuelling dangerous misuse of steroids, stimulant-heavy pre-workout powders and unregulated gym supplements, with cardiologists warning of rising risks of arrhythmias, heart failure and sudden cardiac events in seemingly healthy young men.

Doctors said the trend, amplified by social media fitness culture and online supplement marketing, is pushing many gym-goers towards products and exercise regimens that may severely strain the heart.

"We are increasingly seeing young individuals with palpitations, abnormal heart rhythms, high blood pressure spikes and even early structural heart changes linked to unsupervised supplement or steroid use," Dr Rahul Chandola, cardiovascular and thoracic surgeon and chairman of the Institute of Heart and Lung Diseases, told PTI.

"The concern is not exercise itself. Regular exercise protects the heart. The danger comes when people combine extreme workouts with stimulants, anabolic steroids, dehydration and unrealistic body-image expectations," he said.

Doctors said sudden collapses and cardiac deaths among young fitness enthusiasts and amateur bodybuilders were becoming a growing concern globally, including in India.

Dr Mayank Yadav, cardiothoracic and vascular surgeon at AIIMS, said many young consumers wrongly assume that supplements sold online or promoted by influencers are medically safe.

"People think if a product is available on an e-commerce platform or being used by fitness influencers, it must be harmless. That assumption is dangerous because many formulations are poorly regulated or consumed in unsafe quantities," Yadav said.

India's growing fitness economy and social media-driven "aesthetic fitness" culture are contributing significantly to the trend, he added.

Doctors said platforms such as Instagram and YouTube are flooded with transformation videos, supplement promotions and extreme fitness challenges targeting the youth.

Recent international scientific reviews have shown that anabolic-androgenic steroid use is associated with reduced heart pumping efficiency, thickening of heart walls and harmful cardiac remodelling.

Similarly, many modern pre-workout supplements contain very high doses of caffeine, stimulants and performance-enhancing compounds that may elevate heart rate and blood pressure and trigger dangerous cardiovascular effects in susceptible individuals.

Chandola said another serious issue being overlooked was the absence of proper heart-health screening before people begin aggressive exercise programmes or extreme fitness regimens.

"Many young individuals may already have silent or underlying cardiac abnormalities that remain completely undiagnosed until a catastrophic event occurs during intense exercise," he said.

He said most routine annual health check-ups are often inadequate for identifying hidden cardiovascular disease.

"Many patients who suffer heart attacks later tell us they had recently undergone a 'normal health check-up'. Unfortunately, most standard annual packages consist primarily of blood tests and a resting ECG, which is only a brief snapshot of the heart's electrical activity and has limited ability to detect underlying blockages or deeper structural problems," he said.

According to Chandola, this creates a false sense of reassurance, leaving many high-risk individuals undiagnosed despite undergoing regular health checks.

He stressed that people engaging in high-intensity fitness programmes, gym training or endurance exercise should undergo more meaningful cardiovascular screening, particularly those above 40 years of age or with risk factors such as diabetes, hypertension, obesity, smoking history or family history of heart disease.

"Preventive cardiology must evolve beyond routine blood reports. Advances in biosensor technology and AI-driven cardiovascular screening are enabling earlier and more accurate assessment of heart health," Chandola said.

He added that emerging technologies such as iLiveConnect, an AI-powered wellness healthcare management platform, were helping shift healthcare towards proactive and preventive screening models capable of identifying hidden cardiac risks with greater precision and scalability.

"The future of heart care lies in early detection. If we can identify vulnerable individuals before symptoms appear, we can prevent many avoidable tragedies," he said.

Doctors also warned against widespread use of stimulant-loaded pre-workout powders before intense gym sessions.

"These products may contain extremely high caffeine concentrations along with multiple stimulants. Some users consume double scoops or mix them with energy drinks, creating enormous cardiovascular stress," Chandola said.

Yadav advised young gym-goers to avoid shortcuts to rapid muscle gain and seek professional medical guidance before using performance-enhancing substances.

"Exercise and fitness routines should prioritise overall health and longevity rather than endangering the heart for appearance-driven goals or social media approval," he said.