Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favors greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependant on the dose, route of administration (oral vs. injectable), type of steroid (aromatizable or non-aromatizable), and level of resistance to hepatic metabolism. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction.
Some bodybuilders and athletes use trenbolone esters for their muscle-building and otherwise performance-enhancing effects.  Such use is illegal in the United States and many other countries. The DEA classifies trenbolone and its esters as Schedule III controlled substances under the Controlled Substances Act .  Trenbolone is classified as a Schedule 4 drug in Canada  and a class C drug with no penalty for personal use or possession in the United Kingdom .  Use or possession of steroids without a prescription is a crime in Australia .