This is one reason I keep banging on about longevity.

Anyone who thinks there aren’t long term negative effects from steroid use is deluded. All we can really do is accept them and try to minimalize them.
Cholesterol levels will change and not for the better, so to help we can live a healthy lifestyle. Fish oils, fresh foods, minimal processed foods, stop smoking, curb alcohol etc etc. All the stuff that anyone should be doing to live a healthy life.

Blood pressure is kept low by exercise, healthy eating etc etc. The same approach as with keeping cholesterol level good.

Liver damage tends to result mainly from orals, so keep them to a minimum or don’t use them at all. Also, bear in mind that usually for every pill we take to cure or treat one thing, it usually has a detrimental effect somewhere else. Serms and anti estrogens, for example, aren’t without possible long term detrimental effects.

Steroids are also linked with cysts on the liver, so I suppose to a certain extent, it’s pot luck.

Other risks are to do with your reproductive system. That’s why we should cycle on and off, to prevent short damage changes becoming long term and irreversible.

It’s not all bad though. Most bodybuilding steroid users will not be morbidly obese. Being obese and sedentary has just as negative an effect on health, if not more, than that of sensible recreational steroid users. Smoking, eating fried, heavily processed food, drinking to excess and generally lazing about are equally damaging in my book. That’s my excuse anyway.