It takes a large toll if done incorrectly on the cardiovascular system.
But does show up for decades, but it will, just like babyboomers getting older and entering older decades, same with the people who abused steroids. It doesnt happen right away.
Like rheumatic fever, it just starts the process which will shorten lifespan over time due to congestive heart failure, atherosclerotic cardiovascular disease, hypertension with brittleness of arteries, hyperlipidemia.
It's not like shooting heroin where you can die overnight from respiratory arrest. The effects are cumulative and the disease process often takes decades to fully manifest itself