Key Points

Doping based on new blood vessel formation (‘angiogenic doping’) can likely boost athletic performance and would be difficult to detect.
Angiogenic doping could target growth factors for blood vessels or regulatory proteins. Suitable pharmacologic agents, currently not subject to doping controls, are readily available.
Despite the risk of serious side effects, angiogenic doping is likely already a reality, and its use will increase with the emergence of effective advanced medical procedures such as gene therapy and gene editing.