Courtesy of endocrine.org
Men who have low testosterone levels may have a slightly elevated
risk of developing or dying from heart disease, according to a recent
study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).
Testosterone is a key male sex hormone that helps maintain sex drive,
sperm production and bone health. Over time, low testosterone may
contribute to an increase in body fat, loss of body hair and muscle
bulk.
“When we reviewed the existing research into testosterone and
cardiovascular disease, a growing body of evidence suggested a modest
connection between the two. A specific pathogenesis did not come
forward, but perhaps less frequently investigated events may play a
role, such as thrombosis where a blood clot develops in the circulatory
system or arrhythmia, where there is a problem with the heart beat or
rate,” said the study’s lead author, Johannes Ruige, MD, PhD, of Ghent
University Hospital in Belgium. “Based on current findings, though, we
cannot rule out that low testosterone and heart disease both result from
poor overall health.”
Treating low testosterone with replacement therapy did not have any
beneficial effect on cardiovascular health, Ruige said. Although the
number of older and middle-aged men who are being prescribed
testosterone replacement therapy is rising rapidly, there is debate
about whether the practice is too widespread. In its testosterone therapy clinical practice guidelines, The Endocrine Society recommends treating only men who have unequivocally low testosterone levels and consistent symptoms.
The clinical review examined findings from studies on cardiovascular
disease and testosterone published between 1970 and 2013. Although the
studies suggested some sort of relationship, existing research found
little evidence of a connection between low testosterone and arteriosclerosis, the hardening and narrowing of arteries that can cause
heart attacks and strokes. The reviewed studies also found no
relationship between testosterone levels and heart attacks.
Many of the studies had cross-sectional designs that do not provide
information about causality, but the review also looked at 19
prospective observational studies that can provide additional
information about whether one condition causes another. Because these
studies did not completely rule out some potential preceding causes of
both low testosterone and cardiovascular disease, additional research is
needed to confirm the relationship between the two conditions, Ruige
said.
“Gaps still remain in our understanding of low testosterone and
cardiovascular disease,” he said. “Ultimately, the goal is to more
accurately assess the impact testosterone substitution therapy may have
on the heart health of men who qualify for the treatment.”
Other researchers working on the study include D.M. Ouwens and J.-M. Kaufman of Ghent University Hospital.
The article, “Beneficial and Adverse Effects of Testosterone on the Cardiovascular System in Men,” was published online, ahead of print.
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Founded in 1916, The Endocrine Society is the world’s oldest, largest
and most active organization devoted to research on hormones and the
clinical practice of endocrinology. Today, The Endocrine Society’s
membership consists of over 16,000 scientists, physicians, educators,
nurses and students in more than 100 countries. Society members
represent all basic, applied and clinical interests in endocrinology.
The Endocrine Society is based in Chevy Chase, Maryland. To learn more
about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at https://twitter.com/#!/EndoMedia.
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