Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life.
BACKGROUND
Low serum testosterone is associated with several cardiovascular risk factors including dyslipidaemia, adverse clotting profiles, obesity, and insulin resistance. Testosterone has been reported to improve symptoms of angina and delay time to ischaemic threshold in unselected men with coronary disease.


OBJECTIVE
This randomised single blind placebo controlled crossover study compared testosterone replacement therapy (Sustanon 100) with placebo in 10 men with ischaemic heart disease and hypogonadism.


RESULTS
Baseline total testosterone and bioavailable testosterone were respectively 4.2 (0.5) nmol/l and 1.7 (0.4) nmol/l. After a month of testosterone, delta value analysis between testosterone and placebo phase showed that mean (SD) trough testosterone concentrations increased significantly by 4.8 (6.6) nmol/l (total testosterone) (p = 0.05) and 3.8 (4.5) nmol/l (bioavailable testosterone) (p = 0.025), time to 1 mm ST segment depression assessed by Bruce protocol exercise treadmill testing increased by 74 (54) seconds (p = 0.002), and mood scores assessed with validated questionnaires all improved. Compared with placebo, testosterone therapy was also associated with a significant reduction of total cholesterol and serum tumour necrosis factor alpha with delta values of -0.41 (0.54) mmol/l (p = 0.04) and -1.8 (2.4) pg/ml (p = 0.05) respectively.


CONCLUSIONS
Testosterone replacement therapy in hypogonadal men delays time to ischaemia, improves mood, and is associated with potentially beneficial reductions of total cholesterol and serum tumour necrosis factor alpha.
Malkin
C J
CJ
Department of Cardiology, Royal Hallamshire Hospital, Sheffield S10 2JF, UK.
Pugh
P J
PJ
Morris
P D
PD
Kerry
K E
KE
Jones
R D
RD
Jones
T H
TH
Channer
K S
KS
D000728:Androgens / Q000097:blood / Q000627:therapeutic use*; D000787:Angina Pectoris / Q000150:complications; D023921:Coronary Stenosis / Q000150:complications; D018592:Cross-Over Studies; D015444:Exercise / Q000502:physiology; D005080:Exercise Test; D020249:Hormone Replacement Therapy; D006801:Humans; D007006:Hypogonadism / Q000150:complications / Q000188:drug therapy*; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D017202:Myocardial Ischemia / Q000517:prevention & control*; D016037:Single-Blind Method; D013739:Testosterone / Q000097:blood / Q000627:therapeutic use*; D016896:Treatment Outcome
D000728:Androgens; D013739:Testosterone