title: Cardiovascular risk associated with testosterone-boosting medications: a systematic review and meta-analysis.
abstract: BACKGROUND
  Recent reports have significantly halted the enthusiasm regarding androgen-boosting; suggesting that testosterone supplementation (TS) increases cardiovascular (CV) events.
  
  
  METHODS
  In order to overcome some of the limitations of the current evidence, the authors performed an updated systematic review and meta-analysis of all placebo-controlled randomized clinical trials (RCTs) on the effect of TS on CV-related problems. Out of 2747 retrieved articles, 75 were analyzed, including 3016 and 2448 patients in TS and placebo groups, respectively, and a mean duration of 34 weeks. Our analyses, performed on the largest number of studies collected so far, indicate that TS is not related to any increase in CV risk, even when composite or single adverse events were considered. In RCTs performed in subjects with metabolic derangements a protective effect of TS on CV risk was observed.
  
  
  CONCLUSIONS
  The present systematic review and meta-analysis does not support a causal role between TS and adverse CV events. Our results are in agreement with a large body of literature from the last 20 years supporting TS of hypogonadal men as a valuable strategy in improving a patient's metabolic profile, reducing body fat and increasing lean muscle mass, which would ultimately reduce the risk of heart disease.
authors.affiliation: Azienda-Usl Bologna, Maggiore-Bellaria Hospital, Medical Department, Endocrinology Unit , Bologna , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corona
authors.forename: Elisa
authors.initials: E
authors.lastname: Maseroli
authors.forename: Giulia
authors.initials: G
authors.lastname: Rastrelli
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Isidori
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sforza
authors.forename: Edoardo
authors.initials: E
authors.lastname: Mannucci
authors.forename: Mario
authors.initials: M
authors.lastname: Maggi
mesh_terms: D000728:Androgens / Q000008:administration & dosage / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy; D008297:Male; D012307:Risk Factors; D013739:Testosterone / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000728:Androgens; D013739:Testosterone
keywords: cardiovascular risk; mortality; randomized clinical trial; testosterone