title: Testosterone and Cardiovascular Disease.
abstract: Testosterone (T) is the principal male sex hormone. As men age, T levels typically fall. Symptoms of low T include decreased libido, vasomotor instability, and decreased bone mineral density. Other symptoms may include depression, fatigue, erectile dysfunction, and reduced muscle strength/mass. Epidemiology studies show that low levels of T are associated with more atherosclerosis, coronary artery disease, and cardiovascular events. However, treating hypogonadism in the aging male has resulted in discrepant results in regard to its effect on cardiovascular events. Emerging studies suggest that T may have a future role in treating heart failure, angina, and myocardial ischemia. A large, prospective, long-term study of T replacement, with a primary endpoint of a composite of adverse cardiovascular events including myocardial infarction, stroke, and/or cardiovascular death, is needed. The Food and Drug Administration recently put additional restrictions on T replacement therapy labeling and called for additional studies to determine its cardiac safety.
authors: Huntington Medical Research Institutes, Pasadena, California; Division of Cardiovascular Medicine, Department of Medicine, Keck School of Medicine at University of Southern California, Los Angeles, California. Electronic address: kloner@hmri.org.
authors: Robert A
authors: RA
authors: Kloner
authors: Department of Urology, University of North Carolina, Chapel Hill, North Carolina.
authors: Culley
authors: C
authors: Carson
authors: Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors: Adrian
authors: A
authors: Dobs
authors: Division of Cardiology, Mayo Clinic, Rochester, Minnesota.
authors: Stephen
authors: S
authors: Kopecky
authors: Section of Vascular Medicine, Division of Cardiovascular Disease, Perelman School of Medicine at the University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania.
authors: Emile R
authors: ER
authors: Mohler
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D000728:Androgens / Q000378:metabolism / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism / Q000517:prevention & control; D006801:Humans; D007006:Hypogonadism / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism / Q000628:therapy; D008297:Male; D012307:Risk Factors; D013739:Testosterone / Q000378:metabolism / Q000627:therapeutic use
chemical_list: D000728:Androgens; D013739:Testosterone
keywords: angina; heart failure; hormone replacement therapy; major adverse cardiovascular events; male health; myocardial infarction