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Assessment of Vascular Tone Responsiveness using Isolated Mesenteric Arteries with a Focus on Modulation by Perivascular Adipose Tissues
Published on: June 3, 2019
Testosterone as a modulator of vascular behavior
Marguerite Littleton-Kearney1, Patricia D Hurn
1Johns Hopkins Schools of Nursing and Medicine, 525 N. Wolfe Street, Room 460, Baltimore, MD 21205-2110, USA. mkearney@jhmi.edu
Insights
Testosterone
Area of Science:
- Cardiovascular Science
- Endocrinology
- Physiology
Background:
- Male sex is a known risk factor for cardiovascular disease, with differing prevalence patterns between men and women.
- Testosterone's vascular effects are complex, varying with dose, duration, and underlying conditions.
- Physiological effects of testosterone on vascular tone are not fully understood, with evidence for both vasodilation and vasoconstriction.
Purpose of the Study:
- To review the current understanding of testosterone's physiological effects on vascular behavior.
- To explore testosterone's role in vascular health and disease.
- To highlight the need for further research, particularly in women.
Main Methods:
- Review of existing literature on testosterone's vascular effects.
- Analysis of data from isolated vessels, animal models, and clinical studies.
- Focus on endothelium-dependent and independent mechanisms, including nitric oxide pathways and ion channels.
Main Results:
- Pharmacological doses of testosterone/dihydrotestosterone may cause vasodilation.
- Testosterone can alter vascular tone via endothelium-dependent (nitric oxide) and independent mechanisms.
- Clinical data suggest potential benefits in men with coronary artery disease, but risks (hypertension, cardiovascular events) in women.
Conclusions:
- Testosterone's vascular actions are complex and sex-dependent.
- More research is needed to clarify testosterone's role in vascular health and disease, especially in women.
- The efficacy and safety of androgen therapy require further investigation.
Abstract:
Male sex is an acknowledged risk factor for many forms of cardiovascular disease, and vascular disease prevalence patterns appear to be different in men versus women. The vascular properties of the principal mammalian androgen, testosterone, are complex and linked to dose, duration of exposure, presence of underlying vascular disease, and, possibly, biological sex. Data from isolated vessels and animal models suggest that pharmacological doses of testosterone, or its potent intracellular metabolite dihydrotestosterone, produce vasodilation. Testosterone's major effect on vascular beds at physiologic concentrations remains unclear, with documentation of both vasodilatory and vasoconstrictive actions. Results of various studies suggest that testosterone can alter vascular tone through both endothelium-dependent and endothelium-independent mechanisms in a variety of vascular beds and vessel types. Testosterone's endothelium-dependent effects are likely mediated at least in part through nitric oxide (NO) elaboration, whereas mechanisms of endothelium-independent effects involve 1 or more types of smooth muscle ion conductance channels. Data from clinical studies indicate that, in men, androgen replacement may provide beneficial effects when coronary artery disease is present. Conversely, in women, testosterone may augment existing hypertension, increase risk for cardiovascular events, or promote atherogenesis. However, it should be emphasized that most of these observations are anecdotal or come from small-scale clinical studies, and limited information is available in women. New research is required to understand the potential efficacy of androgen therapy, or lack thereof. This review focuses on current understanding of testosterone's physiological effects on vascular behavior and of testosterone's putative role in vascular health and disease.
