Endogenous sex hormones and cardiovascular disease incidence in men

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Epidemiology

Background:

• Endogenous sex hormones (testosterone, DHEA-S, estradiol) may influence cardiovascular disease (CVD) risk factors and vascular function.
• Previous studies on sex hormones and CVD incidence in men have produced conflicting results.

Purpose of the Study:

• To investigate the relationship between circulating sex hormone levels and the risk of developing CVD in men.
• To determine if estradiol, testosterone, or dehydroepiandrosterone sulfate (DHEA-S) levels are associated with incident CVD.

Main Methods:

• A prospective cohort study was conducted with 2084 middle-aged white men without baseline CVD.
• Multivariable Cox regression analysis was used to assess the association between baseline hormone levels (testosterone, DHEA-S, estradiol) and CVD incidence over 10 years.
• CVD outcomes included coronary, cerebrovascular, peripheral vascular disease, and heart failure.

Main Results:

• Higher serum estradiol levels were associated with a significantly lower risk of CVD events (HR per SD increment, 0.90; P = 0.035).
• This association was more pronounced in older men (median age >56 years) (HR per SD increment, 0.86; P = 0.005).
• Serum testosterone and DHEA-S levels showed no significant association with incident CVD.

Conclusions:

• Elevated serum estradiol levels are associated with a reduced risk of cardiovascular disease in older men.
• These findings support the hypothesis that endogenous estrogen may exert vasculoprotective effects in men.
• Limitations include baseline hormone measurements and potential lack of generalizability to women and nonwhite populations.