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Testosterone and cardiovascular risk in patients with erectile dysfunction
G Corona1, G Rastrelli, G Balercia
1Sexual Medicine and Andrology and Unit, Department of Clinical Physiopathology, University of Florence, Italy.
Journal of Endocrinological Investigation
|November 16, 2011
Summary
Low testosterone levels are linked to cardiovascular disease risk in men with erectile dysfunction. This association is significant in non-obese individuals, suggesting obesity may mask the direct impact of testosterone on heart health.
Area of Science:
- Endocrinology
- Cardiology
- Men's Health
Background:
- The link between cardiovascular diseases (CVD) and testosterone (T) levels in men requires further clarification.
- Erectile dysfunction (ED) is often associated with underlying cardiovascular risk factors.
Purpose of the Study:
- To investigate the association between testosterone levels and cardiovascular risk in men with ED.
- To determine if body mass index (BMI) confounds the relationship between testosterone and cardiovascular risk stratification.
Main Methods:
- Analysis of 2269 male patients with ED.
- Cardiovascular risk assessment using the Progetto Cuore risk engine.
- Evaluation of testosterone levels (total, free, SHBG-bound, and unbound) in relation to cardiovascular risk and BMI.
Main Results:
- Testosterone levels (SHBG-bound and unbound) decreased with increasing cardiovascular risk, even after adjusting for BMI and comorbidities.
- Higher prevalence of hypogonadism symptoms correlated with increased cardiovascular risk.
- Age, cholesterol levels, and diabetes were associated with cardiovascular risk-dependent changes in testosterone levels.
- The observed associations between testosterone and cardiovascular risk were significant only in non-obese patients (BMI < 30 kg/m²).
Conclusions:
- Hypogonadism may be linked to either increased or decreased cardiovascular risk, depending on individual patient characteristics.
- Low testosterone in obese patients might be a consequence of higher cardiovascular risk rather than a direct cause.
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