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Risk factors associated with cardiovascular events during testosterone administration in older men with mobility

Shehzad Basaria1, Maithili N Davda, Thomas G Travison

  • 1Department of Internal Medicine, Boston University School of Medicine, 670 Albany Street, Suite 205, Boston, MA 02118, USA. Shehzad.basaria@bmc.org

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|May 8, 2012
PubMed
Abstract

Insights

Older men with mobility limitations experiencing cardiovascular events showed greater increases in free testosterone levels. This suggests a link between elevated free testosterone and cardiovascular risk in this population.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Geriatrics

Background:

  • A previous trial (Testosterone in Older Men with Mobility Limitations Trial) was halted due to increased cardiovascular events in men receiving testosterone.
  • This study investigates gonadal hormones and associated biomarkers to understand cardiovascular event risk factors.

Purpose of the Study:

  • To evaluate changes in gonadal hormones, inflammation, and coagulation markers.
  • To identify risk factors for cardiovascular events in older men with mobility limitations undergoing testosterone therapy.

Main Methods:

  • Randomized 209 men (aged ≥65) with mobility limitations to receive daily testosterone gel or placebo for 6 months.
  • Measured changes in testosterone, estradiol, estrone, C-reactive protein, interleukin 6, fibrinogen, PAI-1, and pro-BNP.
  • Compared biomarker changes between groups and within the testosterone group based on cardiovascular event occurrence.

Main Results:

  • Among 179 men with available data, baseline characteristics were similar between groups.
  • Men in the testosterone group who experienced cardiovascular events had a significantly greater 6-month increase in free testosterone compared to those who did not (10.6 vs 5.2 ng/dL).
  • Multivariable analysis indicated that the change in serum free testosterone levels was associated with cardiovascular events.

Conclusions:

  • Mobility-limited older men who experienced cardiovascular events exhibited higher increases in serum free testosterone levels.
  • These findings suggest that greater elevations in free testosterone may be associated with increased cardiovascular risk in this demographic.

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