Testosterone and cardiovascular risk
Giacomo Tirabassi1, Angelo Gioia, Lara Giovannini
1Division of Endocrinology, Department of Clinical and Molecular Sciences, Umberto I Hospital, Polytechnic University of Marche, Via Conca 71, 60126, Ancona, Italy.
Insights
Low testosterone levels (T) may increase cardiovascular disease risk in men, contrary to previous beliefs. This review examines testosterone's protective CV effects and its link to hypogonadism and heart conditions.
Area of Science:
- Endocrinology
- Cardiology
- Men's Health
Background:
- Cardiovascular disease (CV) is a leading cause of death, particularly in males.
- Testosterone (T) deficiency, or late-onset hypogonadism, is common with aging.
- Previous assumptions linked T to negative CV effects, but evidence suggests otherwise.
Purpose of the Study:
- To review the current understanding of the association between testosterone deficit and cardiovascular disease.
- To analyze the protective role of testosterone on the cardiovascular system.
- To explore the relationship between low T and metabolic syndrome, CV morbidity, and mortality.
Main Methods:
- Literature review of existing studies on testosterone and cardiovascular health.
- Analysis of epidemiological data and clinical trial findings.
- Synthesis of evidence regarding testosterone's impact on CV risk factors and outcomes.
Main Results:
- Growing evidence indicates testosterone may have protective cardiovascular effects.
- Low testosterone levels are associated with increased cardiovascular risk, morbidity, and mortality in men.
- Testosterone deficiency is linked to metabolic syndrome, ischemic heart disease, heart failure, and stroke.
Conclusions:
- Testosterone deficiency, common in aging men, is linked to adverse cardiovascular outcomes.
- Re-evaluating the role of testosterone is crucial for understanding and managing cardiovascular risk in men.
- Further research is needed to clarify testosterone's precise role and therapeutic implications in cardiovascular health.
Abstract:
Cardiovascular (CV) disease is one of the most common causes of death in the western populations and, nowadays, its incidence is increasing even in the developing countries; although CV disease affects both sexes, it is more frequent in males in whom it shortens the average life expectancy. In this regard, this difference has been wrongly attributed for many years to the negative effects of testosterone (T); however, nowadays, a large amount of evidence suggests that this hormone may have protective effects on the CV system and that, indeed, the low levels of T could be associated with an increased CV risk and with an augmentation of morbidity and mortality in males. Such an aspect gains great relevance in light of the consideration that T decrease, besides occurring as a consequence of rare pathological conditions, can often take place with natural aging, causing a state of "male menopause", also called late-onset hypogonadism. In this review, we aimed to summarize the present state of the art concerning the association between T deficit and CV disease by analyzing the protective role of T on CV system and the relationship of this hormonal lack with metabolic syndrome, CV morbidity and mortality, and with the CV complications, such as ischemic heart disease, heart failure and stroke, that frequently occur in T deficiency.
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