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An update on heart disease risk associated with testosterone boosting medications

G Corona1, G Rastrelli2, F Guaraldi1,3

  • 1a Endocrinology Unit, Medical Department, Azienda-Usl Bologna , Maggiore-Bellaria Hospital , Bologna , Italy.

Expert Opinion on Drug Safety
|April 19, 2019
PubMed

Insights

Testosterone replacement therapy (TRT) is safe for hypogonadal men, improving heart function and not increasing cardiac risks when used appropriately. Low testosterone is linked to increased heart attack risk and mortality.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Cardiovascular (CV) safety of testosterone replacement therapy (TRT) is a critical concern for managing late-onset hypogonadism.
  • Low endogenous testosterone levels are increasingly recognized as a potential risk factor for cardiovascular events.

Purpose of the Study:

  • To systematically review and analyze the available evidence on the cardiovascular safety of TRT.
  • To evaluate the impact of TRT on heart-related issues in hypogonadal patients.

Main Methods:

  • Systematic review of prospective observational studies on endogenous testosterone and acute myocardial infarction (AMI) risk.
  • Analysis of pharmaco-epidemiological studies and randomized placebo-controlled trials (RCTs) on TRT's impact on heart diseases.

Main Results:

  • Endogenous low testosterone is associated with increased risk of AMI and related mortality.
  • TRT can improve angina symptoms in patients with ischemic heart disease and exercise capacity in heart failure patients.
  • When used at recommended dosages, TRT does not elevate the risk of cardiac events.

Conclusions:

  • TRT is safe and beneficial for hypogonadal patients with cardiovascular conditions.
  • TRT can improve symptoms and exercise capacity in specific cardiac patient populations.
  • Appropriate TRT administration does not pose an increased risk for cardiovascular events.
Abstract

Keywords:
Testosteronecardiovascular diseasesheart failureischemic heart diseases

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