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Endogenous sex hormones and cardiovascular disease in men. A prospective population-based study
1University of California, San Diego, Department of Community and Family Medicine, La Jolla 92093.
Insights
This study found no significant link between sex hormones like testosterone and estrogen and cardiovascular disease in older men. Testosterone levels were inversely associated with risk factors, while estrogen showed some positive correlations with metabolic markers.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Epidemiology
Background:
- Endogenous sex hormones are implicated in cardiovascular health.
- Previous research suggests potential roles for both androgens and estrogens in heart disease risk.
- Understanding these relationships is crucial for disease prevention and management.
Purpose of the Study:
- To investigate the association between endogenous sex hormone levels and cardiovascular disease (CVD) in older men.
- To determine if specific hormones (testosterone, androstenedione, estrone, estradiol) or their ratios predict CVD incidence, mortality, or morbidity.
- To explore the relationship between sex hormones and established CVD risk factors.
Main Methods:
- Analysis of stored plasma samples from 1,009 men aged 40-79, collected between 1972-1974.
- Measurement of endogenous sex hormones and sex hormone-binding globulin (SHBG).
- 12-year follow-up to assess prevalent and subsequent cardiovascular disease, including mortality and ischemic heart disease.
Main Results:
- No significant association was found between measured sex hormones (testosterone, androstenedione, estrone, estradiol) and prevalent or subsequent cardiovascular disease, mortality, or morbidity.
- Sex hormone-binding globulin levels did not differ significantly by disease status.
- Testosterone showed inverse associations with blood pressure, fasting plasma glucose, triglycerides, and body mass index.
- Estrone positively correlated with total plasma cholesterol, triglycerides, and glucose.
Conclusions:
- The study does not support a causal role for elevated endogenous estrogen levels in heart disease.
- While testosterone levels were inversely related to several metabolic risk factors, this did not translate to a protective association against CVD in this cohort.
- Further research may be needed to elucidate the complex interplay between sex hormones and cardiovascular health in aging men.
Abstract:
Plasma obtained and frozen in 1972-1974 from 1,009 white men (40-79 years old) who have been followed for 12 years was examined for endogenous sex hormone levels according to prevalent or subsequent cardiovascular disease. In these older men, no sex hormone measured (testosterone, androstenedione, estrone, or estradiol) was significantly associated with known cardiovascular disease at baseline or with subsequent cardiovascular mortality or ischemic heart disease morbidity or mortality. Sex hormone-binding globulin levels were also similar by disease status. Analyses of hormone:sex hormone-binding globulin ratios or of estrogen:androgen ratios showed a similar lack of association with cardiovascular disease. Testosterone levels were significantly inversely associated with levels of blood pressure, fasting plasma glucose, and triglyceride and body mass index. In contrast, the only significant estrogen risk factor associations were positive correlations of estrone with total plasma cholesterol, triglyceride, and glucose. These data do not support a causal role for elevated endogenous estrogen levels and heart disease.