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Cardiovascular Outcomes of Hypogonadal Men Receiving Testosterone Replacement Therapy: A Meta-analysis of Randomized

Aayushi Sood1, Alireza Hosseinpour2, Akshit Sood3

  • 1Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|October 5, 2023
PubMed

Insights

Testosterone replacement therapy (TRT) in hypogonadal men showed no increased risk of mortality or adverse cardiovascular events. This meta-analysis provides reassurance for TRT use in this population.

Area of Science:

  • Endocrinology
  • Cardiology
  • Men's Health

Background:

  • Hypogonadism, characterized by low testosterone levels, affects numerous men.
  • The cardiovascular safety of testosterone replacement therapy (TRT) remains a subject of ongoing research and clinical debate.
  • Previous studies have yielded conflicting results regarding TRT's impact on cardiovascular outcomes.

Approach:

  • A comprehensive meta-analysis was performed, synthesizing data from 26 randomized controlled trials.
  • The analysis included 10,941 participants diagnosed with hypogonadism.
  • Key cardiovascular outcomes such as mortality, myocardial infarction, stroke, and heart failure were rigorously assessed.

Key Points:

  • TRT was not associated with statistically significant differences in all-cause mortality, cardiovascular mortality, myocardial infarction, stroke, congestive heart failure, atrial fibrillation, pulmonary embolism, or venous thrombosis.
  • Sensitivity analyses and publication bias assessments confirmed the robustness of these findings.
  • Meta-regression revealed no significant links between clinical outcomes and covariates like age, diabetes, hypertension, dyslipidemia, or smoking status.

Conclusions:

  • This systematic review and meta-analysis, focusing exclusively on hypogonadal men, offers reassurance regarding the cardiovascular safety of TRT.
  • The findings suggest that TRT does not elevate mortality risk or exacerbate cardiovascular issues in this specific patient group.
  • Further long-term studies with diverse populations are recommended to solidify these conclusions and expand their generalizability.
Abstract

Keywords:
cardiovascularhypogonadismmeta-analysismortalitytestosteronetrials

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