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Association between Low Serum Testosterone Levels and All-cause Mortality in Patients With Cardiovascular Disease: A

Rui Jiang1, Yongchen Wang2

  • 1Department of General Practice, the Second Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.

Cardiovascular Toxicology
|March 6, 2025
PubMed

Insights

Low testosterone levels increase all-cause mortality risk in male cardiovascular disease (CVD) patients. This association was not found in female CVD patients, indicating a sex-specific relationship in mortality risk.

Area of Science:

  • Endocrinology
  • Cardiology
  • Gerontology

Background:

  • Cardiovascular disease (CVD) is a leading cause of mortality globally.
  • Serum testosterone levels have been implicated in various health outcomes, including cardiovascular health.
  • The relationship between low testosterone and mortality in CVD patients requires further investigation, particularly considering sex differences.

Purpose of the Study:

  • To investigate the association between low serum testosterone levels and all-cause mortality in male and female patients with cardiovascular disease (CVD).

Main Methods:

  • Data from 1,177 CVD patients (689 males) were extracted from the NHANES database (1999-2014).
  • Low serum testosterone was defined as ≤300 ng/dL.
  • Univariate and multivariate Cox regression analyses were used to evaluate the association with all-cause mortality, calculating hazard ratios (HR) and 95% confidence intervals (CI).

Main Results:

  • Low serum testosterone levels were prevalent in both male (70.68%) and female (80.74%) CVD patients.
  • After adjusting for covariates, low serum testosterone was significantly associated with an increased risk of all-cause mortality in male CVD patients (HR = 1.48, 95% CI 1.08-2.02, P = 0.013).
  • This association was not statistically significant in female CVD patients.

Conclusions:

  • Low serum testosterone levels may be a significant risk factor for all-cause mortality in male patients with cardiovascular disease.
  • The findings suggest a sex-specific association, with no significant link observed between low testosterone and mortality in female CVD patients.
  • Further research is warranted to explore the underlying mechanisms and clinical implications of these sex-specific findings.

Keywords:
Cardiovascular diseasesEstradiolMortalityNational health and nutrition examination surveyTestosterone

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