Italian researchers from the University of Florence have conducted a systematic review and meta-analysis of 75 studies concerning testosterone (T) therapy and cardiovascular (CV) risk.
After analyzing the data, they concluded that there is no relationship between testosterone supplementation and cardiovascular risk.
Their review was published in August by Informa Healthcare.
The authors explained that concerns about testosterone and cardiovascular risk have risen in light of recent research, which some experts believe to be flawed. For this study, they aimed to review the body of literature and provide their opinion on its clinical relevance.
To do this, they searched the Medline, Embase, and Cochrane databases for studies published in English over the past 25 years. They limited their search to placebo-controlled randomized clinical trials (RCTs).
Seventy-five studies were included in their final analysis. Combined, the studies involved 3,016 patients on testosterone therapy and 2,448 patients who did not take testosterone. The patients’ mean age was 59.9 years.
“The present systematic review of the available evidence and meta-analysis of RCTs did not substantiate the view of T treatment as carrying any additional risk of CV-related adverse events, when hypogonadism is properly diagnosed and replacement therapy correctly performed,” the authors wrote.
They also noted that for patients with metabolic disease, testosterone therapy could have play a “possible protective role.”
They added that the benefit of testosterone therapy for men without hypogonadism is unclear. The number of testosterone prescriptions has risen over the past decade, they explained. Many of these prescriptions could be for men whose testosterone levels are declining in the course of normal aging.
“Although the hormone is FDA-approved for hypogonadism substitution only, T is widely marketed for treating symptoms compatible with ‘low T syndrome’, including fatigue, low libido, and loss of energy, common conditions often faced by senior subjects, in the absence of a proper biochemical confirmation of hypogonadism,” they wrote.
Although media outlets have been reporting on the link between testosterone and cardiovascular risk, men already on testosterone therapy should not stop it without discussing their concerns with their doctor, the researchers said.
Corona, Giovanni, et al.
“Cardiovascular risk associated with testosterone-boosting medications: a systematic review and meta-analysis”
(Full-text. Posted online: August 19, 2014)