Middle-aged and elderly men might be at higher risk for heart disease when their testosterone levels drop below 440 ng/dL, according to a recent study in the Journal of Sexual Medicine.
Low testosterone is a common issue for men, especially as they get older. When testosterone levels decline, men may feel fatigued, weak, moody, and less interested in sex. Medical societies recommend varying testosterone thresholds for the diagnosis of low testosterone, but a range of 230 ng/dL to 350 ng/dL is generally accepted.
Low testosterone is also associated with several cardiovascular risk factors that can raise a person’s risk for heart disease, like diabetes, obesity, and abnormal levels of lipids in the blood. However, the testosterone level at which these conditions become more common has not been clearly defined.
The current study sought to define a level of testosterone where men were at a higher risk for cardiovascular disease.
To answer this question, the current study evaluated 876 men between the ages of 45 and 75 (average age 57). Participants were interviewed by a physician and underwent an assessment to determine their 10-year risk for cardiovascular disease as well as their levels of high-sensitivity C-reactive protein (hsCRP), which can signal a higher risk for heart disease.
Overall, the scientists determined that 10-year risk scores increased at a 440 ng/dL threshold. Levels of hsCRP began to increase at a threshold of 480 ng/dL. The authors set the cutoff at 440 ng/dL for cardiovascular risk, but this value might be different for men with sexual dysfunction.
The researchers found that men who had sexual dysfunction, such as erection problems and low desire and libido, were at significantly greater risk for heart disease. For these men, a testosterone threshold range of 300 to 350 ng/dL signaled cardiovascular concerns. For men without sexual dysfunction, the threshold was a range of 425 to 475 ng/dL.
“These findings generally confirm the view that various hypogonadal [associated with low testosterone] symptoms and adverse health outcomes occur at different testosterone levels and that a single threshold to define testosterone deficiency is not appropriate,” the authors wrote.
“Clinically, our findings might help to determine who should be considered deficient in testosterone in view of the [cardiovascular disease] risk,” they added, noting that patients’ characteristics, such as sexual symptoms, should be considered as well. For example, men with erectile dysfunction (ED) may develop symptoms of coronary artery disease and experience heart-related problems several years before men without ED.
It’s important to note that this was an association study. The findings should not be used to suggest that treating testosterone levels below 440 ng/dL reduces a man’s risk for heart disease.
More research is needed to determine the validity of these results, the authors said.
The Journal of Sexual Medicine
Liao, Pin-Wen, MD, et al.
“Testosterone Threshold for Increased Cardiovascular Risk in Middle-Aged and Elderly Men: A Locally Weighted Regression Analysis”
(Full-text. Published online: November 11, 2016)