Testosterone replacement therapy is not associated with higher risk for major adverse cardiac events (MACEs), according to research presented last month in Chicago at the American Heart Association Scientific Sessions conference.
Testosterone replacement therapy in relation to cardiovascular risk has been controversial. In September, an advisory panel of the U.S. Food and Drug Administration (FDA) recommended stricter guidelines on the use of testosterone for men. The panel also called for additional studies on the safety of testosterone.
These recommendations were prompted by previous studies that reported a link between testosterone therapy and cardiovascular risk.
In this study, researchers from the Intermountain Medical Center Heart Institute in Murray, UT, USA examined the electronic medical records of 5,695 men between the ages of 53 and 71 (mean age of 62.3 years). The records covered the years of 1996 through 2011. The study subjects had a low initial testosterone levels at baseline.
Using a follow-up time frame of three years or less, the researchers noted which patients took supplemental testosterone. They also looked at the men’s later testosterone measurements along with the number of cardiovascular events, which included a composite of death, nonfatal myocardial infarction, and stroke (MACE) and death alone.
Overall, 8.6% of the men had experienced MACE at the three-year mark. About 6% of the men had died.
However, the men who had undergone testosterone replacement therapy resulting in normal/high levels had lower rates of MACE and death when compared to the men who had persistent low testosterone during the three year period. Similar rates were found at the one-year mark as well.
“With this study we are getting closer to defining the true associations between testosterone treatment and cardiovascular risks or benefits,” said lead researcher Dr. Jeffrey Anderson in a press release. Dr. Anderson is a cardiologist at the Intermountain Medical Center Heart Institute.
More research is needed, however. “Resolving the difference in [cardiovascular] risk impact of [testosterone] therapy between this, and previous studies, warrants a large randomized clinical trial in a similar, younger population,” the study authors explained.
Their abstract was published in the November 25, 2014 issue of Circulation, a journal of the American Heart Association.
Circulation (American Heart Association)
Anderson, Jeffrey L., et al.
“Abstract 13220: Cardiovascular Impact of Testosterone Therapy in Men with Low Testosterone Levels”
(Abstract presented at AHA Scientific Sessions conference, Chicago, November 18, 2014)
“New Study Finds Testosterone Replacement Therapy Does Not Increase Cardiovascular Risks In Men with Low Testosterone Levels”
(Press release. November 18, 2014)
“Study: No increase in CV risk with testosterone”
(November 20, 2014)