Testosterone and Cardiovascular Health |
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Authors: | Andrew Elagizi Tobias S Köhler Carl J Lavie |
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Institution: | 1. Department of Internal Medicine, Leonard J. Chabert Medical Center, Houma, LA;2. Department of Urology, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN;3. Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School–The University of Queensland School of Medicine, New Orleans, LA |
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Abstract: | There is an ongoing debate in the medical community regarding the effects of testosterone on cardiovascular (CV) health. For decades, there has been conflicting evidence regarding the association of endogenous testosterone levels and CV disease (CVD) events that has resulted in much debate and confusion among health care providers and patients alike. Testosterone therapy has become increasingly widespread, and after the emergence of studies that reported increased CVD events in patients receiving testosterone therapy, the US Food and Drug Administration (FDA) released a warning statement about testosterone and its potential risk regarding CV health. Some of these studies were later found to be critically flawed, and some experts, including the American Association of Clinical Endocrinologists and an expert panel regarding testosterone deficiency and its treatment, reported that some of the FDA statements regarding testosterone therapy were lacking scientific evidence. This article summarizes the current evidence regarding the relationship between testosterone (endogenous and supplemental) and CV health. A literature review was conducted via search using PubMed and specific journal databases, including the New England Journal of Medicine and the Journal of the American College of Cardiology. Key search terms included testosterone and cardiovascular health, coronary artery disease, heart failure, androgen deprivation therapy, intima-media thickness, and adrenal androgens. Initial study selection was limited to publications within the past 10 years (January 1, 2007, through December 31, 2016); however, key publications outside of this time frame were selected if they provided important quantitative data or historical perspectives for the review of this topic. The search was further supplemented by reviewing references in selected articles. |
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Keywords: | 6MWT 6-Minute Walk Test AACE American Association of Clinical Endocrinologists ACE American College of Endocrinology ADT androgen deprivation therapy BMI body mass index BRS baroreflex sensitivity CAC coronary artery calcium CAD coronary artery disease CCTA coronary computed tomographic angiography CHF chronic heart failure CV cardiovascular CVD cardiovascular disease DVT deep vein thrombosis EF ejection fraction FDA Food and Drug Administration FSH follicle-stimulating hormone GnRH gonadotropin-releasing hormone HDL high-density lipoprotein HF heart failure HR hazard ratio hs-CRP high-sensitivity C-reactive protein IFG impaired fasting glucose IL interleukin IMT intima-media thickness LDL low-density lipoprotein LH luteinizing hormone MI myocardial infarction OR odds ratio PE pulmonary embolism RCT randomized controlled trial ROS reactive oxygen species SCD sudden cardiac death SHBG sex hormone binding globulin TNF tumor necrosis factor TOM Testosterone in Older Men With Mobility Limitations |
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