Deaths and Cardiovascular Events in Men Receiving Testosterone

Riche, Daniel M.; Baker, William L.; Koch, Christian A.

doi:10.1001/jama.2014.386

Cited by 9 publications

(1 citation statement)

References 4 publications

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“…6 This study was, however, criticised as the biological effects of testosterone therapy were not reported and only 1:5 of the testosterone prescriptions were ever filled suggesting the hypogonadism was not corrected. 40…”

Section: Cardiovascular Risks and Exogenous Sex Steroids Therapy (Hrt)mentioning

confidence: 99%

Cardiovascular disease in transgendered people: A review of the literature and discussion of risk

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2019

JRSM Cardiovascular Disease

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This review examines the impact of gender affirming hormone therapy used in the transgendered and non-binary populations on cardiovascular outcomes and surrogate markers of cardiovascular health. Current evidence suggests that hormonal therapy for transgendered women decreases or is neutral regarding myocardial infarction risk. There is an increased incidence of venous thromboembolism (VTE), but newer studies suggest that the risk is significantly lower than previously described. For transgendered men, there appears to be an adverse effect on lipid parameters but this does not translate into an increased risk of cardiovascular disease above that of general male population. In all transgendered people, risk factor interventions such as smoking cessation, weight management and treatment of co-morbid conditions are important in optimising cardiovascular health. The effect of gender affirming hormonal therapy in transgendered people is difficult to interpret due to the variety of hormone regimens used, the relative brevity of the periods of observation and the influence of confounding factors such as the historical use of less physiological, oestrogens such as conjugated equine oestrogen and ethinylestradiol which are more pro-thrombotic than the 17b oestradiol that is used in modern practice.

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Section: Cardiovascular Risks and Exogenous Sex Steroids Therapy (Hrt)mentioning

confidence: 99%

Cardiovascular disease in transgendered people: A review of the literature and discussion of risk

Seal

2019

JRSM Cardiovascular Disease

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Cardiovascular risk and testosterone – from subclinical atherosclerosis to lipoprotein function to heart failure

Gencer

Bonomi

Adorni

et al. 2021

Rev Endocr Metab Disord

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The cardiovascular (CV) benefit and safety of treating low testosterone conditions is a matter of debate. Although testosterone deficiency has been linked to a rise in major adverse CV events, most of the studies on testosterone replacement therapy were not designed to assess CV risk and thus excluded men with advanced heart failure or recent history of myocardial infarction or stroke. Besides considering observational, interventional and prospective studies, this review article evaluates the impact of testosterone on atherosclerosis process, including lipoprotein functionality, progression of carotid intima media thickness, inflammation, coagulation and thromboembolism, quantification of plaque volume and vascular calcification. Until adequately powered studies evaluating testosterone effects in hypogonadal men at increased CV risk are available (TRAVERSE trial), clinicians should ponder the use of testosterone in men with atherosclerotic cardiovascular disease and discuss benefit and harms with the patients.

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The Role of Testosterone Therapy in Cardiovascular Mortality: Culprit or Innocent Bystander?

Tanna

Schwartzbard

Berger

et al. 2015

Curr Atheroscler Rep

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Testosterone therapy is recommended for men with symptomatic androgen deficiency and unequivocally low testosterone levels. Although the prevalence of hypogonadism seems relatively constant, studies of prescribing patterns in both the United States and the United Kingdom show a dramatic increase in testosterone prescription in recent years, possibly due to increased marketing and inappropriate therapy. Concurrent with this, there has been growing concern regarding the potential adverse effects of testosterone therapy, particularly its cardiovascular risks. In this review, we present our current understanding of the implications of testosterone deficiency, as well as the conflicting evidence surrounding the cardiovascular effects of testosterone replacement therapy. Although there is a lack of adequate data, based on the current evidence, we conclude that testosterone therapy can be safely considered in men with appropriately diagnosed clinical androgen deficiency and increased cardiovascular risk after a thorough discussion of potential risks and with guideline recommended safety monitoring.

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Deaths and Cardiovascular Events in Men Receiving Testosterone

Cited by 9 publications

References 4 publications

Cardiovascular disease in transgendered people: A review of the literature and discussion of risk

Cardiovascular disease in transgendered people: A review of the literature and discussion of risk

Cardiovascular risk and testosterone – from subclinical atherosclerosis to lipoprotein function to heart failure

The Role of Testosterone Therapy in Cardiovascular Mortality: Culprit or Innocent Bystander?

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