Testosterone: a natural tonic for the failing heart?

Pugh, Peter J.; English, K; Jones, T Hugh; Channer, Kevin S.

doi:10.1093/qjmed/93.10.689

Cited by 40 publications

(28 citation statements)

References 65 publications

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“…Animal evidence suggests that testosterone produces coronary artery relaxation, which would improve coronary perfusion, although there are some contradictory findings in this regard. 63 Endogenous testosterone levels have also been related to fasting glucose and insulin concentrations and have predicted the onset of type 2 diabetes mellitus. 61 Intervention studies have also suggested that testosterone treatment improves insulin sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Cortisol, Testosterone, and Coronary Heart Disease

et al. 2005

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Background-There is a popular belief that chronic stress causes heart disease through psychoneuroendocrine mechanisms. We have examined whether an elevated circulating cortisol-to-testosterone ratio increases the risk of ischemic heart disease. Methods and Results-We undertook a prospective cohort study of 2512 men aged 45 to 59 years between 1979 and 1983 from Caerphilly, South Wales, with a mean follow-up of 16.5 years. Subjects underwent a clinical examination, and morning fasting blood samples were taken for analysis of cortisol levels, testosterone levels, and other cardiovascular risk factors. The ratio of cortisol to testosterone showed weak associations with potential confounding factors but strong positive associations with components of the insulin resistance syndrome (PϽ0.001). A positive linear trend was seen across quintiles of cortisol:testosterone ratio for incident ischemic heart disease (age-adjusted OR per z score change in ratio 1.22, 95% CI 1.07 to 1.38, Pϭ0.003). This was markedly attenuated after adjustment for components of the insulin resistance syndrome (age-adjusted OR per z score change in ratio 1.10, 95% CI 0.96 to 1.25, Pϭ0.18). There was no association between the cortisol:testosterone ratio and other causes of death (age-adjusted hazard ratio 0.99, 95% CI 0.88 to 1.11, Pϭ0.81). Conclusions-This is the first population-based prospective study that has found a specific association between cortisol:testosterone ratio and incident ischemic heart disease, apparently mediated through the insulin resistance syndrome. Whether this reflects the effects of chronic stress, behavioral factors, or genetic influences remains to be determined. (Circulation. 2005;112:332-340.)

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Section: Discussionmentioning

confidence: 99%

Cortisol, Testosterone, and Coronary Heart Disease

et al. 2005

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“…146). Interestingly, testosterone appears to be most effective in men with lower baseline androgen levels.…”

Section: Androgen Effects On Vascular Tonementioning

confidence: 99%

Cardiovascular Effects of Androgens

Weidemann

Hanke

2002

Cardiovascular Drug Reviews

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In the process of atherosclerosis sex steroids play a complex role in the vascular vessel wall system. Although a number of experimental studies have clearly documented an atheroprotective effect of estrogens, in recent clinical studies, estrogen replacement therapy has failed to reduce cardiovascular mortality. The effects of androgens on the cardiovascular system and cardiovascular diseases are even more controversial. Whereas in the past, androgens were mainly believed to exert adverse effects on the cardiovascular system, recent studies in men have documented a number of beneficial actions of testosterone in the arterial vascular system. Androgens affect lipid metabolism (e.g., LDL and HDL cholesterol, Lp(a)) and hemostasis (e.g., platelet aggregation and fibrinolytic activity). In addition, several other physiological and pathophysiological processes in the arterial vessel wall are influenced by androgens. Acute hemodynamic effects of testosterone on coronary vasomotion and stress-test-induced ischemia were reported. Additionally, recent animal and in vitro studies have further documented an inhibitory effect of androgens on neointimal plaque formation. This review discusses different and, in part, contradictory effects of androgens on the cardiovascular system including potential signal transduction pathways in androgen target cells.

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“…However, in bodybuilding, the doses used are often 10-100 times the therapeutic dose; in one report involving 24 weight lifters, the lowest dose was 350% of the usual therapeutic dose [17]. Lower physiologic replacement doses of testosterone have demonstrated a beneficial effect on angina pectoris, exercise tolerance, exercise-induced ST segment depression and coronary diameter [18]. In a small randomized clinical trial of older men (n=209) with limitations in mobility and a high prevalence of chronic disease, the application of a testosterone gel was associated with increased muscle strength and an increased risk of cardiovascular adverse events [19].…”

Section: Discussionmentioning

confidence: 99%

Effect of Testosterone and Resistance Training on Cardiac Mass and Contractility in Men with COPD

Budoff¹,

Mao²,

Rambod³

et al. 2011

J Allergy Ther

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Introduction: Testosterone therapy and resistance training have been demonstrated to improve muscle mass and strength in patients with testosterone deficiency. However the effects on cardiac mass and contractility of these interventions have not been identified in prospective placebo-controlled trials. The hypothesis of this trial was that resistance training and testosterone replacement would improve cardiac mass and contractility in male COPD patients with low testosterone levels. Methods:We conducted a 10 week trial in a 2 by 2 factorial design, randomizing 53 patients to replacement doses of testosterone enanthate (100 mg weekly) or placebo, as well as to a program of lower extremity resistance training or no exercise. We performed rest and exercise cardiac computed tomography (CCT) studies before and after 10 weeks of therapy to evaluate right and left heart function. Patients were injected with 40-50 ml of non-ionic, iodinated contrast and cine CCT images were obtained at rest. Patients were exercised to 60% of their maximal work rate on a semi-supine ergometer, then re-injected with another bolus of 40-50 ml of contrast and re-imaged. We evaluated cardiac output and left ventricular (LV) and right ventricular (RV) mass, LV and RV stroke volume, ejection fractions and end-diastolic volumes at rest and exercise, before and after therapy.Results: 42 men with COPD (mean FEV 1 =40%pred. pre-bronchodilator) and low testosterone levels (mean=320ng/dl) completed the 10 week protocol. Factorial analysis demonstrated that testosterone, but not resistance training increased LV and RV mass (by 4.9% and 8.3%, respectively). Resistance training, but not testosterone, was associated with increased LV ejection fraction at rest and during exercise (by 5.5% and 4.4%, respectively). In the entire study group, increases in both left and right ventricular mass were correlated with increases in lean body mass (assessed by DEXA) (r=0.49 and r=0.65, respectively). Conclusions:In men with COPD, testosterone replacement and strength training are associated with distinct alterations in cardiac structure and function. Specifically, resistance training improved ejection fraction, while testosterone increased lean body mass and LV mass.

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Testosterone: a natural tonic for the failing heart?

Cited by 40 publications

References 65 publications

Cortisol, Testosterone, and Coronary Heart Disease

Cortisol, Testosterone, and Coronary Heart Disease

Cardiovascular Effects of Androgens

Effect of Testosterone and Resistance Training on Cardiac Mass and Contractility in Men with COPD

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