Testosterone replacement therapy and cardiovascular risk factors modification

Abstract

Hypogonadism in males is associated with increased atherosclerotic disease. Physiologically, testosterone appears to have both positive and negative effects on the cardiovascular system. Testosterone decreases angina and may improve the cardiac healing response after myocardial infarction. Testosterone enhances function in males with heart failure (HF). Testosterone causes water retention and oedema is common in older persons. Oedema should not be used to diagnose HF in older persons. Studies in older persons with HF and frailty have shown a non-statistically lower mortality rate compared to those receiving placebo.

Hypogonadism in the Aging Male Diagnosis, Potential Benefits, and Risks of Testosterone Replacement Therapy

“…Over the last decade several papers have examined the relationship of androgens with CVD. Many of these studies suggest that there may be even neutral to beneficial effect of testosterone-replacement therapy on the cardiovascular risk factors and adverse cardiovascular complications (e.g., angina) [142, 176–179]. Testosterone replacement is not without risks for the aging males.…”

“…Testosterone replacement is not without risks for the aging males. TRT can lead to water retention and edema [176]. However, in one interventional trial, there were an increased number of cardiovascular-related adverse events in a population of older men who had significant chronic disease and with limitations with mobility [180].…”

Effects of three different medications on metabolic parameters and testicular volume in patients with hypogonadotropic hypogonadism: 3‐year experience

“…4 Gonadotropin therapy is initiated with human chorionic gonadotropin (hCG) alone, which may be sufficient to stimulate spermatogenesis and fertility; but, the optimal strategy for hormone replacement in hypogonadotropic hypogonadism remains debatable. 5 Infertility, mood disorders, anaemia, central obesity, 6 insulin resistance, 7 metabolic syndrome, 8 type 2 diabetes mellitus 9 and coronary artery disease 10 are among the long-term risks that patients with hypogonadism are likely to experience. Although testosterone and hCG treatments are successful in inducing and maintaining normal secondary sexual characteristics, 6 effects of these medications on the metabolic parameters have been questioned.…”

Testosterone Replacement Therapy Improves QTaVI in Hypogonadal Men with Spinal Cord Injury

“…Serum endogenous testosterone (T) concentration that falls below normal age-adjusted physiological range in men is considered to be a risk for future cardiovascular-related morbidity and mortality [1,2]. Specifically, an inverse relationship between serum T concentration and mortality due to cardiovascular disease, and all causes, has been demonstrated in the general population [3].…”