In the Journals Plus

Testosterone injection in older men increases CV risk

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February 26, 2018

Bradley Layton
J. Bradley Layton

Men aged at least 65 years receiving testosterone injections had an increased risk for cardiovascular events, including myocardial infarction, stroke or unstable angina, within 7 days of administration, but the risk was not increased in younger men, study data show.

“The necessity of injection treatment should be carefully considered before initiating testosterone, particularly in older men,” J. Bradley Layton, PhD, a pharmacoepidemiologist at RTI Health Solutions in Research Triangle Park, North Carolina, told Endocrine Today.

Layton and colleagues evaluated data on men hospitalized for MI, stroke or a composite of MI, stroke or unstable angina within 7 days of receiving testosterone from U.S. commercial claims (2000-2013; n = 1,266; mean age, 57.3 years) or Medicare (2007-2010; n = 208; mean age, 75.4 years) databases to determine the short-term CV risks of receiving testosterone injections.

The short-term risk for MI, stroke or the composite outcome was not associated with receipt of testosterone injections in the commercially insured population. However, in the Medicare population, testosterone was associated with increased short-term risk for the composite outcome (OR = 1.45; 95% CI, 1.07-1.98).

“Older testosterone-using men were more likely to experience MI and strokes in the 7 days immediately following a testosterone injection than they were at other times,” Layton said. “Testosterone injections may be associated with an increased risk of CV and cerebrovascular events.

“There is considerable ongoing debate and disagreement about the role of testosterone treatment and CVD,” he said. “Many men use testosterone for off-label reasons, including normal age-related decreases in testosterone. Further research should investigate if the safety of testosterone differs among men with appropriate vs. inappropriate use, and if the benefits of treatment outweigh any potential risks.” – by Amber Cox

For more information:

J. Bradley Layton, PhD, can be reached at

Disclosures: Layton reports he is an employee of RTI International. Please see the study for all other authors’ relevant financial disclosures.