Testosterone therapy may reduce CV events, mortality in men with very low hormone levels
Long-term testosterone therapy significantly reduced MI and stroke events in men with abnormally low testosterone levels, according to new data presented at the European Association of Urology Congress.
“Testosterone can be seriously harmful if taken by men with normal levels, or who function perfectly well with reduced levels of the hormone,” Omar M. Aboumarzouk, MD, from the Hamad Medical Corp., Qatar, said in a press release. “While men need testosterone for certain psychological and biological functions, only those with low levels who display other symptoms are likely to benefit from testosterone therapy.”
Researchers conducted a 10-year cumulative registry study of 805 men with testosterone deficiency from Germany and Qatar with high risk for MI or stroke due to family history, BP, cholesterol levels, diabetes or weight. Participants were assigned to parenteral long-term testosterone replacement therapy at 1,000 mg per 12 weeks (n = 412; mean age, 58 years) or act as controls (n = 393; mean age, 64 years). All men were encouraged by researchers to implement lifestyle changes in diet, alcohol consumption, smoking and exercise.
There was a mean Framingham risk score of 15.5 for those in the testosterone therapy group and 15.8 for the control group at baseline (P < .05), and the mean 10-year CVD risk was 22.7% in the testosterone therapy group and 23.5% in the control group (P = .11).
At 8 years, in the testosterone therapy group, 3.9% of men died, but there were no reports of any MI or stroke events. Conversely, in the control group, 18.8% of men died and there were 70 MI and 59 stroke events reported.
Researchers observed a 25% reduced risk for MI and stroke for men younger than 55 years and a 15% reduced risk among men older than 60 years.
Improvement in CV risk factors, including obesity, glycemic control, lipid pattern and C-reactive protein, was observed among those in the testosterone therapy group, but in the control group, those factors worsened, according to the researchers.
There was an overall reduction of 24.7% in CV events after long-term testosterone replacement therapy in the linear mixed model and 15.5% in the random-effect longitudinal model.
“It’s likely that bringing the hormone back to normal levels helps them to maximize the benefits of other steps necessary to improve their overall health. This includes increasing exercise levels, eating healthier food, giving up smoking and reducing alcohol consumption,” Aboumarzouk said in the release. “We believe that physicians treating patients with low testosterone, who are at high risk of heart attack or stroke, should consider testosterone therapy as one aspect of their treatment.”