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Beneficial and adverse effects of testosterone on the cardiovascular system in men

Johannes Ruige (UGent) , Margriet Ouwens (UGent) and Jean Kaufman (UGent)
Author
Organization
Abstract
Context: The widespread use of T therapy, particularly in aging males, necessitates knowledge of the relationship between T and the cardiovascular system. Evidence Acquisition: The review is based on a 1970 to 2013 PubMed search with terms related to androgens in combination with cardiovascular disease, including T, dihydrotestosterone, trial, mortality, cardiovascular disease, myocardial infarction, blood pressure, endothelial function, dyslipidemia, thrombosis, ventricular function, and arrhythmia. Original articles, systematic reviews and meta-analyses, and relevant citations were screened. Evidence Synthesis: Low T has been linked to increased blood pressure, dyslipidemia, atherosclerosis, arrhythmia, thrombosis, endothelial dysfunction, as well as to impaired left ventricular function. On the one hand, a modest association is suggested between low endogenous T and incident cardiovascular disease or cardiovascular mortality, implying unrecognized beneficial T effects, residual confounding, or a relationship with health status. On the other hand, treatments with T to restore "normal concentrations" have so far not been proven to be beneficial with respect to cardiovascular disease; neither have they definitely shown specific adverse cardiovascular effects. The cardiovascular risk-benefit profile of T therapy remains largely evasive in view of a lack of well-designed and adequately powered randomized clinical trials. Conclusions: The important knowledge gap as to the exact relationship between T and cardiovascular disease would support a cautious, restrained approach to T therapy in aging men, pending clarification of benefits and risks by adequately powered clinical trials of sufficient duration.
Keywords
ENDOTHELIAL PROGENITOR CELLS, ENDOGENOUS SEX-HORMONES, MIDDLE-AGED MEN, CORONARY-ARTERY-DISEASE, CAG REPEAT POLYMORPHISM, ANDROGEN RECEPTOR GENE, CHRONIC HEART-FAILURE, IMPROVES INSULIN SENSITIVITY, PLACEBO-CONTROLLED TRIAL, INTIMA-MEDIA THICKNESS

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MLA
Ruige, Johannes, et al. “Beneficial and Adverse Effects of Testosterone on the Cardiovascular System in Men.” JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, vol. 98, no. 11, 2013, pp. 4300–10, doi:10.1210/jc.2013-1970.
APA
Ruige, J., Ouwens, M., & Kaufman, J. (2013). Beneficial and adverse effects of testosterone on the cardiovascular system in men. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 98(11), 4300–4310. https://doi.org/10.1210/jc.2013-1970
Chicago author-date
Ruige, Johannes, Margriet Ouwens, and Jean Kaufman. 2013. “Beneficial and Adverse Effects of Testosterone on the Cardiovascular System in Men.” JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 98 (11): 4300–4310. https://doi.org/10.1210/jc.2013-1970.
Chicago author-date (all authors)
Ruige, Johannes, Margriet Ouwens, and Jean Kaufman. 2013. “Beneficial and Adverse Effects of Testosterone on the Cardiovascular System in Men.” JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM 98 (11): 4300–4310. doi:10.1210/jc.2013-1970.
Vancouver
1.
Ruige J, Ouwens M, Kaufman J. Beneficial and adverse effects of testosterone on the cardiovascular system in men. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM. 2013;98(11):4300–10.
IEEE
[1]
J. Ruige, M. Ouwens, and J. Kaufman, “Beneficial and adverse effects of testosterone on the cardiovascular system in men,” JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, vol. 98, no. 11, pp. 4300–4310, 2013.
@article{4217920,
  abstract     = {{Context: The widespread use of T therapy, particularly in aging males, necessitates knowledge of the relationship between T and the cardiovascular system.
Evidence Acquisition: The review is based on a 1970 to 2013 PubMed search with terms related to androgens in combination with cardiovascular disease, including T, dihydrotestosterone, trial, mortality, cardiovascular disease, myocardial infarction, blood pressure, endothelial function, dyslipidemia, thrombosis, ventricular function, and arrhythmia. Original articles, systematic reviews and meta-analyses, and relevant citations were screened.
Evidence Synthesis: Low T has been linked to increased blood pressure, dyslipidemia, atherosclerosis, arrhythmia, thrombosis, endothelial dysfunction, as well as to impaired left ventricular function. On the one hand, a modest association is suggested between low endogenous T and incident cardiovascular disease or cardiovascular mortality, implying unrecognized beneficial T effects, residual confounding, or a relationship with health status. On the other hand, treatments with T to restore "normal concentrations" have so far not been proven to be beneficial with respect to cardiovascular disease; neither have they definitely shown specific adverse cardiovascular effects. The cardiovascular risk-benefit profile of T therapy remains largely evasive in view of a lack of well-designed and adequately powered randomized clinical trials.
Conclusions: The important knowledge gap as to the exact relationship between T and cardiovascular disease would support a cautious, restrained approach to T therapy in aging men, pending clarification of benefits and risks by adequately powered clinical trials of sufficient duration.}},
  author       = {{Ruige, Johannes and Ouwens, Margriet and Kaufman, Jean}},
  issn         = {{0021-972X}},
  journal      = {{JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM}},
  keywords     = {{ENDOTHELIAL PROGENITOR CELLS,ENDOGENOUS SEX-HORMONES,MIDDLE-AGED MEN,CORONARY-ARTERY-DISEASE,CAG REPEAT POLYMORPHISM,ANDROGEN RECEPTOR GENE,CHRONIC HEART-FAILURE,IMPROVES INSULIN SENSITIVITY,PLACEBO-CONTROLLED TRIAL,INTIMA-MEDIA THICKNESS}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{4300--4310}},
  title        = {{Beneficial and adverse effects of testosterone on the cardiovascular system in men}},
  url          = {{http://dx.doi.org/10.1210/jc.2013-1970}},
  volume       = {{98}},
  year         = {{2013}},
}

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