by: E. Thomas Arne, Jr., DO, FACC
The relationship between testosterone and cardiovascular health is a complex subject and is still being studied. However, there are some benefits of testosterone therapy and cardiovascular health. These include an improved lipid profile.
Testosterone therapy has been shown to improve cholesterol levels, specifically increasing the “good” HDL cholesterol, and reducing the “bad” LDL cholesterol. It has also been shown to decrease insulin resistance. Testosterone therapy may help to improve insulin sensitivity, this can lower the risk of developing diabetes which is a major cardiovascular risk factor.
Additionally, it has been shown to improve heart function. Low testosterone levels have been associated with an increased risk of heart failure, and testosterone therapy helped to improve left ventricular function in men with heart failure.
With regards to coronary artery disease, some studies have suggested that low testosterone levels may be associated with an increased risk of coronary artery disease and coronary events such as myocardial infarction. Testosterone replacement therapy was not associated with an increased risk of coronary artery disease or coronary events in men with low testosterone levels as was previously reported in some poorly done studies.
It is important to note that while these studies suggest that testosterone therapy may improve some cardiovascular risk factors, more research is needed to fully understand the relationship between testosterone and cardiovascular health.
Key References for Further Reading:
- “Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline,” J. Clin. Endocrinol. Metab., 2010
- “The effects of testosterone replacement therapy on insulin resistance and glucose metabolism in hypogonadal men,” Eur. J. Endocrinol., 2013
- “Testosterone therapy and cardiovascular risk: advances and controversies,” Int. J. Cardiol., 2012
- “Testosterone and cardiovascular disease,” Am. J. Cardiol., 2010
- “Testosterone and coronary artery disease: a meta-analysis,” Clin. Endocrinol. (Oxf.), 2014
- “Testosterone therapy and coronary artery plaque volume in older men with low testosterone,” J. Am. Coll. Cardiol., 2011
- “Testosterone therapy in men with heart failure,” Eur. J. Heart Fail., 2013