Testosterone Deficiency in Patients with Erectile Dysfunction: When Should a Higher Cardiovascular Risk Be Considered?
- 1 August 2014
- journal article
- research article
- Published by Oxford University Press (OUP) in The Journal of Sexual Medicine
- Vol. 11 (8), 2083-2091
- https://doi.org/10.1111/jsm.12596
Abstract
Low testosterone levels (low T) increase the cardiovascular (CV) risk of men with erectile dysfunction (ED). T levels associated with a higher CV risk are unknown. To determine the prevalence of CV risk factors associated with low T as defined by European Guidelines and their contribution to low T, overall and at different ages. Multicenter, cross-sectional, observational study conducted in Spain among men with ED aged ≥ 18 years visiting Urology/Andrology offices for sexual dysfunction. Anthropometric, clinical, and laboratory data, including total T (TT) values, were collected for 1,278 men. Risk factors were assessed in men with TT ≤ 8, 8-12, and ≥ 12 nmol/L, and two-group comparisons were made. Bivariate and multivariate logistic regression analyses were performed to calculate odds ratios for low T after adjusting for possible confounding factors. Mean age (standard deviation) was 58.0 (9.2) years. Age and prevalence of CV risk factors was similar in men with TT ≤ 8 nmol/L or 8-12 nmol/L and significantly higher than in men with TT >12 nmol/L. Low T was therefore considered as TT ≤ 12 nmol/L, with a prevalence of 33.3%. Obesity, hypertension, hyperlipidemia, and severe ED were the variables most strongly associated with low T: obesity in middle-aged men; hyperlipidemia, and hypertension in older men. Severe ED was a risk factor in both groups. Hypolipidemic therapy had the greater effect in young men. Multivariate analysis showed that severe ED and obesity were the strongest predictors of low T. T levels associated with increased CV risk could go as high as 12 nmol/L in men with ED, with distribution of risk factors showing differences according to age. Obesity and severe ED are the best predictors of low T-related CV risk.Keywords
Funding Information
- Bayer Hispania SL.
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