The Dark Side of Testosterone Deficiency: III. Cardiovascular Disease
Open Access
- 10 September 2009
- journal article
- review article
- Published by Wiley in Journal of Andrology
- Vol. 30 (5), 477-494
- https://doi.org/10.2164/jandrol.108.007245
Abstract
A considerable body of evidence exists suggesting that androgen deficiency contributes to the onset, progression, or both of cardiovascular disease (CVD). The aim of this review is to evaluate the relationships between testosterone (T) deficiency and risk factors of CVD and to discuss the implications of androgen deficiency in men with cardiovascular risk factors. The relationship between androgen deficiency and endothelial function, lipid profiles, inflammatory responses, altered vascular smooth muscle reactivity, and hypertension are discussed with regard to CVD. A comprehensive literature search was carried out with the use of Pub Med from 1980 through 2009, and relevant articles pertinent to androgen deficiency and vascular disease were evaluated and discussed. Low T, whether attributed to hypogonadism or androgen deprivation therapy, in men with prostate carcinoma, produces adverse effects on cardiovascular health. Androgen deficiency is associated with increased levels of total cholesterol, low‐density lipoprotein, increased production of proinflammatory factors, and increased thickness of the arterial wall and contributes to endothelial dysfunction. Testosterone supplementation restores arterial vasoreactivity; reduces proinflammatory cytokines, total cholesterol, and triglyceride levels; and improves endothelial function but also might reduce high‐density lipoprotein levels. Testosterone is an anabolic hormone with a wide range of beneficial effects on men's health. The therapeutic role of T in men's health, however, remains a hotly debated issue for a number of reasons, including the purported risk of prostate cancer. In view of the emerging evidence suggesting that androgen deficiency is a risk factor for CVD, androgen replacement therapy could potentially reduce CVD risk in hypogonadal men. It should be emphasized, however, that androgen replacement therapy should be done with very thorough and careful monitoring for prostate diseases.Keywords
This publication has 100 references indexed in Scilit:
- Mechanisms involved in testosterone-induced vasodilatation in pig prostatic small arteriesLife Sciences, 2008
- Survival Following Primary Androgen Deprivation Therapy Among Men With Localized Prostate CancerJAMA, 2008
- Effects of Oral Testosterone Treatment on Myocardial Perfusion and Vascular Function in Men With Low Plasma Testosterone and Coronary Heart DiseaseThe American Journal of Cardiology, 2008
- Relationship Between Low Levels of Anabolic Hormones and 6-Year Mortality in Older MenThe Aging in the Chianti Area (InCHIANTI) StudyArchives of Internal Medicine, 2007
- Androgen deprivation therapy for prostate cancer: new concepts and concernsCurrent Opinion in Endocrinology, Diabetes and Obesity, 2007
- Obesity and Sex Steroids during Gonadotropin-Releasing Hormone Agonist Treatment for Prostate CancerClinical Cancer Research, 2007
- Non‐genomic effect of testosterone on airway smooth muscleBritish Journal of Pharmacology, 2006
- High levels of circulating testosterone are not associated with increased prostate cancer risk: A pooled prospective studyInternational Journal of Cancer, 2003
- Effect of Testosterone Replacement on Whole Body Glucose Utilisation and Other Cardiovascular Risk Factors in Males with Idiopathic Hypogonadotrophic HypogonadismHormone and Metabolic Research, 1998
- Testosterone and Regional Fat DistributionObesity Research, 1995