Age of study population and year of publication modified the relationship between testosterone and CVD .
Results were largely confirmed by separate analyses of free- and bioavailable testosterone .
The systematic review displayed no association between endogenous testosterone and risk for CVD in middle-aged men .
In elderly men , testosterone may weakly protect against CVD .
Alternatively , low testosterone may indicate a poor general health
CONTEXT The literature provides no clear answer as to whether low endogenous testosterone increases risk of cardiovascular disease ( CVD ) in healthy men .
OBJECTIVE Our purpose was to estimate the predictive value of testosterone for CVD and to identify study features explaining conflicting results .
Plasma levels of estradiol, testosterone, and DHEAS do not predict risk of coronary artery disease in men.
Prior studies have reported men with coronary artery disease ( CAD ) to have elevated plasma levels of estrogens and reduced concentrations of dehydroepi and rosterone ( DHEA ) or DHEA-sulfate ( DHEAS ) . We investigated whether gonadal steroids or DHEAS are risk factors for CAD in men , using a prospect i ve design , in a well characterized population studied at regular intervals . We studied 46 men ( Cardiac group ) who developed CAD and 124 men ( Control group ) who remained free of CAD ( mean follow-up , 9.5 years ) . We measured  testosterone ( T ) , estradiol ( E2 ) , and DHEAS  , as well as  plasma binding of T and E2  , in sample s stored before the onset of CAD ( Cardiac group ) or at matched times ( Control group ) . Body mass index , blood pressure , and total serum cholesterol were measured at each visit . Both systolic blood pressure ( SBP ; P less than 0.001 ) and cholesterol ( P less than 0.001 ) were increased in the Cardiac group , but no significant differences were found in total or free T or E2 , the ratio of E2/T , or DHEAS between the two groups . The difference in cholesterol was significant only in men less than or equal to 65 years old ( P less than 0.001 ) , and SBP only in men greater than 65 years old ( P less than 0.005 ) . Cholesterol ( P less than 0.05 ) and E2 ( P less than 0.001 ) appeared to decrease with age in the Cardiac , but not the Control , group . Moreover , total ( P less than 0.01 ) and free E2 ( P less than 0.05 ) were lower only in Cardiac men less than or equal to 55 years old . ( ABSTRACT TRUNCATED AT 250 WORDS
Age of study population and year of publication modified the relationship between testosterone and CVD .
Results were largely confirmed by separate analyses of free- and bioavailable testosterone .
The systematic review displayed no association between endogenous testosterone and risk for CVD in middle-aged men .
In elderly men , testosterone may weakly protect against CVD .
Alternatively , low testosterone may indicate a poor general health
CONTEXT The literature provides no clear answer as to whether low endogenous testosterone increases risk of cardiovascular disease ( CVD ) in healthy men .
OBJECTIVE Our purpose was to estimate the predictive value of testosterone for CVD and to identify study features explaining conflicting results .