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 .
Cortisol, Testosterone, and Coronary Heart Disease: Prospective Evidence From the Caerphilly Study
Background —There is a popular belief that chronic stress causes heart disease through psychoneuroendocrine mechanisms . We have examined whether an elevated circulating cortisol-to-testosterone ratio increases the risk of ischemic heart disease . Methods and Results —We undertook a prospect i ve cohort study of 2512 men aged 45 to 59 years between 1979 and 1983 from Caerphilly , South Wales , with a mean follow-up of 16.5 years . Subjects underwent a clinical examination , and morning fasting blood sample s were taken for analysis of cortisol levels , testosterone levels , and other cardiovascular risk factors . The ratio of cortisol to testosterone showed weak associations with potential confounding factors but strong positive associations with components of the insulin resistance syndrome ( P<0.001 ) . A positive linear trend was seen across quintiles of cortisol : testosterone ratio for incident ischemic heart disease ( age-adjusted OR per z score change in ratio 1.22 , 95 % CI 1.07 to 1.38 , P=0.003 ) . This was markedly attenuated after adjustment for components of the insulin resistance syndrome ( age-adjusted OR per z score change in ratio 1.10 , 95 % CI 0.96 to 1.25 , P=0.18 ) . There was no association between the cortisol : testosterone ratio and other causes of death ( age-adjusted hazard ratio 0.99 , 95 % CI 0.88 to 1.11 , P=0.81 ) . Conclusions —This is the first population -based prospect i ve study that has found a specific association between cortisol : testosterone ratio and incident ischemic heart disease , apparently mediated through the insulin resistance syndrome . Whether this reflects the effects of chronic stress , behavioral factors , or genetic influences remains to be determined
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 .