Testosterone and Cardiovascular Disease in Men
Authors: Di Zhao, Eliseo Guallar
Journal: Annals of Internal Medicine (2021)

EditorialsFebruary 2022Testosterone and Cardiovascular Disease in MenDi Zhao, PhD and Eliseo Guallar, MD, DrPHDi Zhao, PhDDepartments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland and Eliseo Guallar, MD, DrPH Annals of Internal Medicine, Philadelphia, Pennsylvania, and Johns Hopkins University, Baltimore, MarylandAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-4777 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In men, testosterone levels increase rapidly in early adolescence, peak in late adolescence to young adulthood, and steadily decline throughout the remainder of adulthood (1). In contrast, the incidence of cardiovascular disease (CVD) increases by more than 20-fold from age 40 to 90 years (2). Studies have evaluated the role of declining testosterone levels in explaining the age-related increase in atherosclerosis and CVD, but it is still unclear if low testosterone levels have a causal effect or simply act as risk markers (3).In their article, Yeap and colleagues (4) used data from the UK Biobank to evaluate the association ...References1. Ober C, Loisel DA, Gilad Y. Sex-specific genetic architecture of human disease. Nat Rev Genet. 2008;9:911-22. [PMID: 19002143] doi:10.1038/nrg2415 CrossrefMedlineGoogle Scholar2. Virani SS, Alonso A, Aparicio HJ, et al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2021 update: a report from the American Heart Association. Circulation. 2021;143:e254-e743. [PMID: 33501848] doi:10.1161/CIR.0000000000000950 CrossrefMedlineGoogle Scholar3. Shores MM, Matsumoto AM. Testosterone, aging and survival: biomarker or deficiency. Curr Opin Endocrinol Diabetes Obes. 2014;21:209-16. [PMID: 24722173] doi:10.1097/MED.0000000000000057 CrossrefMedlineGoogle Scholar4. Yeap BB, Marriott RJ, Antonio L, et al. Associations of serum testosterone and sex hormone–binding globulin with incident cardiovascular events in middle-aged to older men. Ann Intern Med. 2022;175:159-170. doi:10.7326/M21-0551 Google Scholar5. Ruige JB, Mahmoud AM, De Bacquer, et al. Endogenous testosterone and cardiovascular disease in healthy men: a meta-analysis. Heart. 2011;97:870-5. [PMID: 21177660] doi:10.1136/hrt.2010.210757 CrossrefMedlineGoogle Scholar6. Luo S, Au Yeung, Zhao JV, et al. Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: Mendelian randomisation study in UK Biobank. BMJ. 2019;364:l476. [PMID: 30842065] doi:10.1136/bmj.l476 CrossrefMedlineGoogle Scholar7. Li Y, Si S, Hou L, et al. Causal effect of sex hormone-binding globulin and testosterone on coronary heart disease: a multivariable and network Mendelian randomization analysis. Int J Cardiol. 2021;339:179-184. [PMID: 34181993] doi:10.1016/j.ijcard.2021.06.037 CrossrefMedlineGoogle Scholar8. Onasanya O, Iyer G, Lucas E, et al. Association between exogenous testosterone and cardiovascular events: an overview of systematic reviews. Lancet Diabetes Endocrinol. 2016;4:943-956. [PMID: 27669646] doi:10.1016/S2213-8587(16)30215-7 CrossrefMedlineGoogle Scholar9. U.S. Food and Drug Administration. FDA Drug Safety Communication: FDA cautions about using testosterone products for low testosterone due to aging; requires labeling change to inform of possible increased risk of heart attack and stroke with use. Updated 26 February 2018. Accessed at www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-cautions-about-using-testosterone-products-low-testosterone-due on 20 December 2021. Google Scholar10. Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103:1715-1744. [PMID: 29562364] doi:10.1210/jc.2018-00229 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland Annals of Internal Medicine, Philadelphia, Pennsylvania, and Johns Hopkins University, Baltimore, MarylandDisclosures: Authors have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-4777.Corresponding Author: Eliseo Guallar, MD, DrPH, Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Room 2-645, Baltimore, MD 21205; e-mail, [email protected]edu.This article was published at Annals.org on 28 December 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAssociations of Serum Testosterone and Sex Hormone–Binding Globulin With Incident Cardiovascular Events in Middle-Aged to Older Men Bu B. Yeap , Ross J. Marriott , Leen Antonio , Suchitra Raj , Girish Dwivedi , Christopher M. Reid , Bradley D. Anawalt , Shalender Bhasin , Adrian S. Dobs , David J. Handelsman , Graeme J. Hankey , Robin Haring , Alvin M. Matsumoto , Paul E. Norman , Terence W. O'Neill , Claes Ohlsson , Eric S. Orwoll , Dirk Vanderschueren , Gary A. Wittert , Frederick C.W. Wu , and Kevin Murray Metrics Cited byAssociation of total and free testosterone with cardiovascular disease in a nationally representative sample of white, black, and Mexican American men February 2022Volume 175, Issue 2Page: 287-288KeywordsCardiovascular disease riskCardiovascular diseasesSex hormonesTestosterone ePublished: 28 December 2021 Issue Published: February 2022 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...