Testosterone Replacement Therapy and Cardiovascular Risk
An exciting new study just released by The Intermountain Medical Center Heart Institute (IMCHI) found that testosterone replacement therapy used to increase testosterone to normal levels in androgen-deficient men doesn’t increase risk of a serious heart attack or stroke. In the past, several studies had noted the potential increased risk associated with testosterone replacement therapy (TRT), prompting The Journal of the American Medical Association (JAMA) to write an article about the FDA increasing its scrutiny of supplemental testosterone and cardiovascular risk, inviting stricter controls including requiring manufacturers of all approved testosterone products to add labels outlining the coronary risks of testosterone supplementation.
IMCHI's new multi-year study found that TRT helped elderly men with low testosterone levels and pre-existing coronary artery disease reduce their risks of major adverse cardiovascular events—including strokes, heart attacks, and death. Patients in the study who received testosterone as part of their follow-up treatments fared better than those who did not. Those without testosterone as part of their follow-up treatment were 80% more likely to suffer an adverse cardiovascular event.
“The study shows that using testosterone replacement therapy to increase testosterone to normal levels in androgen-deficient men doesn’t increase their risk of a serious heart attack or stroke,” said cardiologist Brent Muhlestein, MD, co-director of cardiovascular research at the Intermountain Medical Center Heart Institute. “That was the case even in the highest-risk men—those with known pre-existing heart disease.”
The study included 755 male patients at Intermountain Healthcare hospitals between the ages of 58 and 78 with severe coronary artery disease. Placed into three different groups, they received varied doses of testosterone administered either by injection or gel and found that:
- After one year, 64 patients who weren’t taking testosterone supplements suffered major adverse cardiovascular events, while only 12 who were taking medium doses of testosterone and nine who were taking high doses did
- After three years, 125 non-testosterone-therapy patients suffered major adverse cardiovascular events, while only 38 medium-dose and 22 high-dose patients did
“Although this study indicates that hypo-androgenic men with coronary artery disease might actually be protected by testosterone replacement, this is an observational study that doesn’t provide enough evidence to justify changing treatment recommendations,” Dr. Muhlestein said. “It does, however, substantiate the need for a randomized clinical trial that can confirm or refute the results of this study.”