Testosterone and Cardiovascular Disease

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• 作者：Robert A. Kloner ; MD ; PhD^a ; ^b ; ^{kloner@hmri.org" class="auth_mail" title="E-mail the corresponding author} ; Culley Carson III ; MD^c ; Adrian Dobs ; MD^d ; Stephen Kopecky ; MD^e ; Emile R. Mohler III ; MD^f
• 关键词：angina ; heart failure ; hormone replacement therapy ; major adverse cardiovascular events ; male health ; myocardial infarction
• 刊名：Journal of the American College of Cardiology
• 出版年：2016
• 出版时间：9 February 2016
• 年：2016
• 卷：67
• 期：5
• 页码：545-557
• 全文大小：771 K

文摘

Testosterone (T) is the principal male sex hormone. As men age, T levels typically fall. Symptoms of low T include decreased libido, vasomotor instability, and decreased bone mineral density. Other symptoms may include depression, fatigue, erectile dysfunction, and reduced muscle strength/mass. Epidemiology studies show that low levels of T are associated with more atherosclerosis, coronary artery disease, and cardiovascular events. However, treating hypogonadism in the aging male has resulted in discrepant results in regard to its effect on cardiovascular events. Emerging studies suggest that T may have a future role in treating heart failure, angina, and myocardial ischemia. A large, prospective, long-term study of T replacement, with a primary endpoint of a composite of adverse cardiovascular events including myocardial infarction, stroke, and/or cardiovascular death, is needed. The Food and Drug Administration recently put additional restrictions on T replacement therapy labeling and called for additional studies to determine its cardiac safety.