Trials of Testosterone Replacement Reporting Cardiovascular Adverse Events

Overview

Journal Asian J Androl

Specialty Urology

Date 2017 Aug 8

PMID 28782738

Citations 5

Authors

Thiago Gagliano-Juca

Shehzad Basaria

Affiliations

Soon will be listed here.

Abstract

The numbers of testosterone prescriptions written have increased several-fold worldwide, but the incidence of pathological hypogonadism due to hypothalamic, pituitary, and testicular disease has remained unchanged. Most of these prescriptions are being dispensed to middle-aged and older men who have experienced age-related decline in serum testosterone levels; a subset of the population in which benefits of testosterone replacement is at best, modest. Recently, some randomized controlled trials have reported increased cardiovascular events in men (mainly older men and those with prevalent cardiovascular disease) with testosterone use, and a few recent meta-analyses have confirmed these findings. In this review, we discuss trials of testosterone therapy that have reported higher cardiovascular events, relevant trials that have not reported increased cardiovascular events and large trials that have focused on cardiovascular risk (mainly atherosclerosis progression) as their main outcome. We also review findings from meta-analyses that have evaluated cardiovascular events in various testosterone trials. Finally, we discuss some potential mechanisms by which testosterone use might result in an increased cardiovascular risk. As none of the trials conducted to date were adequately powered to evaluate cardiovascular events, no firm conclusions can be drawn regarding the cardiovascular safety of testosterone therapy at this time. In the interim, we hope that this review will help practitioners make informed decisions regarding the care of their patients.

Citing Articles

Testosterone aggravates cerebral vascular injury by reducing plasma HDL levels.

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Emerging Evidences in the Long Standing Controversy Regarding Testosterone Replacement Therapy and Cardiovascular Events.

Clavell-Hernandez J, Wang R World J Mens Health. 2018; 36(2):92-102.

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Conclusions about testosterone therapy and cardiovascular risk.

Anawalt B, Yeap B Asian J Androl. 2018; 20(2):152-153.

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Why is understanding the relationship of testosterone to cardiovascular risk so important?.

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