Testosterone Therapy Tied to Heart Risks
Veterans With History of Heart Disease Had Higher Risk of Death, Heart Attack and Stroke, According to JAMA Study
By
Melinda Beck
Updated Nov. 5, 2013 7:55 p.m. ET
Testosterone therapy raised the risk of death, heart attack and stroke by about 30% in a group of veterans with a history of heart disease, according to a new study.
While it isn't known how applicable the findings are to healthier men, some experts said doctors and patients should be aware that testosterone therapy might carry risks as well as benefits.
"Prior to this study, we didn't know much about the cardiovascular risk," said Michael Ho, a cardiologist at the VA Eastern Colorado Health Care System, senior author of the study, published in the Journal of the American Medical Association. "Men taking testosterone have to ask themselves whether the risks are worth the benefits they may be receiving," he said.
Numerous studies have shown that treating low testosterone can improve men's sexual function, bone density, strength and lean muscle mass, while lowering cholesterol and insulin resistance. U.S. testosterone prescriptions, including refills, more than doubled to 432 million last year from 208 million in 2008, according to IMS Health, a health-care information company.
Medical problems can cause testosterone levels to fall sharply in younger men. But levels of the hormone decline naturally with age and experts differ on which men should be treated.
In 2009, researchers halted a trial funded by the National Institutes of Health of about 200 frail older men with a high prevalence of heart disease due to a high rate of heart attacks among those taking testosterone. But another study of 1,031 Veterans Health Administration patients last year found that testosterone therapy lowered the risk of heart disease and cut the mortality risk by 39%.
The new study examined the health records of 8,709 men with low testosterone (defined as below 300 nanograms per deciliter) who had coronary angiography—a test to determine plaque buildup in blood vessels—in the VA health system between 2005 and 2011.
Of the men, 1,223 had testosterone therapy—and nearly 26% of them suffered a heart attack, stroke or died for any reason within the next three years. That compared with 20% of those not taking testosterone. Many of the men in both groups had a history of heart attacks, diabetes or coronary artery disease, although those taking testosterone were slightly younger and had lower rates of other illnesses.
Cardiologist Steven Nissen of the Cleveland Clinic said he and other experts "saw trouble on the horizon" with the rising use of testosterone. "I get it—men want to feel stronger. But we should insist on long-term well-designed safety trials," he said.
The National Institutes of Health is sponsoring a multicenter trial of nearly 800 men aged 65 and older with low testosterone, studying the effects of testosterone on walking ability, fatigue, sexual function, verbal memory, hemoglobin and plaque buildup. Although results won't be released for at least a year, University of Pennsylvania endocrinologist Peter Snyder, the principal investigator, said he wasn't aware of serious problems among the participants.
- - - Updated - - -
now don't forget the part where most of them already had heart issues prior to the test. personally it sounds like it was set up for the result they reached.
Veterans With History of Heart Disease Had Higher Risk of Death, Heart Attack and Stroke, According to JAMA Study
By
Melinda Beck
Updated Nov. 5, 2013 7:55 p.m. ET
Testosterone therapy raised the risk of death, heart attack and stroke by about 30% in a group of veterans with a history of heart disease, according to a new study.
While it isn't known how applicable the findings are to healthier men, some experts said doctors and patients should be aware that testosterone therapy might carry risks as well as benefits.
"Prior to this study, we didn't know much about the cardiovascular risk," said Michael Ho, a cardiologist at the VA Eastern Colorado Health Care System, senior author of the study, published in the Journal of the American Medical Association. "Men taking testosterone have to ask themselves whether the risks are worth the benefits they may be receiving," he said.
Numerous studies have shown that treating low testosterone can improve men's sexual function, bone density, strength and lean muscle mass, while lowering cholesterol and insulin resistance. U.S. testosterone prescriptions, including refills, more than doubled to 432 million last year from 208 million in 2008, according to IMS Health, a health-care information company.
Medical problems can cause testosterone levels to fall sharply in younger men. But levels of the hormone decline naturally with age and experts differ on which men should be treated.
In 2009, researchers halted a trial funded by the National Institutes of Health of about 200 frail older men with a high prevalence of heart disease due to a high rate of heart attacks among those taking testosterone. But another study of 1,031 Veterans Health Administration patients last year found that testosterone therapy lowered the risk of heart disease and cut the mortality risk by 39%.
The new study examined the health records of 8,709 men with low testosterone (defined as below 300 nanograms per deciliter) who had coronary angiography—a test to determine plaque buildup in blood vessels—in the VA health system between 2005 and 2011.
Of the men, 1,223 had testosterone therapy—and nearly 26% of them suffered a heart attack, stroke or died for any reason within the next three years. That compared with 20% of those not taking testosterone. Many of the men in both groups had a history of heart attacks, diabetes or coronary artery disease, although those taking testosterone were slightly younger and had lower rates of other illnesses.
Cardiologist Steven Nissen of the Cleveland Clinic said he and other experts "saw trouble on the horizon" with the rising use of testosterone. "I get it—men want to feel stronger. But we should insist on long-term well-designed safety trials," he said.
The National Institutes of Health is sponsoring a multicenter trial of nearly 800 men aged 65 and older with low testosterone, studying the effects of testosterone on walking ability, fatigue, sexual function, verbal memory, hemoglobin and plaque buildup. Although results won't be released for at least a year, University of Pennsylvania endocrinologist Peter Snyder, the principal investigator, said he wasn't aware of serious problems among the participants.
- - - Updated - - -
now don't forget the part where most of them already had heart issues prior to the test. personally it sounds like it was set up for the result they reached.
