Testosterone replacement therapy and cardiovascular risk.
Animals
Atherosclerosis
/ diagnostic imaging
Blood Platelets
/ physiology
Cardiac Output
/ drug effects
Cardiovascular Diseases
/ drug therapy
Coronary Vessels
Disease Progression
Drug Prescriptions
/ statistics & numerical data
Endothelium
/ physiopathology
Exercise Tolerance
/ drug effects
Glucose
/ metabolism
Hormone Replacement Therapy
Humans
Lipid Metabolism
Lipoproteins
/ blood
Meta-Analysis as Topic
Randomized Controlled Trials as Topic
Risk Factors
Testosterone
/ blood
Vascular Resistance
/ drug effects
Journal
Nature reviews. Cardiology
ISSN: 1759-5010
Titre abrégé: Nat Rev Cardiol
Pays: England
ID NLM: 101500075
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
pubmed:
28
5
2019
medline:
21
1
2020
entrez:
25
5
2019
Statut:
ppublish
Résumé
Testosterone is the main male sex hormone and is essential for the maintenance of male secondary sexual characteristics and fertility. Androgen deficiency in young men owing to organic disease of the hypothalamus, pituitary gland or testes has been treated with testosterone replacement for decades without reports of increased cardiovascular events. In the past decade, the number of testosterone prescriptions issued for middle-aged or older men with either age-related or obesity-related decline in serum testosterone levels has increased exponentially even though these conditions are not approved indications for testosterone therapy. Some retrospective studies and randomized trials have suggested that testosterone replacement therapy increases the risk of cardiovascular disease, which has led the FDA to release a warning statement about the potential cardiovascular risks of testosterone replacement therapy. However, no trials of testosterone replacement therapy published to date were designed or adequately powered to assess cardiovascular events; therefore, the cardiovascular safety of this therapy remains unclear. In this Review, we provide an overview of epidemiological data on the association between serum levels of endogenous testosterone and cardiovascular disease, prescription database studies on the risk of cardiovascular disease in men receiving testosterone therapy, randomized trials and meta-analyses evaluating testosterone replacement therapy and its association with cardiovascular events and mechanistic studies on the effects of testosterone on the cardiovascular system. Our aim is to help clinicians to make informed decisions when considering testosterone replacement therapy in their patients.
Identifiants
pubmed: 31123340
doi: 10.1038/s41569-019-0211-4
pii: 10.1038/s41569-019-0211-4
doi:
Substances chimiques
Lipoproteins
0
Testosterone
3XMK78S47O
Glucose
IY9XDZ35W2
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
555-574Références
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