Key cardiovascular disease risk factors were associated with low plasma testosterone in men, but after adjustment, there was no association with mean carotid intima-media thickness, incident cardiac thickness or mortality, according to recent findings.

Adrian Dobs, MD, of the division of endocrinology, diabetes and metabolism at Johns Hopkins University School of Medicine, and colleagues evaluated 1,558 men (mean age, 63.1 years) not taking androgen therapy and without coronary heart disease, stroke or heart failure to determine the relationship between plasma testosterone and mean carotid intima-media thickness. The relationship with incident CVD, cardiac mortality and all-cause mortality was also examined.

Adrian Dobs

The median plasma total testosterone was 377.6 ng/dL. No significant association was found between testosterone levels, age, race, LDL cholesterol or use of lipid-lowering medications.

Significantly higher BMI, greater waist circumference, higher prevalence of diabetes and hypertension and lower HDL cholesterol were found among participants with lower testosterone (all P for trend <.001).

Mean carotid intima-media thickness was 0.9 mm. No association was found cross-sectionally between testosterone quartiles with carotid intima-media thickness after adjustment for CV risk factors (P for trend=.56). Similarly, no association was found between incident coronary heart disease or incident cardiac heart failure and quartile testosterone after multivariable adjustment.

Overall, there were 347 deaths and 29 attributed to cardiac causes; however, there was no association between all-cause mortality or cardiac mortality and quartile testosterone after multivariable adjustment.

“Low serum testosterone in men did not predict the later development of heart disease,” Dobs told Endocrine Today.“However, it was highly associated with cardiac risk factors. Thus, low testosterone should be viewed, not as causative of later cardiac problems, but rather as a marker to suggest that aggressive treatment of classical risk factors need to be addressed.” – by Amber Cox