Effect of acute testosterone on myocardial ischemia in men with coronary artery disease

Webb, Carolyn; Adamson, Dawn; Zeigler, Dominique de; Collins, Peter

doi:10.1016/s0002-9149(98)00880-7

Cited by 217 publications

(137 citation statements)

References 21 publications

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“…The increased risk of arterial and venous thromboembolism associated with HRT and the OCP, may not occur with testosterone replacement therapy in men, since physiological doses of testosterone do not adversely affect blood coagulation factor expression. This negative finding is important, since recent research has shown that testosterone is beneficial in patients with angina (13)(14)(15)(16)(17) and chronic heart failure (40,41). The findings of this study suggest that male hormone replacement therapy may provide cardiovascular benefit without adversely affecting blood coagulation.…”

Section: Discussionmentioning

confidence: 69%

“…It has been shown that PAI-1 is of particular importance in CHD, with elevated levels predicting MI and progression of atherosclerosis in stable CHD patients (22,23). Crosssectional studies have reported a positive association between testosterone levels and tPA and a negative association with PAI-1, VIIc and fibrinogen (14,15,24). Replacement of testosterone in hypogonadal men and treatment of normal men with dehydroepiandrosterone (DHEA) reduces PAI-1 serum levels, whilst testosterone administration in healthy men also reduces plasma levels of the acute phase protein fibrinogen (23), which is an independent risk factor for CAD (25).…”

Section: Introductionmentioning

confidence: 99%

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Testosterone does not adversely affect fibrinogen or tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels in 46 men with chronic stable angina

et al. 2005

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Objective: In women, sex hormones cause increased morbidity and mortality in patients with coronary heart disease (CHD) and adversely affect the coagulation profile. We have studied the effect of physiological testosterone replacement therapy in men on coagulation factor expression, to determine if there is an increased risk of thrombosis. Methods: Double-blind, randomized, placebo-controlled trial of testosterone in 46 men with chronic stable angina. Measurements of free, total and bioavailable testosterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH), estradiol, plasminogen activator inhibitor-1 (PAI-1), fibrinogen, tissue plasminogen activator (tPA) and full blood count were made at 0, 6 and 14 weeks.

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Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Testosterone does not adversely affect fibrinogen or tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels in 46 men with chronic stable angina

et al. 2005

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“…Mice lacking the gene encoding the natriuretic peptide receptor A (Npr1) are characterized by both high blood pressure and low circulating levels of testosterone (26). Testosterone may exert antihypertensive effects on the vasculature as testosterone induces endothelium-independent relaxation of isolated rabbit and rat aorta (27,28), and testosterone has also been shown to have a beneficial effect on myocardial ischemia (29) and coronary blood flow in men with CHD (30). These observations suggest a direct role for testosterone in modulating vessel resistance and arterial blood flow.…”

Section: Discussionmentioning

confidence: 99%

Association of endogenous testosterone with blood pressure and left ventricular mass in men. The Tromso Study

Svartberg

Mühlen²,

Schirmer³

et al. 2004

European Journal of Endocrinology

245

188

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Objective: To test the hypothesis that lower endogenous testosterone levels are associated with higher blood pressure, left ventricular mass, and left ventricular hypertrophy. Design: Population-based cross-sectional study. Methods: Sex hormone levels, measured by immunoassay, anthropometric measurements and resting blood pressure were studied in 1548 men aged 25-84 years; echocardiography was completed in 1264 of these men. Partial correlations and multiple regressions were used to estimate the associations between sex hormones, blood pressure and left ventricular mass by height. Analyses of variance and covariance were used to compare men with categorical hypertension and left ventricular hypertrophy. Results: In age-adjusted partial correlations, total testosterone and sex hormone-binding globulin (SHBG) were each inversely associated with systolic blood pressure (SBP) (P , 0.001). Men with categorical hypertension (SBP $ 140 or diastolic blood pressure (DBP) $ 90 mmHg) had lower levels of total and free testosterone and SHBG before (P , 0.001, P ¼ 0.011 and P , 0.001, respectively) and after (P , 0.001, P ¼ 0.035 and P ¼ 0.002, respectively) adjusting for body mass index (BMI). Total testosterone and SHBG were each inversely associated with left ventricular mass (P , 0.001), and men with left ventricular hypertrophy had significantly lower levels of total testosterone (P ¼ 0.042) and SHBG (P ¼ 0.006); these associations were no longer significant after adjusting for BMI. Conclusion:The results of the present study are consistent with the hypothesis that lower levels of testosterone in men are associated with higher blood pressure, left ventricular mass, and left ventricular hypertrophy. The reduced associations after adjusting for BMI suggest that the association of low testosterone levels with blood pressure and left ventricular mass is mediated by obesity.European Journal of Endocrinology 150 65-71

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“…Noteworthy, in men with CAD, i.m. testosterone treatment has been shown to have a beneficial effect on angina pectoris 24,25 and exercise-induced ST-segment depression 26,27 and to enhance endotheliumindependent coronary artery dilation and flow-mediated brachial arterial vasoreactivity. 28,29 A more recent study has shown that even long-term oral administration of testosterone enhances endothelium-dependent and endotheliumindependent vasodilation.…”

Section: Discussionmentioning

confidence: 99%

Free testosterone plasma levels are negatively associated with the intima-media thickness of the common carotid artery in overweight and obese glucose-tolerant young adult men

et al. 2003

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OBJECTIVE:To evaluate the relation between free testosterone (FT) levels and the intima-media thickness of the common carotid artery (IMT-CCA) in overweight and obese glucose-tolerant (NGT) young adult men. DESIGN: Cross-sectional study of FT and IMT-CCA in obese men. SUBJECTS: A total of 127 overweight and obese NGT male individuals, aged 18-45 y. MEASUREMENTS: FT plasma levels; IMT-CCA, as measured by high-resolution B-mode ultrasound imaging; central fat accumulation, as evaluated by waist circumference; body composition, as measured by bioimpedance analysis; insulin resistance, as calculated by homeostatic model assessment (HOMA IR ); systolic and diastolic blood pressure; and fasting concentrations of glucose, insulin, and lipids. RESULTS: IMT-CCA was positively correlated with age, body mass index (BMI), fat mass (FM), waist circumference, and fasting glucose concentrations, and inversely associated with FT levels. After multivariate analysis, IMT-CCA maintained an independent association with BMI, FM, and FT levels. This study indicates that IMT-CCA is negatively associated with FT levels, independent of age, total body fat, central fat accumulation, and fasting glucose concentrations in overweight and obese NGT patients. CONCLUSION: Hypotestosteronemia may accelerate the development of atherosclerosis and increase the risk for CHD in obese men.

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Effect of acute testosterone on myocardial ischemia in men with coronary artery disease

Cited by 217 publications

References 21 publications

Testosterone does not adversely affect fibrinogen or tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels in 46 men with chronic stable angina

Testosterone does not adversely affect fibrinogen or tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) levels in 46 men with chronic stable angina

Association of endogenous testosterone with blood pressure and left ventricular mass in men. The Tromso Study

Free testosterone plasma levels are negatively associated with the intima-media thickness of the common carotid artery in overweight and obese glucose-tolerant young adult men

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