Abstract 16401: Cardiovascular Clinical Effects of Testosterone Supplementation Among Healthy Hypo-androgenic Men: Information From the Intermountain Healthcare Health Plans Database
Introduction: Epidemiologic studies have identified low serum testosterone (T) levels as an independent risk factor for cardiovascular (CV) and total mortality. However, the cardiovascular safety of T therapy among healthy men with low T levels is unknown.
Hypothesis: We hypothesized that T supplementation among healthy men over the age of 50 yrs with low T levels is not associated with an increased risk of major adverse cardiovascular events (MACE).
Methods: All men in the Intermountain Healthcare Health Plans Database >50 years of age, with no prior history of CV disease, a documented low (<212 ng/dL) baseline T level, at least 1 follow-up (f/u) T level and 3 years of clinical f/u were stratified by whether or not they received at least 90 days of T supplementation (topical gel or injection) or not. Cox hazard regression analysis, adjusting for 17 baseline variables, was performed to determine any association between T supplementation and 3 year MACE (death [D], non-fatal MI, and stroke).
Results: A total of 1,472 men (age 57.0 ± 5.5 y, diabetes: 20%, hypertension: 41%, hyperlipidemia: 43%, smokers: 13%) were studied. Event rates at 1 and 3-y by supplementation status, and adjusted HRs, are shown in the Table. Overall 3-y rates of MACE, D, MI and stroke were low consistent with the baseline age and health of the population. After adjustment, subjects supplemented with T had statistically reduced 1 and 3 year rates of D and total MACE, including numerically reduced rates of MI and stroke compared to those receiving no supplementation.
Conclusions: Among a generally healthy and relatively young population of hypo-androgenic men, T therapy was associated with reduced MACE and D over 3-y compared to no T supplementation. These findings provide further observational evidence of the CV safety associated with T supplementation in this population.
Author Disclosures: T.L. Bair: None. H.T. May: None. V.T. Le: None. D.L. Lappé: None. J.L. Anderson: None. J.B. Muhlestein: None.
- © 2015 by American Heart Association, Inc.