According to information in a recent study, the data on the effects of testosterone injections on men s cardiovascular health have been mixed, with some reports finding an increased risk of heart attack (MI) and stroke, and others not doing so. In order to resolve some of these conflicting results, Dr.Jacques Baillargeon and colleagues at the University of Texas Medical Branch in Galveston used Medicare records to identify nearly 6400 men who had received at least one testosterone injection between 1997 and 2005. They paired these men with 19,000 non-users of testosterone, based on similarities in risk for MI.
Men who had used testosterone were more likely than non-users to have been diagnosed with fatigue, hypogonadism, osteoporosis and sexual dysfunction (typical diagnoses that would lead to testosterone use). Otherwise, the groups were similar with respect to age, race and education level.
Analysis of the data indicated that testosterone therapy was not associated with an increased risk for MI. When the researchers divided the participants into quartiles (fourths) based on their level of cardiovascular risk, they found that those in the highest quartile of risk actually had a decreased risk of MI compared to non-users. This was not true of men in the lower quartiles, whose MI risk was similar to that of non-users.
Dr. Baillargeon and colleagues pointed out that while the large size of their study and length of follow-up were strong points, its retrospective nature meant no causal connection could be assumed. Further, they acknowledged that their results did not necessarily extend to other types of testosterone supplementation such as gels, transdermal patches or oral supplements.
In their summary, the investigators stated In view of the large increase in the use of testosterone therapy in recent years, examining the short- and long-term risks of testosterone therapy holds increasing clinical and public health relevance. Future research, both observational studies and randomized clinical trials, should be conducted to further examine potential adverse effects of testosterone therapy.
ACSH s Dr. Ruth Kava added While these data should help reassure older men who have been using injected testosterone about possible heart risks, I certainly concur that more research is needed to expand these results to other forms of testosterone supplementation as well as to younger men.
