Low Testosterone, Higher Heart Risks

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As the population ages, more men are experiencing waning testosterone levels, which can contribute to depression and changes in blood pressure and blood sugar.

A new review, published in the Journal of Clinical Endocrinology & Metabolism (JCEM), of nine observational studies from 1970 to 2013, however, reveals that men with low testosterone may also have a slightly higher risk of developing or dying from heart disease compared to men with higher levels.

Testosterone helps to maintain sex drive, and the hormone also strengthens bone and muscle. Low testosterone levels can trigger metabolic changes that lead to increased body fat and thinning muscles, as well as reduced sex drive.

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Because the analysis combined the results of multiple trials, at this point, the researchers do not have enough data to speculate on why waning levels of the hormone can contribute to heart disease. But they suspect that changing testosterone levels could, for example, generate blood clots that can lead to irregular heart rhythms and to more serious heart abnormalities. They also note that the connection may simply reflect the fact that both low testosterone and heart disease may be the consequences of poor health. “Based on current findings, we cannot rule out that low testosterone and heart disease both result from poor overall health,” said lead study author Dr.  Johannes Ruige of Ghent University Hospital in Belgium in a statement.

In fact, men with low testosterone levels who were treated with hormone replacement therapy did not experience a drop in their heart disease risk, which further suggests that other factors may be contributing both to declining hormone levels and a higher risk of heart problems.

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More studies are needed to explore how testosterone levels influence heart health, but in the meantime the Endocrine Society recommends using hormone therapy only if blood tests show that men have abnormally low testosterone levels and experience consistent symptoms of the disorder.