High testosterone may reflect better heart health

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Elderly men with naturally high levels of testosterone seem to be less likely to suffer a heart attack or stroke than their peers with lower levels of the hormone, reports a study just published in the Journal of the American College of Cardiology.

The study, led by a doctor at a university hospital in Sweden, measured the testosterone levels and cardiovascular health of 2,400 Swedish men in their 70s and 80s. Ultimately, the upper quartile of men with the highest levels of testosterone showed a 30 percent lower risk of heart disease or stroke, compared to the remaining subjects with lower testosterone levels.

Doctors, however, are cautious about drawing any definitive conclusions just yet. While most medical experts acknowledge that higher levels of testosterone are typically associated with the lower body fat and more lean muscle, which is indicative of a healthy heart, they are not yet sure whether male hormone replacement therapy for men is a good idea. First of all, lower levels of testosterone may simply be a mark of other health conditions that put men at higher risk for cardiovascular disease. The researchers also point out that testosterone can contribute to blood clots, liver damage, and prostate cancer. Finally, the men in the study had naturally occurring high levels of testosterone; it s hard to say whether testosterone replacement therapy would replicate the cardiovascular health benefits of the natural hormone in other men.

The findings in this observational study may be significant, the medical community agrees, but no conclusion about cause-and-effect is justified now; these findings must be borne out by evidence from prospective clinical trials. And such trials are, in fact, in progress; they should be able to give researchers a better sense of whether testosterone replacement in older men actually lowers the risk of heart disease and stroke.

ACSH's Dr. Gilbert Ross agrees that it s difficult to reach a conclusion based on the Swedish research alone. It s a very good preliminary study, he says, but right now there are too many confounding factors for the findings to be useful in practice. He, too, is waiting to learn what the clinical trials uncover.