Testosterone replacement therapy and the heart

Friend, foe or bystander?

David Lopez, Steven Canfield, Run Wang

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

The role of testosterone therapy (TTh) in cardiovascular disease (CVD) outcomes is still controversial, and it seems will remain inconclusive for the moment. An extensive body of literature has investigated the association of endogenous testosterone and use of TTh with CVD events including several meta-analyses. In some instances, a number of studies reported beneficial effects of TTh on CVD events and in other instances the body of literature reported detrimental effects or no effects at all. Yet, no review article has scrutinized this body of literature using the magnitude of associations and statistical significance reported from this relationship. We critically reviewed the previous and emerging body of literature that investigated the association of endogenous testosterone and use of TTh with CVD events (only fatal and nonfatal). These studies were divided into three groups, "beneficial (friendly use)", "detrimental (foe)" and "no effects at all (bystander)", based on their magnitude of associations and statistical significance from original research studies and meta-analyses of epidemiological studies and of randomized controlled trials (RCT's). In this review article, the studies reporting a significant association of high levels of testosterone with a reduced risk of CVD events in original prospective studies and meta-analyses of cross-sectional and prospective studies seems to be more consistent. However, the number of meta-analyses of RCT's does not provide a clear picture after we divided it into the beneficial, detrimental or no effects all groups using their magnitudes of association and statistical significance. From this review, we suggest that we need a study or number of studies that have the adequate power, epidemiological, and clinical data to provide a definitive conclusion on whether the effect of TTh on the natural history of CVD is real or not.

Original languageEnglish (US)
Pages (from-to)898-908
Number of pages11
JournalTranslational Andrology and Urology
Volume5
Issue number6
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Fingerprint

Testosterone
Cardiovascular Diseases
Meta-Analysis
Therapeutics
Randomized Controlled Trials
Prospective Studies
Epidemiologic Studies
Cross-Sectional Studies
Research

Keywords

  • Associations
  • Cardiovascular
  • Endogenous
  • Testosterone
  • Treatment

ASJC Scopus subject areas

  • Reproductive Medicine
  • Urology

Cite this

Testosterone replacement therapy and the heart : Friend, foe or bystander? / Lopez, David; Canfield, Steven; Wang, Run.

In: Translational Andrology and Urology, Vol. 5, No. 6, 01.01.2016, p. 898-908.

Research output: Contribution to journalReview article

@article{f8b6f296266246feaa363c8378683b86,
title = "Testosterone replacement therapy and the heart: Friend, foe or bystander?",
abstract = "The role of testosterone therapy (TTh) in cardiovascular disease (CVD) outcomes is still controversial, and it seems will remain inconclusive for the moment. An extensive body of literature has investigated the association of endogenous testosterone and use of TTh with CVD events including several meta-analyses. In some instances, a number of studies reported beneficial effects of TTh on CVD events and in other instances the body of literature reported detrimental effects or no effects at all. Yet, no review article has scrutinized this body of literature using the magnitude of associations and statistical significance reported from this relationship. We critically reviewed the previous and emerging body of literature that investigated the association of endogenous testosterone and use of TTh with CVD events (only fatal and nonfatal). These studies were divided into three groups, {"}beneficial (friendly use){"}, {"}detrimental (foe){"} and {"}no effects at all (bystander){"}, based on their magnitude of associations and statistical significance from original research studies and meta-analyses of epidemiological studies and of randomized controlled trials (RCT's). In this review article, the studies reporting a significant association of high levels of testosterone with a reduced risk of CVD events in original prospective studies and meta-analyses of cross-sectional and prospective studies seems to be more consistent. However, the number of meta-analyses of RCT's does not provide a clear picture after we divided it into the beneficial, detrimental or no effects all groups using their magnitudes of association and statistical significance. From this review, we suggest that we need a study or number of studies that have the adequate power, epidemiological, and clinical data to provide a definitive conclusion on whether the effect of TTh on the natural history of CVD is real or not.",
keywords = "Associations, Cardiovascular, Endogenous, Testosterone, Treatment",
author = "David Lopez and Steven Canfield and Run Wang",
year = "2016",
month = "1",
day = "1",
doi = "10.21037/tau.2016.10.02",
language = "English (US)",
volume = "5",
pages = "898--908",
journal = "Translational Andrology and Urology",
issn = "2223-4683",
publisher = "AME Publishing Company",
number = "6",

}

TY - JOUR

T1 - Testosterone replacement therapy and the heart

T2 - Friend, foe or bystander?

AU - Lopez, David

AU - Canfield, Steven

AU - Wang, Run

PY - 2016/1/1

Y1 - 2016/1/1

N2 - The role of testosterone therapy (TTh) in cardiovascular disease (CVD) outcomes is still controversial, and it seems will remain inconclusive for the moment. An extensive body of literature has investigated the association of endogenous testosterone and use of TTh with CVD events including several meta-analyses. In some instances, a number of studies reported beneficial effects of TTh on CVD events and in other instances the body of literature reported detrimental effects or no effects at all. Yet, no review article has scrutinized this body of literature using the magnitude of associations and statistical significance reported from this relationship. We critically reviewed the previous and emerging body of literature that investigated the association of endogenous testosterone and use of TTh with CVD events (only fatal and nonfatal). These studies were divided into three groups, "beneficial (friendly use)", "detrimental (foe)" and "no effects at all (bystander)", based on their magnitude of associations and statistical significance from original research studies and meta-analyses of epidemiological studies and of randomized controlled trials (RCT's). In this review article, the studies reporting a significant association of high levels of testosterone with a reduced risk of CVD events in original prospective studies and meta-analyses of cross-sectional and prospective studies seems to be more consistent. However, the number of meta-analyses of RCT's does not provide a clear picture after we divided it into the beneficial, detrimental or no effects all groups using their magnitudes of association and statistical significance. From this review, we suggest that we need a study or number of studies that have the adequate power, epidemiological, and clinical data to provide a definitive conclusion on whether the effect of TTh on the natural history of CVD is real or not.

AB - The role of testosterone therapy (TTh) in cardiovascular disease (CVD) outcomes is still controversial, and it seems will remain inconclusive for the moment. An extensive body of literature has investigated the association of endogenous testosterone and use of TTh with CVD events including several meta-analyses. In some instances, a number of studies reported beneficial effects of TTh on CVD events and in other instances the body of literature reported detrimental effects or no effects at all. Yet, no review article has scrutinized this body of literature using the magnitude of associations and statistical significance reported from this relationship. We critically reviewed the previous and emerging body of literature that investigated the association of endogenous testosterone and use of TTh with CVD events (only fatal and nonfatal). These studies were divided into three groups, "beneficial (friendly use)", "detrimental (foe)" and "no effects at all (bystander)", based on their magnitude of associations and statistical significance from original research studies and meta-analyses of epidemiological studies and of randomized controlled trials (RCT's). In this review article, the studies reporting a significant association of high levels of testosterone with a reduced risk of CVD events in original prospective studies and meta-analyses of cross-sectional and prospective studies seems to be more consistent. However, the number of meta-analyses of RCT's does not provide a clear picture after we divided it into the beneficial, detrimental or no effects all groups using their magnitudes of association and statistical significance. From this review, we suggest that we need a study or number of studies that have the adequate power, epidemiological, and clinical data to provide a definitive conclusion on whether the effect of TTh on the natural history of CVD is real or not.

KW - Associations

KW - Cardiovascular

KW - Endogenous

KW - Testosterone

KW - Treatment

UR - http://www.scopus.com/inward/record.url?scp=85006237472&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85006237472&partnerID=8YFLogxK

U2 - 10.21037/tau.2016.10.02

DO - 10.21037/tau.2016.10.02

M3 - Review article

VL - 5

SP - 898

EP - 908

JO - Translational Andrology and Urology

JF - Translational Andrology and Urology

SN - 2223-4683

IS - 6

ER -