Low Testosterone Affects Many Men With Coronary Disease


By Stephen Pincock

GLASGOW (Reuters Health) Mar 25 - Around 50% of men with coronary heart disease have low levels of testosterone that could have contributed to the development of the disease, British researchers reported on Tuesday.

At the British Endocrine Societies' 22nd joint meeting, Professor T. Hugh Jones from the University of Sheffield Medical School reported data from a study of 831 men with significant coronary disease, defined as either 70% coronary artery stenosis or 50% stenosis of the main stem artery. Men with active inflammation were excluded because this is known to lower testosterone levels.

Total testosterone and bioavailable testosterone levels were measured prior to elective coronary angiograms, Professor Jones told Reuters Health.

Previous research has linked low testosterone levels to dyslipidemia, hypertension, insulin resistance, obesity and a prothrombotic state, but the scale of the problem has not been established.

"We took this on because nobody had done anything about it for years. And what we've shown is that men with coronary heart disease have got lower testosterone levels than men with clean coronary arteries," Professor Jones said.

The study showed that 23.4% of these men had either total testosterone or bioactive testosterone levels in the hypogonadal range--less than 7.5 nmol/L. There was also a group whose total levels were in the bottom of the normal range, between 7.5 and 12 nmol/L, suggesting the amount of the hormone circulating in their blood had dropped from higher levels.

"If you include those in the analysis, 52.9% are testosterone deficient," Professor Jones said. "This is really quite a large number of potential people who may need testosterone replacement."

About 17% or 18% of the general population of men would be expected to have low testosterone levels, the researcher said.

Obese men and men with hypertension were more likely to have low testosterone levels, and as expected the prevalence of the condition was higher in older men.

"A lot of these men should be on testosterone replacement if they want it," Professor Jones said, adding that his group and others have shown that this treatment can improve heart disease symptoms. "Obviously they would need to be evaluated individually."

He noted that hormone replacement therapy for men is "isn't very widespread at the moment," although that seems to be changing. Testosterone can be delivered via weekly muscle injections, pellets injected into the abdomen or patches.

A testosterone gel that is available in the US is soon to be launched in the UK.