Title:Testosterone and Peripheral Arterial Disease
Volume: 21
Issue: 5
Author(s): Aleš Blinc*, Gerit Holger Schernthaner, Pavel Poredoš, Panagiotis Anagnostis, Mojca Jensterle, Katica Bajuk Studen, Pier Luigi Antignani, Dimitri P. Mikhailidis and Mišo Šabović
Affiliation:
- Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Keywords:
Testosterone, cardiovascular disease, peripheral arterial disease, vascular function, male hypogonadism, androgendeprivation, performance-enhancing drug, trans-men.
Abstract: Testosterone levels in men begin declining in the early years of adulthood, with a 1-2%
reduction/year. Low testosterone levels in men are associated with obesity, metabolic syndrome, diabetes
mellitus, dyslipidaemia, hypertension and increased cardiovascular mortality. However, observational
studies of testosterone levels in males and their relationship with peripheral arterial disease (PAD) have
yielded mixed results; only some cohorts show a clear association with low free testosterone levels. This
discrepancy may, in part, be due to methodological issues with estimating free testosterone but also to
different effects of testosterone on the vessel wall and metabolism. While testosterone improves
glycaemic control, has anti-obesity effects and induces vasodilation, it also stimulates platelet aggregation
and increases the haematocrit. Androgen deprivation treatment for advanced prostate cancer may be
associated with elevated cardiovascular risk, as is testosterone abuse for performance enhancement. On
the other hand, judicious treatment of male hypogonadism or testosterone treatment of trans-men
appears to be safe.
