Testosterone therapy in hypogonadal patients and the associated risks of cardiovascular events - 28/08/20
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Graphical abstract |
Highlights |
• | Clinical trials have shown presence and absence of correlation between cardiovascular risks and testosterone therapy. |
• | Such contradictions have reduced certainty in predicting cardiovascular risks during testosterone replacement therapy. |
• | The cardiovascular risk of such therapy was found to be associated with age. |
• | The risk was even more severe in patients who had a previous history of myocardial infarction or stroke. |
Abstract |
Since the male secondary sex characters, libido and fertility are attributed to their major androgen hormone testosterone, the sub-optimum levels of testosterone in young adults may cause infertility and irregularities in their sexual behaviour. Such deficiency is often secondary to maladies involving testes, pituitary or hypothalamus that could be treated with an administration of exogenous testosterone. In the last few decades, the number of testosterone prescriptions has markedly increased to treat sub-optimal serum levels even though its administration in such conditions is not yet approved. On account of its associated cardiovascular hazards, the food and drug authority in the United States has issued safety alerts on testosterone replacement therapy (TRT). Owing to a great degree of conflict among their findings, the published clinical trials seem struggling in presenting a decisive opinion on the matter. Hence, the clinicians remain uncertain about the possible cardiovascular adversities while prescribing TRT in hypogonadal men. The uncertainty escalates even further while prescribing such therapy in older men with a previous history of cardiovascular ailments. In the current review, we analysed the pre-clinical and clinical studies to evaluate the physiological impact of testosterone on cardiovascular and related parameters. We have enlisted studies on the association of cardiovascular health and endogenous testosterone levels with a comprehensive analysis of epidemiological studies, clinical trials, and meta-analyses on the cardiovascular risk of TRT. The review is aimed to assist clinicians in making smart decisions regarding TRT in their patients.
El texto completo de este artículo está disponible en PDF.Keywords : Male secondary sex characters, Testosterone replacement therapy, Hypogonadal men, Cardiovascular ailments, Endogenous testosterone, Comorbidities
Esquema
Vol 129
Artículo 110423- septembre 2020 Regresar al númeroBienvenido a EM-consulte, la referencia de los profesionales de la salud.
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