Promising new research suggests patients with low testosterone levels who have gone one testosterone replacement therapy (TRT) could have a lower risk of cardiovascular events including heart attack and stroke.
A team of researchers looked at incidents of "heart attack, stroke, and all-cause mortality" in both treated and untreated patients, Oxford University Press reported. The major study is the largest cohort of patients and the longest follow-up for testosterone replacement therapy ever conducted.
The study included 83,010 male veterans who did not have a history of myocardial infarction (MI) or stroke and were given TRT between December 1999 and May 2014. The researchers found only 63 percent of the patients achieved normal testosterone levels following the treatment, and those who did reach normal levels were less likely to suffer serious cardiovascular events.
"With such widespread and ever increasing use of TRT, there has been growing concern regarding its effect on mortality, as well as conflicting results. Our aim was to address the knowledge gap," said Rajat S. Barua, the corresponding author of the paper and a cardiologist. "In this study of men, without previous history MI or stroke, with low testosterone levels, normalization of testosterone levels using TRT is associated with lower mortality, fewer MIs, and strokes. This is the first study to demonstrate that significant benefit is observed only if the dose is adequate to normalize the testosterone levels,"
In the future, the researchers hope to conduct randomized controlled trials to better back up these findings.
"Until then, there is a need for guideline-directed TRT with continuous active surveillance to maximize the benefits of TRT and to mitigate potential risks," Barua concluded.
The findings were published in a recent edition of the European Heart Journal.
