Nelson Vergel
Founder, ExcelMale.com
Yeap BB, Alfonso H, Paul Chubb SA, et al. In older men, higher plasma testosterone or dihydrotestosterone are independent predictors for reduced incidence of stroke but not myocardial infarction. The Journal of Clinical Endocrinology & Metabolism.
Context: Older men have lower testosterone (T) levels but whether differences in circulating T, or its metabolites dihydrotestosterone (DHT) or estradiol (E2) contribute to cardiovascular disease remains controversial.
Objective: We tested the hypothesis that plasma T, DHT and E2 are differentially associated with incidence of myocardial infarction (MI) and stroke in older men.
Participants and Methods: Plasma total T, DHT and E2 were assayed using liquid chromatography-mass spectrometry in early morning samples from 3,690 community-dwelling men aged 70–89 years. Outcomes of first hospital admission or death due to MI or stroke were ascertained by data linkage.
Results: Mean follow-up was 6.6 years. Incident MI occurred in 344, stroke in 300 and neither in 3,046 men. In multivariate analysis adjusting for age and other risk factors, neither T, DHT nor E2 were associated with incident MI (fully-adjusted hazard ratio
for T in Quartile (Q)4 vs Q1: 0.92, 95% confidence interval [CI]=0.66–1.28; DHT: 0.83, 0.59–1.15; E2: 0.84, 0.62–1.15).
Higher T or DHT was associated with lower incidence of stroke (T: Q4:Q1 fully-adjusted HR=0.56, 95% CI=0.39–0.81, p=0.002; DHT: 0.57, 0.40–0.81, p=0.002). E2 was not associated with stroke (HR=0.76, 95% CI=0.54–1.08, p=0.123).
Conclusions: Higher plasma T or DHT are biomarkers for reduced risk of stroke but not MI. Androgen exposure may influence outcomes following rather than incidence of MI, while androgens but not E2 are independent predictors of stroke risk. Randomised clinical trials are needed to clarify the impact of modifying T or DHT on the risk of stroke in ageing men.
Context: Older men have lower testosterone (T) levels but whether differences in circulating T, or its metabolites dihydrotestosterone (DHT) or estradiol (E2) contribute to cardiovascular disease remains controversial.
Objective: We tested the hypothesis that plasma T, DHT and E2 are differentially associated with incidence of myocardial infarction (MI) and stroke in older men.
Participants and Methods: Plasma total T, DHT and E2 were assayed using liquid chromatography-mass spectrometry in early morning samples from 3,690 community-dwelling men aged 70–89 years. Outcomes of first hospital admission or death due to MI or stroke were ascertained by data linkage.
Results: Mean follow-up was 6.6 years. Incident MI occurred in 344, stroke in 300 and neither in 3,046 men. In multivariate analysis adjusting for age and other risk factors, neither T, DHT nor E2 were associated with incident MI (fully-adjusted hazard ratio
for T in Quartile (Q)4 vs Q1: 0.92, 95% confidence interval [CI]=0.66–1.28; DHT: 0.83, 0.59–1.15; E2: 0.84, 0.62–1.15).
Higher T or DHT was associated with lower incidence of stroke (T: Q4:Q1 fully-adjusted HR=0.56, 95% CI=0.39–0.81, p=0.002; DHT: 0.57, 0.40–0.81, p=0.002). E2 was not associated with stroke (HR=0.76, 95% CI=0.54–1.08, p=0.123).
Conclusions: Higher plasma T or DHT are biomarkers for reduced risk of stroke but not MI. Androgen exposure may influence outcomes following rather than incidence of MI, while androgens but not E2 are independent predictors of stroke risk. Randomised clinical trials are needed to clarify the impact of modifying T or DHT on the risk of stroke in ageing men.
