Testosterone Replacement Therapy Linked to Decrease in Cardiovascular Outcomes

Finally, the study we have all been waiting for is here.  A February 2017 article in the prestigious Journal of the American Medical Association shows that Testosterone Replacement Therapy is associated with a 33% DECREASE in all cardiovascular outcomes, such as heart attack or stroke, in men with low testosterone levels. The report studied 44,335 men.

Cardiovascular outcomes were defined as 1) acute heart attacks or a coronary revascularization procedure, 2) unstable angina, 3) strokes or transient ischemic attacks (TIA’s), and 4) sudden cardiac death over 3 years.

This study is so impressive and meaningful because it had such a large number of men in it, looked at actual outcomes (as opposed to risk markers), and showed such a remarkable difference in outcomes.

Of these men, 35,527 did not take testosterone.  They had an incidence of 23.9 cardiac events per 1000 person-years.  8808 men did take testosterone.  They had an incidence of 16.9 cardiac events per 1000 person-years.  This is a decrease of almost exactly one third!

For several years, the concern has been, that testosterone replacement therapy (TRT) might increase cardiovascular events.  No mechanism was ever found, and the data behind it was flimsy.  This study finally puts to bed this concern. 

This study mirrors our findings in over 500 patients at Maze Men’s Health.  For over 90% of our patients, the TRT is a game changer.  They have increased energy and libido.  They have more motivation to exercise, and find their workouts are better, their recovery is quicker, and they put on more muscle and take off more fat.  Their erections, moods, and focus are often better as well. 

All of these changes would of course contribute to decreased cardiovascular events.  In fact we often see decreases in blood sugars, cholesterol, and blood pressure.

Hopefully, this one seminal article will finally end the fears both physicians and patients have harbored about testosterone increasing cardiovascular events.  It certainly proves that men with symptomatic low testosterone should be treated with testosterone.  The discussion will now turn to whether men without symptoms of low testosterone, but at increased cardiac risk, should be placed on testosterone preventatively.  The discussion has dramatically shifted!

Read the full story from the NEJM group