A recent retrospective study reporting increased risk of cardiovascular events and death with testosterone therapy has received extensive media attention. However, the authors' conclusions are highly questionable given the extensive data manipulation and serious methodological errors. Indeed, a rich body of literature strongly suggests that testosterone therapy offers cardiovascular benefits.
This is a preview of subscription content, log in via an institution to check access.
References
Rhoden, E. L. & Morgentaler, A. Risks of testosterone-replacement therapy and recommendations for monitoring. N. Engl. J. Med. 350, 482–492 (2004).
Khera, M., Crawford, D., Morales, A., Salonia, A. & Morgentaler, A. A new era of testosterone and prostate cancer: from physiology to clinical implications. Eur. Urol. 65, 115–123 (2013).
Carson, C. C. & Rosano, G. Exogenous testosterone, cardiovascular events, and cardiovascular risk factors in elderly men: a review of trial data. J. Sex. Med. 9, 54–67 (2012).
Traish, A. M., Miner, M., Zitzmann, M. & Morgentaler, A. Testosterone deficiency. Am. J. Med. 124, 578–587 (2011).
Basaria, S. et al. Adverse events associated with testosterone administration. N. Engl. J. Med. 363, 109–122 (2010).
O'Connell, M. D. et al. Do the effects of testosterone on muscle strength, physical function, body composition, and quality of life persist six months after treatment in intermediate-frail and frail elderly men? J. Clin. Endocrinol. Metab. 96 454–458 (2011).
Vigen, R. et al. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA 310, 1829–1836 (2013).
Shores, M. M., Smith, N. L., Forsberg, C. W., Anawalt, B. D. & Matsumoto, A. M. Testosterone treatment and mortality in men with low testosterone levels. J. Clin. Endocrinol. Metab. 97, 2050–2058 (2012).
Muraleedharan, V., Marsh, H., Kapoor, D., Channer, K. S. & Jones, T. H. Testosterone deficiency is associated with increased risk of mortality and testosterone replacement improves survival in men with type 2 diabetes. Eur. J. Endocrinol. 169, 725–733 (2013).
Oskui, P. M. et al. Testosterone and the cardiovascular system: a comprehensive review of the clinical literature. J. Am. Heart Assoc. 2, e000272 (2013).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
A.M. has acted as a consultant for AbbVie, Auxilium, and Merck & Co, has received honoraria from Auxilium, Bayer AG, and Merck & Co, and has received research support from Antares Pharma, Auxilium, and Eli Lilly and Company. R.K. declares no competing interests.
Rights and permissions
About this article
Cite this article
Morgentaler, A., Kacker, R. Testosterone and cardiovascular risk—deciphering the statistics. Nat Rev Urol 11, 131–132 (2014). https://doi.org/10.1038/nrurol.2014.24
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrurol.2014.24
- Springer Nature Limited
This article is cited by
-
Vascular Pathways of Testosterone: Clinical Implications
Journal of Cardiovascular Translational Research (2020)
-
The practical management of testosterone deficiency in men
Nature Reviews Urology (2015)
-
Debate: Testosterone Therapy Reduces Cardiovascular Risk in Men with Diabetes. Against the Motion
Current Cardiovascular Risk Reports (2015)
-
The Implications of Low Testosterone on Mortality in Men
Current Sexual Health Reports (2014)