Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Clin Endocrinol Metab. 2009 Jul;94(7):2353-9. doi: 10.1210/jc.2008-2416. Epub 2009 Apr 7.

Lower testosterone levels predict incident stroke and transient ischemic attack in older men.

Author information

  • 1School of Medicine and Pharmacology, University of Western Australia, Crawley, WA 6009, Australia. byeap@cyllene.uwa.edu.au

Abstract

CONTEXT:

Lower circulating testosterone concentrations are associated with metabolic syndrome, type 2 diabetes, carotid intima-media thickness, and aortic and lower limb arterial disease in men. However, it is unclear whether lower testosterone levels predict major cardiovascular events.

OBJECTIVE:

We examined whether lower serum testosterone was an independently significant risk factor for symptomatic cerebrovascular events in older men.

DESIGN:

This was a prospective observational study with median follow-up of 3.5 yr.

SETTING:

Community-dwelling, stroke-free older men were studied.

PARTICIPANTS:

A total of 3443 men at least 70 yr of age participated in the study.

MAIN OUTCOME MEASURES:

Baseline serum total testosterone, SHBG, and LH were assayed. Free testosterone was calculated using mass action equations. Incident stroke or transient ischemic attack (TIA) was recorded.

RESULTS:

A first stroke or TIA occurred in 119 men (3.5%). Total and free testosterone concentrations in the lowest quartiles (<11.7 nmol/liter and <222 pmol/liter) were associated with reduced event-free survival (P = 0.014 and P = 0.01, respectively). After adjustment including age, waist-hip ratio, waist circumference, smoking, hypertension, dyslipidemia, and medical comorbidity, lower total testosterone predicted increased incidence of stroke or TIA (hazard ratio = 1.99; 95% confidence interval, 1.33-2.99). Lower free testosterone was also associated (hazard ratio = 1.69; 95% confidence interval, 1.15-2.48), whereas SHBG and LH were not independently associated with incident stroke or TIA.

CONCLUSIONS:

In older men, lower total testosterone levels predict increased incidence of stroke or TIA after adjusting for conventional risk factors for cardiovascular disease. Men with low-normal testosterone levels had increased risk. Further studies are warranted to determine whether interventions that raise circulating testosterone levels might prevent cerebrovascular disease in men.

Comment in

PMID:
19351733
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Atypon
    Loading ...
    Write to the Help Desk