CARDIOVASCULAR SAFETY OF TESTOSTERONE

E. A. Jankowska

Cardiology Department, Military Hospital, 50-981 Wroclaw, ul. Weigla 5, Poland
Institute of Anthropology, Polish Academy of Sciences, 50-951 Wroclaw, ul. Kuznicza 35, Poland ewa@antro.pan.wroc.pl
National Heart & Lung Institute, Imperial College London, London, United Kingdom e.jankowska@imperial.ac.uk

Chronic heart failure (CHF) begins with an abnormality of the heart, but involves peripheral mechanisms and dysfunction of most body organs, including the cardiovascular, musculoskeletal, renal, neuroendocrine, haemostatic, and immune systems. A review of recent work carried out on multiple anabolic deficiency seen in men with CHF, suggests ways in which testosterone treatment might be of use in this condition. Testosterone deficiency (serum total testosterone <2.6 ng/mL) is present in approx. 20% of men with CHF aged 30-80. Serum levels of testosterone in men with CHF are independently determined by age and indices of disease severity (NYHA class). In these patients, testosterone deficiency is related to impaired exercise capacity, reduced skeletal muscle mass and strength, depressive symptoms and anaemia. Reduced serum testosterone levels, independently of other anabolic hormones and after adjustment for conventional risk factors and co-morbidities, predict increased 3-year cardiovascular mortality in men with CHF. Performed studies suggest that testosterone supplementation may be beneficial in men with CHF in the context of body composition, exercise capacity, depressive symptoms and overall quality of life. Research has also been done on androgen deficiency and exercise intolerance, and suggests that testosterone treatment, which raises haemoglobin levels, together with its haemostatic, autonomic and immunological effects, is both safe and beneficial in some cases of circulatory disease and chronic heart failure.