Testosterone therapy, is age or type of therapy associated with an increased rate of heart disease?

What is it about?

There are recent concerns are that testosterone supplementation given to people over 65 years of age may increase the rate of heart disease and death . We performed a review of existing trials of testosterone therapy. There were 45 trials with 5328 subjects evaluated, with an average age of 63 years, followed for an average study duration of 10 months. Overall, testosterone supplementation was not associated with increased risk of heart disease. However, there was an increased risk of heart problems during the initial 12 months of therapy especially in men over 65 years. Some of these findings were associated with a fall in the good HDL cholesterol. Of the testosterone preparations available the intramuscular testosterone had the least effect on the HDL cholesterol, and appeared and had he least effect on heart disease compared with oral testosterone and transdermal testosterone.

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Why is it important?

Testosterone supplementation may be associated with an increased rate of heart disease in men over 65 years especially during the first year. Biological actions may differ depending upon mode of testosterone administration with intramuscular testosterone having less cardiovascular risk.