High testosterone levels associated with Heart Attack, Heart Failure and VTE

High testosterone levels associated with Heart Attack, Heart Failure, and venous thromboembolism.

The researchers found that in men, endogenous testosterone was associated with a higher risk of blood clots and heart failure and heart attack. Having a genetic predisposition to high testosterone levels could play a role in the development of these problems in men, finds a study published by The BMJ today. The associations were less obvious in women. Therefore treatments that lower testosterone levels could help protect against these conditions.

The findings may also have implications for men who take testosterone supplements to boost energy levels and sex drive.

An international research team, led by Professor Mary Schooling at the City University of New York's Graduate School of Public Health conducted a study to assess the effect of endogenous testosterone on major blood clots, heart failure, and heart attacks

Some evidence suggests that genetically predicted (“endogenous”) testosterone is positively associated with heart disease and stroke, especially in men. It is not clear whether testosterone has a causal role in the development of heart disease, but this is an important question for public health and regulators.

They analyzed genetic variants that predict testosterone levels and their associations with thromboembolism) heart failure and heart attack (myocardial infarction) in almost 400,000 men and women from a large genome study and the UK Biobank database, using a technique called Mendelian randomization.

Participants were aged 40 to 75 years and most were of British or European ancestry. Heart conditions were identified from self-reports, hospital and death records, and results were validated using data from another large genome study.

Analysing genetic information in this way avoids some of the problems that afflict traditional observational studies, making the results less prone to unmeasured (confounding) factors, and therefore more likely to be reliable.

An association that is observed using Mendelian randomization, therefore, strengthens the inference of a causal relationship.

The researchers point to some study limitations. For example, UK Biobank participants tend to be more highly educated and have healthier lifestyles compared with the general population, which may have affected the results.

Nevertheless, they say these findings extend and complement previous findings, and suggest that endogenous testosterone “is detrimental for thromboembolism, heart failure, and myocardial infarction, especially in men.”

They say further evidence is needed to clarify whether these findings are relevant to the higher rates of these diseases in men than in women, and suggest it might be worth considering whether existing treatments that lower testosterone could help protect against these conditions.

Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction.