Low testosterone increases heart disease mortality in men

More evidence of the importance of testosterone in preventing heart disease for men is offered in a study just published in the journal Heart in which the authors set out to...

"...examine the effect of serum testosterone levels on survival in a consecutive series of men with confirmed coronary disease and calculate the prevalence of testosterone deficiency."

They followed 930 men with coronary disease for an average of seven years and correlating all-cause mortality and vascular mortality with testosterone deficiency. What did the data show?

"The overall prevalence of biochemical testosterone deficiency in the coronary disease cohort using bio-available testosterone (bio-T) was 20.9%, using total testosterone was 16.9% and using either was 24%. Excess mortality was noted in the androgen-deficient group compared with normal (41 (21%) vs 88 (12%). The only parameters found to influence time to all-cause and vascular mortality in multivariate analyses were the presence of left ventricular dysfunction, aspirin therapy, β-blocker therapy and low serum bio-T."

Notice that the bio-available testosterone (free fraction or unbound testosterone, the small percentage that is actually 'working') was more revealing than the total testosterone. This is most conveniently measured in a saliva specimen. Clinicians and patients should bear in mind the authors' conclusion:

"In patients with coronary disease testosterone deficiency is common and impacts significantly negatively on survival."

Important: testosterone replacement by gel, cream or patch (transdermal) can easily accumulate to abnormally high (supraphysiologic) levels which 'back-fires' by causing testosterone receptor desensitization and pituitary suppression. This may be missed if the correct testosterone test (the bio-active, free fraction portion) is not done.