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"Low T" therapy may increase risk for stroke and heart attack

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With the barrage of TV and magazine ads touting the benefits of testosterone therapy for “low T”, it’s no wonder that so many men in Florida and around the country, are pressuring their doctors to prescribe the hormone.

Today, testosterone treatment is prescribed for an estimated 3 percent of American men over age 40 years.
However, a study published in the November 5th issue of JAMA suggests that testosterone therapy raises the risk of heart attack and stroke.

Using data from the Veterans Administration’s Clinical Assessment Reporting and Tracking (CART) program, which collects information on all procedures performed in the 76 VA cardiac catheterization (cath) laboratories across the country, principal investigator Dr. Vigen and her colleagues reviewed the charts of 8709 men who underwent caths and also had low total testosterone levels.

As a group 20 percent had already had heart attacks, half had diabetes, and more than 80 percent had coronary artery disease.

A total of 1,223 of these men were given testosterone therapy to address their low testosterone levels.

Roughly 1 percent were given testosterone gel, 36 were were given injections, and 63 percent were given patches. Men who used testosterone tended to be younger and healthier than those who did not.

During an average of 28 months of follow-up, 748 men died, 443 had heart attacks, and 519 had strokes.

The risks of these adverse events was significantly higher for those men who were taking testosterone than for the group not taking testosterone. There was no difference in terms of adverse effects based on the formulation of the hormone.

According to the authors, these findings "raise concerns about the potential safety of testosterone therapy.”

While they acknowledge that randomized clinical trials are needed to clarify this issue, they suggest that physicians let their patients know that the long-term risks of taking testosterone are unknown at this time. Previous studies showing positive benefits only looked at short-term effects. Moreover, a 2010 clinical trial was stopped when men taking testosterone who also had a history of heart disease experienced more cardiovascular events that the placebo group.

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