4 risk factors for heart disease that are associated with low testosterone
- High cholesterol
- High blood pressure
- Current cigarette smoking
The good news:
These 4 risk factors can be optimized with lifestyle changes and/or medical therapy
Having these risk factors doesn’t exclude men from receiving testosterone therapy, but they should be optimized
Much controversy surrounds testosterone therapy and heart disease due to previous research, FDA warnings, and medication labels suggesting that testosterone therapy increased risk for major cardiovascular events. Unfortunately, those studies were not well designed. The American Urological Association guidelines published in 2018 review what is known and unknown about low testosterone, testosterone therapy, and cardiovascular disease.
More and more research has been published in recent years showing that low testosterone levels are actually associated with increased rates of major events like heart attack, stroke, and early death. Men with low testosterone levels should be assessed for heart disease risk factors including high cholesterol, high blood pressure, diabetes, and current cigarette use. Men with these risk factors are not excluded from being candidates for testosterone therapy, though cholesterol, blood pressure, and blood sugar should be optimized and tobacco stopped.
Currently available research has not shown us, as of yet, what the benefits/harms are for men on testosterone therapy when it comes to cardiovascular health. Men on testosterone therapy should report chest pain, shortness of breath, dizziness, or temporary loss of consciousness to their healthcare provider.