Low levels of testosterone levels increase the risk of major cardiovascular events in a follow-up to 5 years

Abstract

Materials and Methods. We evaluated a series of 802 patients with intermediate cardiovascular risk according to the Framingham Risk Score (FRS). The endothelial function through flow-mediated vasodilatation (FMD), the erectile function (EF), and the total serum testosterone levels were assessed. Patients were followed for up to 5 years and the prevalence and predictors of MACEs were evaluated. Results. The levels of serum testosterone are related with both endothelial function (FMD) (t=9,4080, 95% CI= 0,9318 to 1,4234, p<0,0001) and erectile function (FMD) (t=8,9584, 95% CI= 0,7642 to 1,1932, p<0,0001). Analysis of variance (ANOVA) of serum testosterone levels are related with the MACEs (F-ratio 390,14; p<0.001), hypertension (p<0.0001), cigarette smoking (p=0.03), family history (p=0.02), dyslipidemia (p<0.0001), obesity (p<0.0001), low levels of testosterone (p<0.0001), FMD (p<0.0001), EF (P<0.0001), were related with MACEs. In multivariate analysis dyslipidemia (OR: 2.21, p=0.001), obesity (OR: 2.23, p=0.007), FMD (OR: 0.87, p<0.0001), EF (OR: 0.86, p<0.0001) and testosterone <3ng/dl (OR: 4.90, p<0.0001) are independent predictors of MACEs. Conclusions. The levels of free testosterone are related with both the FMD and erectile function. High erectile function score and low FMD predict MACEs at follow for up 5 years; also testosterone levels <3ng/dl are associated with an increased risk of adverse cariovascular events.