Testosterone deficiency can have a wide-ranging impact on your health — from sexual function, muscle mass, and bone density to energy levels and sleep quality. But what about testosterone and heart disease?
Whether there is a link or whether testosterone is safe for heart patients is something most people don’t even consider in light of testosterone’s dominating association with erectile function and sexual performance. Heart patients include people with a history of cardiac events, cardiovascular disease, or any other form of congenital or acquired heart-related issues.
Since heart health doesn’t have an obvious relationship with testosterone, it’s frequently dismissed but testosterone levels can potentially impact your heart too.
Heart disease is a broad term encompassing issues with the heart or blood vessels and can lead to heart attack or stroke. But while the correlation between heart disease and low testosterone may not be straightforward, they’re nonetheless linked.
What Constitutes Heart Health?
Heart health is a general term and comprises various aspects of your cardiovascular health. It incorporates the health of blood vessels in your body, the heart itself, and even includes the valves responsible for opening and closing the different chambers of your heart (aortic, mitral, pulmonary, and tricuspid valve). Poor heart health can increase your risk of heart attack and stroke.
There are various forms of heart disease:
- Congestive heart failure
- Coronary artery disease
- Arrhythmias
- Angina
- Congenital heart disease
- Vascular disease
The Centers for Disease Control and Prevention (CDC) list elevated blood pressure and cholesterol levels, alongside tobacco use as predominant contributors to heart disease.
But there are other risk factors, all of which also contribute to testosterone deficiency at the same time.
- Poor diet
- Type 2 diabetes
- Obesity
- Lack of exercise
- Excessive use of alcohol
While the relationship between heart disease and testosterone is complicated, low testosterone shares a significant amount of the same risk factors, which can exacerbate both conditions.
Raising Awareness During American Heart Month
Because heart disease is extremely prevalent, being aware of a potential relationship with low testosterone, other risk factors, or environmental contributors is exceedingly important.
Heart disease is the number one leading cause of death in the United States for both genders and people of most racial and ethnic backgrounds. It’s so prevalent that in the U.S. alone, one person dies every 33 seconds due to cardiovascular disease.
Because of the significance and wide reach of heart disease, President Johnson announced in 1964 that Americans should focus on the nationwide problem of heart disease, encouraging research measures and adopting healthy lifestyles.
February was thus named American Heart Month and has served its purpose for the past 60 years now. It continues to raise awareness about poor eating habits and escalating rates of obesity.
What Does Testosterone Do for Heart Health?
There is a reason why researchers felt intrigued by a potential link between testosterone and heart disease. Cardiovascular disease is more prevalent in men — so naturally scientists began to wonder if your levels of testosterone could play a part in the development of heart disease.
While there are many theories, this remains a complicated question. However, much research indicates that biological factors alone wouldn’t be sufficient to account for the increased prevalence in men.
Theories like increased stress levels, social isolation, and higher consumption of alcohol and tobacco products in men could potentially explain the discrepancy. Many men are also less adaptive physiologically and display inadequate stress-coping mechanisms.
Testosterone levels generally begin their natural decline after age 40, which coincides with an increase in cardiovascular risks related to the natural aging process. In many cases, low testosterone levels may exacerbate your risk of developing cardiovascular disease, alongside other conditions such as type 2 diabetes.
Testosterone deficiency in patients with congestive heart failure constitutes a poor prognosis and a higher risk of death. It has also been associated with diabetes, high cholesterol, and high blood pressure — all of which can exacerbate cardiovascular health as well.
Several meta-analyses and review articles established a clear link between low testosterone and heart disease. One meta-analysis determined that higher testosterone levels lowered the risk of cardiovascular events in men over the age of 70.
Another meta-analysis found that there is a strong correlation between testosterone levels and cardiovascular mortality and confirmed that low testosterone levels adversely impacted cardiovascular health.
Is Testosterone Safe for Heart Patients?
While the role of natural testosterone in heart health has been studied extensively, many patients still wonder if testosterone is safe for heart patients. Testosterone replacement therapy presents a form of synthesized testosterone that can help counteract below-normal testosterone levels in patients with testosterone deficiency.
A study assessing 5,000+ men between the ages of 45 and 80 aimed to determine just that, the safety of testosterone in heart patients — enrolling men with active cardiovascular disease or contributing factors, such as diabetes and hypertension.
This placebo-controlled long-term trial used a topical TRT gel and collected data for three years. It found that there was no difference in rates of heart attacks, stroke, or cardiovascular death when comparing the placebo and TRT groups.
In addition, due to insufficient amounts of testosterone, men with testosterone deficiency have less muscle mass and more body fat, which led researchers to investigate body mass index (BMI) in individuals with low T.
They found that the BMI was higher for men with low testosterone, which was aligned with the higher odds of developing testosterone deficiency for men with obesity. TRT can actually lower the amount of fat, which can ultimately lower the risk for obesity and hence cardiovascular events.
Nonetheless, more double-blinded, controlled, and randomized studies are needed to verify the extent of the correlation between low testosterone and heart disease.
Always Consult with Your Doctor about TRT Use
Your doctor will be able to offer guidance on your (heart) disease state and whether you should or should not be taking testosterone. While generally considered safe, TRT should only be taken under the supervision of a qualified physician.
Overall, TRT has been found highly effective, improving a wide range of symptoms and health risks in patients with testosterone deficiency.
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