How Can Testosterone Therapy Help Heart Failure Patients?

When a male grows older, his testosterone level gradually declines. The aim of using testosterone therapy is to increase the muscle mass, sharpen memory and concentration, boost libido and improve energy level.

But testosterone supplements might also be able to improve the quality of life for heart failure patients, according to a group of Canadian and American researchers. Heart failure is a condition in which the heart is incapable of pumping enough blood to the rest of the body. Their findings were published on April 17, 2012 in the journal ‘Circulation Heart Failure’.

Researchers from University of British Columbia, University of Alberta and Mazankowski Alberta Heart Institute, Massachusetts General Hospital in Boston, and Brigham and Women's Hospital in Boston analyzed data from 4 previous studies in which patients were randomly assigned to receive either testosterone therapy or a placebo for a period of 12 to 52 weeks. Testosterone patches and injections were used to improve the breathing and exercise abilities of participants.

Among a total of 198 participants whose average age was 67, 84 percent were men. These participants were taking standard medical treatments for heart failure. Some of these participants had symptoms even after receiving standard therapies, and physically they could not walk, as far as or as much as, they could when they were healthy.

During a 6-minute walking test, participants who took testosterone therapy walked an average of 177 feet (54 meters) more than those who took placebo. For participants taking testosterone therapy, there was also an increase in VO2 max, which is the amount of oxygen used per minute of exercise. VO2 max is a general indicator of a person’s fitness level. Meanwhile, there were no adverse effects found on the heart.

According to researchers, testosterone did not affect the heart itself. Instead, it might target the peripheral tissues such as the skeletal muscles. The hormone has been shown to widen blood vessels, allowing more blood to reach peripheral tissues. It might also raise the levels of hemoglobin, which is a protein in red blood cells that transport oxygen.

While the majority of the participants were males, the results could also apply to women through much smaller doses of testosterone.

It seems that testosterone is a promising therapy, but it is not advisable to use testosterone therapies right away just based on their results. Researchers revealed that there was a small increase in levels of prostate-specific antigen (PSA) among men who took testosterone therapy in the study. High PSA levels indicate that there is a risk of prostate cancer. Previous studies did find a link between high doses of testosterone and increase cases of prostate cancer.

Hence, larger studies are required to confirm the findings and find out the best method of delivery and the appropriate doses, but more importantly, the long-term effects of testosterone therapy, especially their effect on prostate cancer.

Is Hormone Drugs Dangerous To Heart Disease Patients?

Being second most common cancer in men worldwide after lung cancer, prostate cancer kills 254,000 a year globally.

Hormone-based drugs, which block tumor-fueling surges of testosterone, were supposed to help most men with aggressive prostate cancer. Such therapy, however, does have some side effects.

As soon as treatment begins, some patients might experience impotence, hot flushes and sweating, breast tenderness, tumor flare pain. For those patients who are on long-term treatment, other side effects including weight gain, memory problems, mood swings and depression, bone thinning (osteoporosis) and even risk of earlier heart attack, might occur.

A paper that was published on August 25, 2009 in the Journal of the American Medical Association revealed that such hormone-based drugs might be dangerous for some men with heart disease.

After studying cases of more than 5,000 men diagnosed with prostate cancer between 1997 and 2006, researchers from Brigham & Women's Hospital and the Dana-Farber Cancer Institute in Boston reported that those with more than one form of heart disease or diabetes were most likely to die when they got the drugs along with radiation therapy.

The men in the study received both radiation treatment (either external beam radiation or litter radioactive pellets known as brachytherapy) and one of several hormone-based drugs to suppress testosterone production.

It was found that more than 400 died over a follow-up period of 5 years. Men who had heart failure or heart attack were more than twice as likely to die as those without heart disease or who had just one symptom, such as high blood cholesterol. The finding actually showed that 26 percent of the men with heart failure or who had heart attack died, comparing to 11 percent of others.

The number of dead was just 5 percent of the total number of men in the study. As such, the researchers explained why overall, the hormone therapy still helps many other cancer patients. But they also advised doctors to pay attention to their patients with serious heart disease and should be aware of the possible risk that these patients would have.

In fact, some doctors are starting to give less aggressive treatment for some patients as many prostate tumors are slow-growing and take years to cause harm.