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 Male’s Testosterone Level Linked To Cardiovascular Disease Death?

Testosterone is the primary 'male' hormone that helps maintain bone mass, fat distribution, muscle mass and strength, sperm production, sex drive and potency. Women do have testosterone but at lower levels.

There were suggestions from health professionals that men's overall health has somehow connected with their natural testosterone levels, but their relationship has yet been fully understood.

A study by the University of Cambridge School of Clinical Medicine in Britain found that higher naturally occurring levels of the male hormone testosterone apparently would protect men from fatal heart attacks or strokes and death from all causes.

The findings, which appeared on November 26, 2007 in the journal Circulation, showed strong benefits in men with higher natural levels of the hormone. However, the researchers cautioned men not to simply begin taking testosterone supplements just based on the results of this 10-year study because the benefits and risks are still unclear.

11,606 British men ages between 40 and 79, who had no known cancer or cardiovascular disease at the start of the study, were tracked. These participants joined the study from 1993 to 1997 and they were followed until 2003.

During the study period, 825 men died. Their testosterone levels were measured using frozen blood samples provided earlier, and were compared to a group of men still alive at the end of the study period.

The results of the study indicated that men in the upper 25 percent of natural testosterone levels had a 41 percent lower risk of dying from heart attack, stroke and other cardiovascular conditions, cancer and all other causes, comparing with those having the lowest levels.

The relationship between testosterone levels and cardiovascular disease mortality was found to be comparable in magnitude to risk factors such as high blood pressure and cholesterol levels. Thus, this would imply that men who might not have other known risk factors but have low testosterone levels could be at elevated risk for cardiovascular death.

Although the findings did indicate men with low levels of testosterone might cut their risk of death if they take testosterone supplementation, the researchers would not recommend doing this without further research supporting these results.

This is because the study looked only at naturally occurring levels of the hormone but not supplementation. Moreover, research had shown that high testosterone might be a risk factor for prostate cancer.

How Is Erectile Dysfunction Related to Heart Disease?

Erectile dysfunction (ED) or impotence is a common condition worldwide. It is estimated that some 30 million men in the United States are affected by ED. Though it can occur at any age, it is more common among the older men and less seen among the young ones. In general, most men have experienced ED at least some of the time by the age of 45.

ED is often regarded by doctors as a lifestyle issue, but a recent study had rated it as an important problem that provides an early warning of a heart attack. In fact, there is evidence that such condition doubles the risk of heart disease.

British researchers from the Good Hope Hospital in Birmingham warned on October 22, 2008 in the British Medical Journal that men with ED are at a 50 percent higher risk of having heart problems, a level that is comparable to moderate smoking. Smoking has long been regarded as a risk factor of developing heart disease.

Despite the evidence, doctors normally do not screen for ED or low testosterone in patients with Type-2 diabetes or coronary heart disease. Patients with coronary heart disease are usually prescribed by their physicians with drugs that actually make ED worse. Of course, some effective drug treatments do exist, and the patients usually prefer to pay privately because ED has been treated as a recreational or 'lifestyle' issue.

Drugs for ED, such as Pfizer's Viagra or sildenafil, Eli Lilly's Cialis or tadalafil, and Bayer AG's Levitra or vardenafil, work by increasing blood flow to the genitals.

As pointed out by the researchers, the condition is the manifestation of vascular disease in smaller arteries and gives a 2 to 3 year early warning of a heart attack. Therefore, cardiologists should not feel uncomfortable discussing such issue with their patients; otherwise, their act might be regarded as clinically negligent.