Testosterone replacement therapy does not increase cardiovascular risk in erectile dysfunction, suggests study

A new study published in the journal of Research and Reports in Urology showed that the risk of significant adverse cardiovascular events is not increased by testosterone replacement treatment in individuals with erectile dysfunction who are deficient in testosterone.

In 2002, 3 million Thai males between the ages of 40 and 70 had this illness, or around 37.5% of the population. ED is caused by a multitude of reasons. Hypogonadism, or testosterone shortage, is a frequent concurrent endocrine disorder that affects 33% of people with ED. Many variables contribute to the development of both ED and testosterone insufficiency, and these risk factors are also present in cardiovascular disease. There are several ways to provide testosterone replacement therapy (TRT), including oral, buccal, transdermal, subcutaneous, and intramuscular formulations. Numerous investigations have been carried out to assess this possible risk, but the outcomes have been mixed. In this study, Poopuangpairoj and colleagues assessed the major cardiovascular complications and compared them to patients with ED who had normal testosterone levels and who got TRT for the treatment of concurrent hypogonadism.

Thi study gathered the retrospective data of patients with ED at Ramathibodi Hospital between January 2012 and October 2021. The patients were split into two groups where one group were on testosterone replacement therapy (TRT group) and the other group had normal testosterone levels and so did not require TRT (non-TRT group). Clinicodemographic baseline information for the patients was gathered. Within two years of therapy, all groups' major adverse cardiovascular events, which included hospitalization for congestive heart failure, cardiovascular mortality, myocardial infarction (both ST- and non-ST-elevation), transient ischemic attack, and ischemic stroke, were gathered and examined.

The key findings of this study were:

• 111 patients from the 221 total were in the TRT group, while 110 patients were in the non-TRT group.
• There was one instance of myocardial infarction, one transient ischemic attack, and one stroke in the non-TRT group.
• During the 2-year follow-up period, no significant cardiovascular events happened in the TRT group.
• But there was no discernible difference between the two groups' major cardiovascular events.

Overall, TRT did not raise adverse cardiovascular events in ED patients with testosterone insufficiency as compared to the ones with normal testosterone levels.

Source:

Poopuangpairoj, T., Sirisopana, K., Ketsuwan, C., Kongchareonsombat, W., Phengsalae, Y., Matang, W., & Sangkum, P. (2024). Impact of testosterone therapy on major cardiovascular risk in erectile dysfunction patients with testosterone deficiency. Research and Reports in Urology, 16, 195–203. https://doi.org/10.2147/RRU.S476804