Recently, many men have been concerned about advertisements from lawyers who claim testosterone therapy increases heart attacks and strokes. They quote studies suggesting support for these claims(1). However, the truth is probably far from their allegations and many other studies have found the opposite effect; i.e. testosterone seems to decrease heart attacks.

In a recent study on testosterone replacement in the July, 2014 issue of the Annals of Pharmacotherapy,(1) researcher not only failed to find an increased risk of heart attack with testosterone therapy, but they reported a protective benefit of testosterone use among men at high risk of heart attacks.

The study was performed at the University of Texas Medical Branch at Galveston. They evaluated data from Medicare beneficiaries aged 66 years or older who had received some sort of testosterone therapy over an eight year period. In the 6,355 men treated with testosterone, they found a statistically insignificant 16% lower risk of heart attack requiring hospitalization in comparison with 19,065 matched controls who had never received testosterone therapy.

Moreover, their data showed a 31% lower risk of a heart attack in those men whose risk of a heart attack was in the top 25%. Thus, not only did testosterone show there were no increased risks of heart attacks, but also a lower risk even if at high risk for one compared with untreated subjects.

The author, Jacques Baillargeon, PhD, discussed the possible reason for these benefits. “Some investigators have suggested that testosterone therapy may improve cardiovascular health by way of decreasing fat mass, insulin sensitivity, and lipid profile…Moreover, testosterone may possess anti-inflammatory and anticoagulant properties that may reduce carotid intima media thickness. It is possible that our findings of a protective effect among men in the highest myocardial infarction prognostic group reflect a process whereby testosterone reduces peripheral vascular resistance, thereby reducing stress on the heart among those who have some degree of coronary artery disease.”

These findings are very important and support prior studies. (3) However, the FDA seems to be ignoring the many good studies in favor of a few negative (and questionable) ones. The FDA has recently expanded its labeling of testosterone to include a warning concerning the risk of blood clots. Unfortunately, the FDA does not seem to want to incorporate good news into its guidelines, so it is up to physicians who are advocates of improved patient health to inform the public of these errors.

Dr. Baillargeon stated “Our investigation was motivated by a growing concern, in the U.S. and internationally, that testosterone therapy increases men’s risk for cardiovascular disease, specifically heart attack and stroke…This concern has increased in the last few years based on the results of a clinical trial and two observational studies. It is important to note, however, that there is a large body of evidence that is consistent with our finding of no increased risk of heart attack associated with testosterone use.”

“This is a rigorous analysis of a large number of patients,” he added. “Our findings did not show an increased risk of heart attack associated with testosterone use in older men. However, large–scale, randomized clinical trials will provide more definitive evidence regarding these risks in the coming years.”

Dr Baillargeon is an associate professor of epidemiology in the Department of Preventive Medicine and Community Health at the University of Texas Medical Branch. He joins many other physicians who are concerned that the FDA is ignoring much evidence that testosterone is heart disease protective and does not worsen heart disease.

Most anti-aging doctors agree with this statement and this new study confirms these philosophies. Dr. Robert True, a specialist in Anti-Aging medicine, states, “It just makes sense that if you give someone testosterone therapy, which stimulates muscles to grow and be healthier, that it would also increase the health of your heart, which is essentially another muscle in your body.”

According to Dr. Baillargeon, the concern that testosterone increases heart disease “has increased in the last few years based on the results of a clinical trial and two observational studies. It is important to note, however, that there is a large body of evidence that is consistent with our finding of no increased risk of heart attack associated with testosterone use.”(4, 5, 6)

He further adds that this present study “is a rigorous analysis of a large number of patients… Our findings did not show an increased risk of heart attack associated with testosterone use in older men.”

1. Vigen, Rebecca, et al; “Association of Testosterone Therapy With Mortality, Myocardial infarction, and Stroke in Men with Low Testosterone Levels.” JAMA, November 6, 2013, Vol 310, No. 17.

2. Baillargeon, J et al, “Risk of Myocardial Infarction in Older Men Receiving Testosterone Therapy”, The Annals of Pharmacotherapy, July 2, 2014.

3. Khaw KT. et al. Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men. Circulation. 2007;116:2694-2701.

4. Kelly, DM, Jone, TH, “Testosterone: a vascular hormone in health and disease.” J Endocrinol, 2013 May 7;217(3):R47-71.

5. Shores MM, Smith NL, Forsberg CW et al. Testosterone treatment and mortality in men with low testosterone levels. J Clin Endocrinol Metab 2012;97:2050-2058.

6. Tan RS, Cook K, Reilly WR. Testosterone therapy is not associated with MI or strokes. Abstract 1353. Presented at American Association Clinical Endocrinology 23rd Annual Scientific Meeting May 16th, 2014.