5 research outputs found
Plasma Total Testosterone and Incident Cardiovascular Events in Hypertensive Patients
BACKGROUND
Androgen deficiency confers an independent risk for cardiovascular
events and total mortality. Hypertension, a major contributory factor to
the development of cardiovascular disease, has also been associated with
increased prevalence of low testosterone. We investigated whether low
androgen concentration predicts incident major adverse cardiovascular
events (MACE) in middle-aged nondiabetic hypertensive patients without
clinical atherosclerosis.
METHODS
MACE in relation to total testosterone (TT) were analyzed with
proportional hazards models in 228 male patients (mean age 56 years).
RESULTS
During a mean follow-up of 44 months, 19 of 228 participants (8.3%)
experienced a MACE. Compared to patients who did not experience MACE,
hypertensive subjects who developed MACE had lower 7 concentration (3.9
+/- 0.7 ng/ml vs. 4.6 +/- 1.5 ng/ml, P < 0.01) and a higher prevalence
of hypogonadism (36% vs. 16%, P < 0.05). Subjects in the lowest 7
tertile (<4.0 ng/ml) had a statistically significant higher risk of MACE
compared to those in the highest tertile (>4.9 ng/ml) in multivariate
Cox models adjusted for age, systolic blood pressure, and risk factors
(all P < 0.05). A 7 plasma level of 5.04 ng/ml was associated with a
negative predictive value (ability to “rule out” MACE) of 97.2%.
Addition of 7 to standard risk factors model yielded a net
reclassification improvement of 38.8% (P < 0.05).
CONCLUSIONS
Our results show that low plasma testosterone is associated with
increased risk for a MACE in hypertensive patients. Low endogenous
androgen concentration improves risk prediction when added to standard
risk factors and may represent a valuable biomarker of prediction of
cardiovascular disease risk in these patients