Increase in CVD in Men on TRT

[Jinzang]

A new study tracked men on TRT for five years and tracked cardiovascular events. It found about a 20% increased risk in men on TRT, mostly during the first two years. The abstract says:

"Using the UK Clinical Practice Research Datalink (CPRD), we formed a cohort of men aged 45 years or older with low testosterone levels and no evidence of hypogonadotropic or testicular disease, between 1995 and 2017. Hazard ratios (HRs) and 95% confidence intervals (CIs) of a composite of ischemic stroke/transient ischemic attack and myocardial infarction were estimated using time-dependent Cox proportional hazards models, comparing current use of TRT with nonuse."

"The cohort included 15,401 men. During 71,541 person-years of follow-up, 850 patients experienced an ischemic stroke/transient ischemic attack /myocardial infarction (crude incidence rate 1.19 (95% CI 1.11–1.27) per 100 persons per year). Compared with nonuse, current use of TRT was associated with an increased risk of the composite outcome (HR 1.21; 95% CI 1.00–1.46). This risk was highest in the first six months to two years of continuous TRT use (HR 1.35; 95% CI 1.01–1.79), as well as among men aged 45–59 years (HR 1.44; 95% CI 1.07–1.92)."

"TRT may increase the risk of cardiovascular events in aging men with low testosterone levels, particularly in the first 2 years of use. In the absence of identifiable causes of hypogonadism, TRT should be initiated with caution among aging men with low testosterone levels."

 

[luidox33]

A new study tracked men on TRT for five years and tracked cardiovascular events. It found about a 20% increased risk in men on TRT, mostly during the first two years. The abstract says:

"Using the UK Clinical Practice Research Datalink (CPRD), we formed a cohort of men aged 45 years or older with low testosterone levels and no evidence of hypogonadotropic or testicular disease, between 1995 and 2017. Hazard ratios (HRs) and 95% confidence intervals (CIs) of a composite of ischemic stroke/transient ischemic attack and myocardial infarction were estimated using time-dependent Cox proportional hazards models, comparing current use of TRT with nonuse."

"The cohort included 15,401 men. During 71,541 person-years of follow-up, 850 patients experienced an ischemic stroke/transient ischemic attack /myocardial infarction (crude incidence rate 1.19 (95% CI 1.11–1.27) per 100 persons per year). Compared with nonuse, current use of TRT was associated with an increased risk of the composite outcome (HR 1.21; 95% CI 1.00–1.46). This risk was highest in the first six months to two years of continuous TRT use (HR 1.35; 95% CI 1.01–1.79), as well as among men aged 45–59 years (HR 1.44; 95% CI 1.07–1.92)."

"TRT may increase the risk of cardiovascular events in aging men with low testosterone levels, particularly in the first 2 years of use. In the absence of identifiable causes of hypogonadism, TRT should be initiated with caution among aging men with low testosterone levels."

Wheres the link???

 

[Jinzang]

The link to the abstract is through the link in the text abstract. I don't have access to the full text of the article.

 

[luidox33]

The link to the abstract is through the link in the text abstract. I don't have access to the full text of the article.

This study is very vague. It doesn't list the protocols. The affected stroke victims aren't listed by age. What was their health before trt? What was the weekly dose? Did their estrogen get too high??? Whats their HCT???

Isn't this also saying it's decreased by 80%?

Lotta vague here.

 

[Jinzang]

It's only the abstract. I would like to read the full text on articles like this, but I can't afford to buy pay walled articles. One day I'll figure out how to use SciHub, but it won't help on current articles, which is what I like to discuss.

 

[Kirk]

This is from the full text. Keep in mind, cohorts offer helpful information on generalized observational studies. For the most part, they're not "cause and effect" designed studies such as that of RCT.

The mechanism for the effect of exogenous testosterone on the cardiovascular and
cerebrovascular system is complex, and remains to be well established.38 Testosterone has been
observed to enhance platelet aggregation,39 which may increase the risk of ischemic
stroke/transient ischemic attack and myocardial infarction by contributing to coronary plaque
and thrombus development.40 In the recent Cardiovascular Trial of the Testosterone Trials, TRT
also significantly increased coronary artery plaque volume among elderly hypogonadal men after
one year of treatment,41 raising additional concerns as to the risk of coronary atherosclerosis and
acute coronary syndrome in this population. Exogenous testosterone has also been associated
with polycythemia and erythrocytosis,42,43 which may also play a role in heightening the risk of
thrombotic events.44 Finally, it has been suggested that TRT may impart cardiovascular risks by
inducing or exacerbating obstructive sleep apnea.45,46

 

[luidox33]

Man. This “tug of war” with cardiovascular issues will NEVER END. What is the source of this study? Any affiliation with the big pharma’s trying to take testosterone down???

Also, bigger question here, was this “coronary artery noncalcified plaque volume” measured before starting TRT????

 

[HarryCat2]

Man. This “tug of war” with cardiovascular issues will NEVER END. What is the source of this study? Any affiliation with the big pharma’s trying to take testosterone down???

The authors are from McGill and funding was, in part, from the Canadian Institutes of Health Research

 

[luidox33]

bigger question here, was this “coronary artery noncalcified plaque volume” measured before starting TRT????

 

[Kirk]

Why would big pharma take testosterone down? It's in their interest to have as many individuals on testosterone than not. It's a multi-billion market for "big pharma."

 

[luidox33]

bigger question here, was this “coronary artery noncalcified plaque volume” measured before starting TRT????

 

[Kirk]

Maybe some of you guys missed it? There wasn't any clinical testing done in this particular study. It's looking at retrospective studies (past poorly designed studies) and trying to connect the dots to put blame on testosterone as an independent risk factor.

Essentially this was a major waste of time and money.

This is a cohort study.

 

[Kirk]

Cohort Study - Study Design 101

 

[luidox33]

Maybe some of you guys missed it? There wasn't any clinical testing done in this particular study. It's looking at retrospective studies (past poorly designed studies) and trying to connect the dots to put blame on testosterone as an independent risk factor.

Essentially this was a major waste of time and money.

This is a cohort study.

I missed the dots. :/

 

[luidox33]

I don’t understand why there is this unknown secret entity out there always trying to muddy up TRT. I just don’t get that.

 

[Kirk]

Unfortunately this occurs outside of testosterone, or any other drug(s); e.g, aspirin, metformin, different antihypertensive drugs, vaccinations, ect. A very recent example, look how many contrasting disputes there's been over egg consumption in the last few years. Although, it reaches further than just a few years.

Generally there's an agenda.

 

[JohnTaylorHK]

A new study tracked men on TRT for five years and tracked cardiovascular events. It found about a 20% increased risk in men on TRT, mostly during the first two years. The abstract says:

"Using the UK Clinical Practice Research Datalink (CPRD), we formed a cohort of men aged 45 years or older with low testosterone levels and no evidence of hypogonadotropic or testicular disease, between 1995 and 2017. Hazard ratios (HRs) and 95% confidence intervals (CIs) of a composite of ischemic stroke/transient ischemic attack and myocardial infarction were estimated using time-dependent Cox proportional hazards models, comparing current use of TRT with nonuse."

THIS may help. Namaste.