Impact of TRT on Thrombosis, Heart Disease and Apnea

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    This study adds to growing evidence that cardiovascular risk from TRT may be less than once feared. The increased risk of sleep apnea in men using TRT is noteworthy. The study strengths include the large number of healthy and young men exposed to TRT. Limitations include the retrospective study design inability to account for granular details of TRT use such as dosage, specific forms of TRT and serum testosterone levels pre- and post-TRT.

    The evidence piles up that TRT is protective against heart disease. The abstract of this observational study says:

    A cohort of 3,422 male United States military service members, retirees and their dependents, aged 40-64 was identified, who were prescribed TRT between 2006-2010 for low testosterone. Men in this cohort were matched on a 1:1 basis by age and comorbidities to men without a prescription for TRT. Event-free survival and rates of thromboembolism, cardiovascular events and OSA were compared between men using TRT and controls with a median follow-up of 17 months.

    There was no difference in event free survival from thromboembolism (p=0.239). Relative to controls, patients using TRT had improved cardiovascular event free survival (p=0.004), mainly due to decreased coronary artery disease (p=0.0082). Risk of OSA [obstructive sleep apnea] was worse in TRT users (2-year risk 16.5% in TRT vs. 12.7% in controls
    This study adds to growing evidence that cardiovascular risk from TRT may be less than once feared. The increased risk of sleep apnea in men using TRT is noteworthy

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