Summary Points
• Testosterone, the main endogenous active androgen, is used to treat many clinical conditions
• Testosterone and other androgens are also used by athletes, non athlete weightlifters or bodybuilders to enhance muscle development, strength, and performance and endurance
• Testosterone at supraphysiological levels increases cardiovascular disease risk, causes myocardial infarction, stroke, high blood pressure, blood clots, and heart failure
• Testosterone affects the cardiovascular system by changing lipid profile, insulin sensitivity, hemostatic mechanisms, sympathetic nervous system, and renin angiotensin-aldosterone system
• Testosterone activates proinflammatory and redox processes, decreases nitric oxide bioavailability, and stimulates vasoconstrictor signaling pathways
• Testosterone affects the vasculature by interfering with all mechanisms that control vascular function
• In the endothelium, testosterone modulates NO, COX-derived metabolites and EDHF release and signaling
• In VSMCs, testosterone modulates ROS generation, expression, and activity of receptors and ion channels
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