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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Testosterone Therapy and the Risk of Cardiovascular Disease
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<blockquote data-quote="madman" data-source="post: 276780" data-attributes="member: 13851"><p><em><em><strong>*Although observational studies suggest an association between low testosterone and increased risk of CVD, results from testosterone supplementation are inconsistent. <u>RCTs indicate that short-term TT at standard replacement is not associated with increased CVD risk</u>. <u>Nevertheless, the cardiovascular sub-study of T Trials observed increases in NCP and CAC, signaling the need for further investigation into potential long-term implications of TT</u>.</strong></em></em></p><p><em></em></p><p><em><strong>*CIMT, an ultrasound measure of thickness in the carotid artery lining, is a potential marker of early atherosclerosis.</strong> <strong>Compared to ultrasound assessment of carotid plaque presence, however, CIMT is less predictive</strong>.<strong> CAC scoring, in turn, has been directly compared to CIMT and carotid plaque scoring, within several observational and prospective studies. Initial hypotheses predicted that CAC would not predict stroke as effectively as CIMT.</strong> <strong><u>However, despite its anatomical distance from the carotid artery bed, coronary artery calcium presence and burden are strong predictors for CVD events (including stroke and transient ischemic attack)</u>. <u>This well-established finding is likely rooted in atherosclerosis being a systemic process</u>. <u><strong>CA</strong>C presence and CAC score, in fact, are both superior to CIMT for predicting CV events</u>.</strong></em></p><p><em><strong></strong></em></p><p><em><strong>*While CAC is a well-established prognostic tool, it is <u>not a comprehensive measure of atherosclerotic burden</u>. <u>Focusing solely on CAC, without also considering non-calcified plaque (NCP) in the coronary arteries, may overlook changes in other categories of plaque relevant to CVD risk</u>. <u>Honing into CAC alone also ignores the timeline of atherosclerosis development; CAC typically manifests in the later stages of atherogenesis</u>. <u>Coronary atherosclerosis initiates as fatty streaks within the arterial wall, which then develop into noncalcified plaque — composed of lipids, inflammatory cells, and fibrous tissue</u>. Over time, these plaques evolve and undergo calcification as calcium hydroxyapatite deposits within the fibrous cap, the stabilizing layer above the plaque’s lipid core. <u>This process signifies plaque maturation, and calcified plaques typically develop in the later stages of atherosclerosis</u>. <u>These calcified deposits are associated with stable coronary artery disease (CAD), and they possess a lower risk of rupture</u>.</strong></em></p><p><em></em></p><p><em></em></p><p><em></em></p><p><em></em></p><p><em><em><strong>*The TRAVERSE trial, a landmark study unique in its capacity to evaluate CVD events, contributes valuable insights into the short-term safety of TT at lower physiological levels. <u>However, the long-term effects and implications of mid to high physiological testosterone levels are not yet fully understood</u>. <u>The trials’ limitations — achievement of only low-normal testosterone levels, high discontinuation rates, brief follow-up period, and high loss to follow-up rate — suggest that the findings should be interpreted with caution</u>. I<u>t is important to avoid generalizing the safety of TT based on these results alone and to approach the extrapolation of TRAVERSE’s conclusions to higher dosages or longer-term therapy with caution</u>.</strong></em></em></p></blockquote><p></p>
[QUOTE="madman, post: 276780, member: 13851"] [I][I][B]*Although observational studies suggest an association between low testosterone and increased risk of CVD, results from testosterone supplementation are inconsistent. [U]RCTs indicate that short-term TT at standard replacement is not associated with increased CVD risk[/U]. [U]Nevertheless, the cardiovascular sub-study of T Trials observed increases in NCP and CAC, signaling the need for further investigation into potential long-term implications of TT[/U].[/B][/I] [B]*CIMT, an ultrasound measure of thickness in the carotid artery lining, is a potential marker of early atherosclerosis.[/B] [B]Compared to ultrasound assessment of carotid plaque presence, however, CIMT is less predictive[/B].[B] CAC scoring, in turn, has been directly compared to CIMT and carotid plaque scoring, within several observational and prospective studies. Initial hypotheses predicted that CAC would not predict stroke as effectively as CIMT.[/B] [B][U]However, despite its anatomical distance from the carotid artery bed, coronary artery calcium presence and burden are strong predictors for CVD events (including stroke and transient ischemic attack)[/U]. [U]This well-established finding is likely rooted in atherosclerosis being a systemic process[/U]. [U][B]CA[/B]C presence and CAC score, in fact, are both superior to CIMT for predicting CV events[/U]. *While CAC is a well-established prognostic tool, it is [U]not a comprehensive measure of atherosclerotic burden[/U]. [U]Focusing solely on CAC, without also considering non-calcified plaque (NCP) in the coronary arteries, may overlook changes in other categories of plaque relevant to CVD risk[/U]. [U]Honing into CAC alone also ignores the timeline of atherosclerosis development; CAC typically manifests in the later stages of atherogenesis[/U]. [U]Coronary atherosclerosis initiates as fatty streaks within the arterial wall, which then develop into noncalcified plaque — composed of lipids, inflammatory cells, and fibrous tissue[/U]. Over time, these plaques evolve and undergo calcification as calcium hydroxyapatite deposits within the fibrous cap, the stabilizing layer above the plaque’s lipid core. [U]This process signifies plaque maturation, and calcified plaques typically develop in the later stages of atherosclerosis[/U]. [U]These calcified deposits are associated with stable coronary artery disease (CAD), and they possess a lower risk of rupture[/U].[/B] [I][B]*The TRAVERSE trial, a landmark study unique in its capacity to evaluate CVD events, contributes valuable insights into the short-term safety of TT at lower physiological levels. [U]However, the long-term effects and implications of mid to high physiological testosterone levels are not yet fully understood[/U]. [U]The trials’ limitations — achievement of only low-normal testosterone levels, high discontinuation rates, brief follow-up period, and high loss to follow-up rate — suggest that the findings should be interpreted with caution[/U]. I[U]t is important to avoid generalizing the safety of TT based on these results alone and to approach the extrapolation of TRAVERSE’s conclusions to higher dosages or longer-term therapy with caution[/U].[/B][/I][/I] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Testosterone Therapy and the Risk of Cardiovascular Disease
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