Testosterone Replacement Therapy Linked to 7.9% Greater CVD Risk

A recent Cosmos Study, published by Epic Research on January 16, 2024, revealed that men with low testosterone who are being treated with testosterone replacement therapy (TRT) have an increased risk of cardiovascular disease (CVD) compared to those who are not on TRT.

Although both low testosterone levels and TRT have been linked to elevated CVD risk, the researchers wanted to determine how TRT impacts risk among men with low testosterone.

“We found that men with low testosterone prescribed TRT were 7.9% more likely to be diagnosed with CVD than men with low testosterone not on TRT. We also found that this risk increases with age,” researchers determined in the study.

To come to this conclusion, the dual study team evaluated data from almost 500,000 men (491,612) 30 years old and older with low testosterone levels. None of the participants had a history of CVD.

Participant data was gathered from 236 health systems, including over 1,000 hospitals and 28,000 clinics across the United States and Lebanon. 

Using this data, the researchers evaluated and compared the risk of CVD among the participants who were on TRT to those who were not opting for hormone replacement. While analyzing the data, the researchers adjusted to account for other factors that may impact CVD risk, including type 2 diabetes, hypertension, hyperlipidemia, depression, smoking status, race, ethnicity, and body mass index (BMI).

Overall, the risk of CVD in patients taking TRT was approximately 7.9% greater than those not taking TRT, despite both groups having low testosterone levels. This data implies that TRT independently increases the risk of TRT, irrespective of any potential changes in risk from low testosterone levels.

More detailed insights revealed that the risk varies depending on age, increasing over time. While the average increase in risk was 7.9%, patients 70 and older had the highest risk at 12.7%.

Competitively, the risk increase for patients in their 30s on TRT is 6.3%. For those in their 40s, 50s, and 60s, the risk elevation is 5.5%, 5.9%, and 12.2%, respectively.

According to the CDC, cardiovascular disease is the leading cause of death among most groups in the US, with one death every 33 seconds domestically. However, lifestyle changes such as dietary habits, exercise, smoking cessation, and weight management can minimize risk. Understanding the risk of heart disease in patients on TRT can help guide preventative care practices.