Journals of Gerontology Series A: Biological Sciences and Medical Sciences Large Type Edition
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The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 57:M460-M465 (2002)
© 2002 The Gerontological Society of America

Effects of Transdermal Testosterone on Lipids and Vascular Reactivity in Older Men With Low Bioavailable Testosterone Levels

Anne M. Kennya, Karen M. Prestwooda, Cynthia A. Grumanb, Geraldine Fabregasa, Bradley Biskupa and George Mansoorc

a Center on Aging, University of Connecticut Health Center, Farmington.
b Braceland Center for Mental Health and Aging, Institute of Living/Hartford Hospital, Hartford, Connecticut
c Lowell P. Weicker General Clinical Research Center, University of Connecticut Health Center, Farmington.

Anne M. Kenny, Center on Aging, MC-5215, University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030 E-mail: Kenny{at}nso1.uchc.edu.

Background. Sex hormones are known to affect cholesterol levels and vascular tone in women. The effects of testosterone on cholesterol and vascular tone in men are less well understood. Low testosterone levels have been associated with higher cholesterol levels in epidemiologic studies, but testosterone replacement has resulted in variable changes in cholesterol levels. Similarly, clinical studies suggest that testosterone may be vasodilatory, but few studies have directly evaluated the effects of testosterone on vascular tone.

Methods. Sixty-seven men (mean age 76 ± 4 years, range 65–87) with bioavailable testosterone levels below 4.44 nmol/l (lower limit for adult normal range) were randomized to receive transdermal testosterone (2–2.5 mg patches/d) or placebo patches for 1 year. Twenty-three men (34%) withdrew from the study; 44 men completed the trial.

Results. While total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels did not significantly change during the year of therapy, high-density lipoprotein (HDL) levels (p = .004) and, specifically, HDL2 subfraction (p = .02) decreased in men receiving testosterone supplementation. Vascular tone was measured by brachial artery reactivity in 36 men. Endothelium-dependent brachial artery reactivity did not change from baseline measurements in men receiving transdermal testosterone (0.3 ± 6.7% to 1.6 ± 4.6%; p = .58) or in the placebo group (3.2 ± 5.5% to 0.7 ± 5.5%; p = .23).

Conclusions. Transdermal testosterone decreased HDL2 cholesterol but did not affect vascular reactivity in men older than 65 years selected for low testosterone levels. No study to date has addressed the direct relationship between testosterone replacement and cardiovascular events.




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