Home Hypertension Hit the Gym, Skip the Testosterone for Healthy Vessels

Hit the Gym, Skip the Testosterone for Healthy Vessels

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It was regular exercise, not a testosterone cream, that helped aging men in a randomized trial with their vascular endothelial function.

In men ages 50 to 70 with central adiposity and low-to-normal testosterone levels, flow-mediated dilation (FMD) actually declined with daily testosterone application, whereas it increased after 12 weeks of exercise training (P=0.033 overall) in the two-by-two factorial design comparison:

  • Testosterone plus exercise: FMD +0.5% from baseline
  • Placebo plus exercise: +1.0%
  • Testosterone plus no additional exercise: −0.7%
  • Placebo plus no additional exercise: +0.2%

FMD is a surrogate measure of the endothelial dysfunction implicated in atherosclerosis development.

Thus, investigators Daniel Green, of The University of Western Australia in Perth, and colleagues urged caution when prescribing testosterone primarily for vascular health.

Skyrocketing testosterone sales over the last decade are a sign of “less than rigorous prescribing habits grafted onto the unproven concept of a restorative hormone that preserves health,” they complained in their report, published online in the journal Hypertension.

“The results of our study suggest that if you are a healthy but relatively inactive middle-aged or older man with increased abdominal girth, and you are worried about your risk of heart attack, stroke or diabetes, then an exercise program with some support and supervision can help to improve the function and health of your arteries,” Green said in a press release.

Testosterone therapy may have some benefits, for example in increasing muscle mass in the legs, however, we didn’t find any benefits in terms of artery function, which is a determinant of future cardiovascular risk,” he continued.

Green’s team had performed a randomized trial of 80 men from the Perth metropolitan area. Eligible criteria included central adiposity (waist girth ≥95 cm) and low-normal serum testosterone levels (6-14 nmol/L).

The men were assigned randomly to testosterone cream (100 mg/2 mL applied daily) or matching placebo and to supervised exercise (circuit training at a dedicated research gym, two or three times a week) or no supervised exercise.

Study participants averaged 59 years of age, with a mean prescreening testosterone level of 11.1 nmol/L. Baseline characteristics were similar across groups.

Testosterone therapy adherence was 97.6%. Treatment increased serum testosterone levels by 3.0 nmol/L in both testosterone groups, whereas placebo treatment had no impact on testosterone levels.

Those assigned to exercise had adherence rates of 96.5% for attendance twice a week (80% for attendance thrice a week).

There were no significant exercise effects on endothelium-independent glyceryl trinitrate (GTN) responses, indicating that exercise’s vascular health benefit was indeed endothelium-mediated. For that matter, testosterone also showed no relationship with GTN responses, the investigators reported.

“It is important to note that participants in the study were community-dwelling volunteers, so results may pertain to more motivated men,” Green and colleagues acknowledged.

The study was also limited by its small sample and the fact that some participants were also on antihypertensives and other medications that affect vascular function.

  • author['full_name']

    Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was funded by the Heart Foundation of Australia and Lawley Pharmaceuticals.

Green had no disclosures.

One study coauthor reported receiving speaker honoraria and conference support from Bayer, Lilly, and Besins Healthcare; research support from Bayer, Lilly, and Lawley Pharmaceuticals; and participating in advisory roles for Lilly, Besins Healthcare, Ferring, and Lawley Pharmaceuticals.

https://www.medpagetoday.com/cardiology/hypertension/91294

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