CONTEXT: Few studies have examined whether endogenous testosterone is associated with the development of coronary heart disease (CHD) in women. OBJECTIVE: This study tested the association of total testosterone (total T) and bioavailable T (BioT) levels with risk of incident coronary events among older community-dwelling women. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective, population-based study of 639 postmenopausal women, aged 50-91 (mean, 73.8) yr who had serum testosterone measurements at baseline (1984-87) and who were followed for incident CHD events through 2004. MAIN OUTCOME MEASURES: A total of 134 incident CHD events occurred during follow-up [45 nonfatal myocardial infarctions, 79 fatal myocardial infarctions, and 10 coronary revascularizations]. RESULTS: The median follow-up was 12.3 yr. Age-adjusted CHD risk estimates were similar for the four highest total T quintiles relative to the lowest, suggesting a low threshold. In age-adjusted analyses, the lowest total T quintile (</=80 pg/ml) was associated with a 1.62-fold increased risk of incident CHD [95% confidence interval (CI), 1.10-2.39] compared to higher levels. BioT showed a U-shaped association with incident CHD. Age-adjusted risk for the lowest and highest BioT quintiles relative to the third were 1.79 (95% CI, 1.03-3.16) and 1.96 (95% CI, 1.13-3.41), respectively. Additional adjustment for lifestyle, adiposity, estradiol, and ovarian status, or for CHD risk factor covariates, had minimal influence on results. CONCLUSIONS: An optimal range of testosterone may exist for cardiovascular health in women, with increased risk of CHD events at low levels of testosterone overall and at high levels of the bioavailable fraction of testosterone.
CONTEXT: Few studies have examined whether endogenous testosterone is associated with the development of coronary heart disease (CHD) in women. OBJECTIVE: This study tested the association of total testosterone (total T) and bioavailable T (BioT) levels with risk of incident coronary events among older community-dwelling women. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective, population-based study of 639 postmenopausal women, aged 50-91 (mean, 73.8) yr who had serum testosterone measurements at baseline (1984-87) and who were followed for incident CHD events through 2004. MAIN OUTCOME MEASURES: A total of 134 incident CHD events occurred during follow-up [45 nonfatal myocardial infarctions, 79 fatal myocardial infarctions, and 10 coronary revascularizations]. RESULTS: The median follow-up was 12.3 yr. Age-adjusted CHD risk estimates were similar for the four highest total T quintiles relative to the lowest, suggesting a low threshold. In age-adjusted analyses, the lowest total T quintile (</=80 pg/ml) was associated with a 1.62-fold increased risk of incident CHD [95% confidence interval (CI), 1.10-2.39] compared to higher levels. BioT showed a U-shaped association with incident CHD. Age-adjusted risk for the lowest and highest BioT quintiles relative to the third were 1.79 (95% CI, 1.03-3.16) and 1.96 (95% CI, 1.13-3.41), respectively. Additional adjustment for lifestyle, adiposity, estradiol, and ovarian status, or for CHD risk factor covariates, had minimal influence on results. CONCLUSIONS: An optimal range of testosterone may exist for cardiovascular health in women, with increased risk of CHD events at low levels of testosterone overall and at high levels of the bioavailable fraction of testosterone.
Authors: Pamela Ouyang; Dhananjay Vaidya; Adrian Dobs; Sherita Hill Golden; Moyses Szklo; Susan R Heckbert; Peter Kopp; Susan M Gapstur Journal: Atherosclerosis Date: 2008-09-06 Impact factor: 5.162
Authors: Marcello Maggio; Fulvio Lauretani; Gian Paolo Ceda; Stefania Bandinelli; Shehzad Basaria; Giuseppe Paolisso; Alessandro Ble; Josephine M Egan; E Jeffrey Metter; Angela M Abbatecola; Giovanni Zuliani; Carmelinda Ruggiero; Giorgio Valenti; Jack M Guralnik; Luigi Ferrucci Journal: Am J Physiol Endocrinol Metab Date: 2006-09-12 Impact factor: 4.310
Authors: Erik Debing; Els Peeters; William Duquet; Kris Poppe; Brigitte Velkeniers; Pierre Van den Brande Journal: Eur J Endocrinol Date: 2007-06 Impact factor: 6.664
Authors: Leslee J Shaw; C Noel Bairey Merz; Ricardo Azziz; Frank Z Stanczyk; George Sopko; Glenn D Braunstein; Sheryl F Kelsey; Kevin E Kip; Rhonda M Cooper-Dehoff; B Delia Johnson; Viola Vaccarino; Steven E Reis; Vera Bittner; T Keta Hodgson; William Rogers; Carl J Pepine Journal: J Clin Endocrinol Metab Date: 2008-01-08 Impact factor: 5.958
Authors: Robin Haring; Thomas G Travison; Shalender Bhasin; Ramachandran S Vasan; Henri Wallaschofski; Maithili N Davda; Andrea Coviello; Joanne M Murabito Journal: J Clin Endocrinol Metab Date: 2011-09-21 Impact factor: 5.958
Authors: Laura N Vandenberg; Theo Colborn; Tyrone B Hayes; Jerrold J Heindel; David R Jacobs; Duk-Hee Lee; Toshi Shioda; Ana M Soto; Frederick S vom Saal; Wade V Welshons; R Thomas Zoeller; John Peterson Myers Journal: Endocr Rev Date: 2012-03-14 Impact factor: 19.871
Authors: Humberto Parada; Marilie D Gammon; Hope L Ettore; Jia Chen; Antonia M Calafat; Alfred I Neugut; Regina M Santella; Mary S Wolff; Susan L Teitelbaum Journal: Environ Int Date: 2019-06-19 Impact factor: 9.621
Authors: A D Coviello; W V Zhuang; K L Lunetta; S Bhasin; J Ulloor; A Zhang; D Karasik; D P Kiel; R S Vasan; J M Murabito Journal: J Clin Endocrinol Metab Date: 2011-07-13 Impact factor: 5.958
Authors: Di Zhao; Eliseo Guallar; Pamela Ouyang; Vinita Subramanya; Dhananjay Vaidya; Chiadi E Ndumele; Joao A Lima; Matthew A Allison; Sanjiv J Shah; Alain G Bertoni; Matthew J Budoff; Wendy S Post; Erin D Michos Journal: J Am Coll Cardiol Date: 2018-06-05 Impact factor: 24.094
Authors: Susan R Davis; Robin J Bell; Penelope J Robinson; David J Handelsman; Tom Gilbert; James Phung; Reena Desai; Jessica E Lockery; Robyn L Woods; Rory S Wolfe; Christopher M Reid; Mark R Nelson; Anne M Murray; John J McNeil Journal: J Clin Endocrinol Metab Date: 2019-12-01 Impact factor: 5.958