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Q J Med 2003; 96: 521-529
© 2003 Association of Physicians

Commentary

Testosterone for secondary prevention in men with ischaemic heart disease?

C.J. Malkin1,2, P.J. Pugh1,2, T.H. Jones2 and K.S. Channer1

From the 1Department of Cardiology, Royal Hallamshire Hospital, Sheffield, and 2Academic Unit of Endocrinology, Division of Genomic Medicine, University of Sheffield Medical School, Sheffield, UK

The first 150 words of the full text of this article appear below.


   Introduction
 
Atherosclerotic coronary artery disease (CAD) is a leading cause of mortality and morbidity in the western world. It is a chronic progressive condition, and treatment is required indefinitely. Men are more than twice as likely as women to develop CAD:1 this ratio is consistent in all populations and is not related to differences in risk factors. Pre-menopausal females have a lower incidence of CAD, but this rises after the menopause, so that the risk of CAD rapidly approaches that of males after about 10 years. One explanation for these epidemiological observations is that female hormones protect against the development of CAD. Observational studies of hormone replacement therapies in women have suggested some benefit,2 but large randomized controlled trials have failed to show protective effects.3,4

Little attention has been paid to the role of testosterone in the pathogenesis of CAD. Males do not have a menopause equivalent, but sex hormones do . . . [Full Text of this Article]


   Lipids and apoproteins
 

   Blood pressure
 

   Testosterone and the haemostatic system
 

   Testosterone and obesity
 

   Testosterone and insulin resistance
 

   Testosterone and atherosclerosis
 

   Conclusions
 

Address correspondence to Dr K.S. Channer, Department of Cardiology, M131, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF. e-mail: Kevin.Channer@sth.nhs.uk


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