Low-Dose Transdermal Testosterone Therapy Improves Angina Threshold in Men With Chronic Stable Angina: A Randomized, Double-Blind, Placebo-Controlled Study
Abstract
Background —Experimental studies suggest that androgens induce coronary vasodilatation. We performed this pilot project to examine the clinical effects of long-term low-dose androgens in men with angina. Methods and Results —Forty-six men with stable angina completed a 2-week, single-blind placebo run-in, followed by double-blind randomization to 5 mg testosterone daily by transdermal patch or matching placebo for 12 weeks, in addition to their current medication. Time to 1-mm ST-segment depression on treadmill exercise testing and hormone levels were measured and quality of life was assessed by SF-36 at baseline and after 4 and 12 weeks of treatment. Active treatment resulted in a 2-fold increase in androgen levels and an increase in time to 1-mm ST-segment depression from (mean±SEM) 309±27 seconds at baseline to 343±26 seconds after 4 weeks and to 361±22 seconds after 12 weeks. This change was statistically significant compared with that seen in the placebo group (from 266±25 seconds at baseline to 284±23 seconds after 4 weeks and to 292±24 seconds after 12 weeks; P =0.02 between the 2 groups by ANCOVA). The magnitude of the response was greater in those with lower baseline levels of bioavailable testosterone ( r =−0.455, P <0.05). There were no significant changes in prostate specific antigen, hemoglobin, lipids, or coagulation profiles during the study. There were significant improvements in pain perception ( P =0.026) and role limitation resulting from physical problems ( P =0.024) in the testosterone-treated group. Conclusions —Low-dose supplemental testosterone treatment in men with chronic stable angina reduces exercise-induced myocardial ischemia.
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In men with chronic stable angina pectoris, the increase in time to 1 mm ST segment depression is noticeable after 14 weeks of testosterone treatment.
“In men with chronic stable angina pectoris the increase in time to 1 mm ST segment depression was noticeable after 14 weeks (59).”
From Onset of effects of testosterone treatment and time span until maximum effects are achieved (2011) · cites this paper as [59]
The present study of exclusively hypogonadal men found the improvement in time to ischaemic threshold to be greater than that among randomly selected men reported by English and colleagues, using identical assessment.
“The present study of exclusively hypogonadal men found the improvement in time to ischaemic threshold to be greater than that among the randomly selected men reported by English and colleagues, 16 using identical assessment.”
From Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life (2004) · cites this paper as [16]
Testosterone therapy with intramuscular, intravenous, and transdermal preparations has a beneficial anti-ischaemic effect in men with coronary disease.
“A number of research groups have reported that testosterone therapy with intramuscular, 14 intravenous, 15 and transdermal preparations had a beneficial anti-ischaemic effect in men with coronary disease.16”
From Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life (2004) · cites this paper as [16]
In the past 30 years, at least six studies of various design have reported effects of androgen therapy on coronary ischaemia; all but one reported a beneficial effect.
“In the past 30 years, at least six studies of various design have reported the effects of androgen therapy on coronary ischaemia 14-16 44-46 ; all but one have reported a beneficial effect.46”
From Testosterone replacement in hypogonadal men with angina improves ischaemic threshold and quality of life (2004) · cites this paper as [16]
Testosterone improves cardiac ischemia in men with chronic stable angina and symptoms in men with heart failure.
“These findings and the fact that testosterone improves cardiac ischemia in men with chronic sta-ble angina (43) and symptoms in men with heart failure (44) suggest that the diagnosis of hypogonadism in men with type 2 diabetes has important clinical consequences besides the benefits on libido and well-being associated with normalization of testosterone status.”
From Clinical and Biochemical Assessment of Hypogonadism in Men With Type 2 Diabetes (2007) · cites this paper as [43]
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- Authors
- English, K. M., Steeds, R. P., Jones, T. H., Diver, M. J., & Channer, K. S.
- Affiliations
- University of Liverpool (GB)
- ORCID
- Steeds, Richard P.
- Venue
- Circulation
- Published
- 2000-10-17
- Volume
- 102
- Issue
- 16
- Pages
- 1906-1911
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2136924707
- Cited by
- 582
- References
- 18
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 12 · 2023: 11 · 2022: 8 · 2021: 11 · 2020: 62 · 2019: 15 · 2018: 14 · 2017: 15 · 2016: 22 · 2015: 32 · 2014: 39 · 2013: 30 · 2012: 16
- FWCI
- 12.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Keywords
- testosterone replacement therapy, stable angina, myocardial ischemia, androgens, coronary vasodilation, ST-segment depression, exercise testing, bioavailable testosterone, quality of life, men
- MeSH terms
- Administration, Cutaneous, Analysis of Variance, Angina Pectoris, Chronic Disease, Dose-Response Relationship, Drug, Double-Blind Method, Exercise Test, Humans, Male, Middle Aged, Pilot Projects, Quality of Life, Gonadal Steroid Hormones, Testosterone, Treatment Outcome, Pain Threshold
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