Cardiovascular risk associated with testosterone-boosting medications: a systematic review and meta-analysis
Abstract
Introduction Recent reports have significantly halted the enthusiasm regarding androgen-boosting; suggesting that testosterone supplementation (TS) increases cardiovascular (CV) events. Areas covered In order to overcome some of the limitations of the current evidence, the authors performed an updated systematic review and meta-analysis of all placebo-controlled randomized clinical trials (RCTs) on the effect of TS on CV-related problems. Out of 2747 retrieved articles, 75 were analyzed, including 3016 and 2448 patients in TS and placebo groups, respectively, and a mean duration of 34 weeks. Our analyses, performed on the largest number of studies collected so far, indicate that TS is not related to any increase in CV risk, even when composite or single adverse events were considered. In RCTs performed in subjects with metabolic derangements a protective effect of TS on CV risk was observed. Expert opinion The present systematic review and meta-analysis does not support a causal role between TS and adverse CV events. Our results are in agreement with a large body of literature from the last 20 years supporting TS of hypogonadal men as a valuable strategy in improving a patient's metabolic profile, reducing body fat and increasing lean muscle mass, which would ultimately reduce the risk of heart disease.
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Current evidence consistently shows that untreated low testosterone levels are associated with an increased risk of MACE.
“Current evidence consistently shows that untreated low testosterone levels are associated with an increased risk of MACE”
From Evaluation and Management of Testosterone Deficiency: AUA Guideline (2018) · cites this paper as [40]
The current scientific literature does not definitively demonstrate that testosterone therapy increases the risk of MACE.
“the current scientific literature does not definitively demonstrate that testosterone therapy increases the risk of MACE.”
From Evaluation and Management of Testosterone Deficiency: AUA Guideline (2018) · cites this paper as [40]
Studies that measure cardiovascular benefit or harm in men on testosterone therapy have returned inconsistent and controversial results.
“studies that measure cardiovascular benefit or harm in men on testosterone therapy have returned inconsistent and controversial results.”
From Evaluation and Management of Testosterone Deficiency: AUA Guideline (2018) · cites this paper as [40]
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- Authors
- Corona, G., Maseroli, E., Rastrelli, G., Isidori, A. M., Sforza, A., Mannucci, E., & Maggi, M.
- Affiliations
- Azienda USL di Bologna (IT)
- University of Florence (IT)
- Sapienza University of Rome (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Venue
- Expert Opinion on Drug Safety
- Publisher
- Informa Healthcare
- Published
- 2014-08-19
- Volume
- 13
- Issue
- 10
- Pages
- 1327-1351
- ISSN
- 1474-0338 (ISSN-L)
- 1744-764X
- OpenAlex
- W2058308329
- Cited by
- 297
- References
- 29
- Citations by year
- 2026: 2 · 2025: 11 · 2024: 14 · 2023: 15 · 2022: 19 · 2021: 14 · 2020: 18 · 2019: 17 · 2018: 36 · 2017: 49 · 2016: 43 · 2015: 46 · 2014: 10
- FWCI
- 7.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Expert Opinion on Drug Safety (publishedVersion)
- PubMed (publishedVersion)
- Florence Research (University of Florence) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- 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 › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- testosterone supplementation, cardiovascular risk, hypogonadism, androgen therapy, cardiovascular adverse events, metabolic disorders, heart disease prevention
- MeSH terms
- Androgens, Cardiovascular Diseases, Humans, Hypogonadism, Male, Risk Factors, Testosterone
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