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Endogenous Sex Hormones and Cardiovascular Disease Incidence in Men
Abstract
BACKGROUND: Data suggest that endogenous sex hormones (testosterone, dehydroepiandrosterone sulfate [DHEA-S], and estradiol) influence cardiovascular disease (CVD) risk factors and vascular function. Yet, prospective studies relating sex hormones to CVD incidence in men have yielded inconsistent results. OBJECTIVE: To examine the association of circulating sex hormone levels and CVD risk in men. DESIGN: Prospective cohort study. SETTING: Community-based study in Framingham, Massachusetts. PARTICIPANTS: 2084 middle-aged white men without CVD at baseline. MEASUREMENTS: The authors used multivariable Cox regression to relate baseline levels of testosterone, DHEA-S, and estradiol to the incidence of CVD (coronary, cerebrovascular, or peripheral vascular disease or heart failure) during 10 years of follow-up. RESULTS: During follow-up, 386 men (18.5%) experienced a first CVD event. After adjustment for baseline standard CVD risk factors, higher estradiol level was associated with lower risk for CVD (hazard ratio per SD increment in log estradiol, 0.90 [95% CI, 0.82 to 0.99]; P = 0.035). The authors observed effect modification by age: Higher estradiol levels were associated with lower CVD risk in older (median age >56 years) men (hazard ratio per SD increment, 0.86 [CI, 0.78 to 0.96]; P = 0.005) but not in younger (median age < or =56 years) men (hazard ratio per SD increment, 1.11 [CI, 0.89 to 1.38]; P = 0.36). The association of higher estradiol level with lower CVD incidence remained robust in time-dependent Cox models (updating standard CVD risk factors during follow-up). Serum testosterone and DHEA-S levels were not statistically significantly associated with incident CVD. LIMITATIONS: Sex hormone levels were measured only at baseline, and the findings may not be generalizable to women and nonwhite people. CONCLUSIONS: In the community-based sample, a higher serum estradiol level was associated with lower risk for CVD events in older men. The findings are consistent with the hypothesis that endogenous estrogen has vasculoprotective influences in men.
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“Likewise, sex hormones are thought to play an important role in the development of cardiovascular diseases [19–21].”
From Intestinal Microbiota Is Influenced by Gender and Body Mass Index (2016) · cites this paper as [19]
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Metadata
- Authors
- Ärnlöv, J., Pencina, M. J., Amin, S., Nam, B.-H., Benjamin, E. J., Murabito, J. M., Wang, T. J., Knapp, P. E., D'Agostino, R. B., Bhasin, S., & Vasan, R. S.
- Affiliations
- Boston University (US)
- From the National Heart, Lung, and Blood Institute's Framingham Heart Study, National Institutes of Health, Bethesda, Maryland; Boston University School of Medicine, Boston University, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts; Mayo Clinic College of Medicine, Rochester, Minnesota; and Uppsala University, Uppsala, Sweden.
- ORCID
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2006-08-01
- Volume
- 145
- Issue
- 3
- Pages
- 176-184
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W1550493347
- Cited by
- 217
- References
- 59
- Citations by year
- 2025: 5 · 2024: 5 · 2023: 3 · 2022: 12 · 2021: 8 · 2020: 5 · 2019: 8 · 2018: 9 · 2017: 4 · 2016: 11 · 2015: 11 · 2014: 12 · 2013: 16 · 2012: 19
- FWCI
- 12.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k23hl074077-03, n01hc25195-41-0-1)
- National Heart, Lung, and Blood Institute (2K24 HL 04334, N01‐HC25195, K23-HL-074077, K24HL004334)
- National Institute of Neurological Disorders and Stroke (6R01NS17950, R01NS017950)
- 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 › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Keywords
- endogenous sex hormones, cardiovascular disease incidence, estradiol, testosterone, dehydroepiandrosterone sulfate, men, coronary artery disease, cerebrovascular disease, peripheral vascular disease, heart failure, age effect modification, vascular protection, Framingham Heart Study
- MeSH terms
- Cardiovascular Diseases, Estradiol, Follow-Up Studies, Humans, Male, Massachusetts, Middle Aged, Prospective Studies, Risk Factors, Testosterone, Incidence, Dehydroepiandrosterone Sulfate
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