Older men who received injections of testosterone were at greater risk of having a heart attack, stroke or unstable angina within a week after receiving the testosterone treatment, according to a new study published in the journal Endocrine Today. However, younger men given testosterone injections were not at increased risk for cardiovascular or cerebrovascular events.
“The necessity of injection treatment should be carefully considered before initiating testosterone, particularly in older men,” said J. Bradley Layton, PhD, a pharmacoepidemiologist at RTI Health Solutions in Research Triangle Park, North Carolina.
Testosterone replacement therapy is available by prescription in various forms including injections, gels, patches and sprays. The treatment is intended for men with hypogonadism, a condition in which a man does not produce enough of the male hormone due to injury, disease or defect. It is not intended for men with natural age-related drops in testosterone.
However, makers of testosterone treatments are facing thousands of lawsuits from consumers who say the drug companies marketed testosterone for off-label conditions – such as a condition called Low T – and failed to warn the public that use could increase their risk for heart attacks, strokes and blood clots, some of which could be fatal.
For the recent study, Layton and colleagues analyzed data on men hospitalized for a heart attack, stroke or unstable angina with seven days of receiving treatment with an injectable testosterone replacement therapy. They found that men 65 years and older were at greater risk for cardiovascular or cerebrovascular events during this short time period.
“There is considerable ongoing debate and disagreement about the role of testosterone treatment and cardiovascular disease,” Layton said. “Many men use testosterone for off-label reasons, including normal age-related decreases in testosterone. Further research should investigate if the safety of testosterone differs among men with appropriate vs. inappropriate use, and if the benefits of treatment outweigh any potential risks.”