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Testosterone and cardiovascular disease - a literature review

Savi Shishkov, Mila Boyadzhieva


The effects of testosterone on the cardiovascular (CV) system make it a matter of scientific interest. Disturbances in endogenous steroid concentrations are some of the factors involved in the pathogenesis of atherosclerosis and ischemic heart disease. The aim of this article is to summarize the role of hypogonadism in the context of ischemic heart disease development and to review the current evidence on the CV benefits of testosterone replacement. Its low endogenous level is associated with worsened lipid profile, accelerated development of atherosclerotic plaques, high body mass index, metabolic syndrome and, type 2 diabetes mellitus. In light of these facts, some studies look into the benefits of exogenous testosterone replacement in patients with coronary heart disease and heart failure. The results are divergent and a large randomized trial is required to define the link between testosterone replacement therapy and CV risk. New clues present the recent data on the possible adaptive role of hypogonadism in acute coronary syndrome. This has the potential to expand the knowledge on the link between the CV system and gonadal function in men. The role of sex steroids in the pathogenesis of atherosclerotic heart disease and adaptation to acute coronary syndrome is a subject of increasing scientific interest as a result of accumulating evidence in this field.


testosterone, ischemic heart disease, acute coronary syndrome

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About The Authors

Savi Shishkov
Second Department of Internal Diseases, Faculty of Medicine, Medical University of Varna Clinic of Endocrinology and Metabolic Diseases, St. Marina University Hospital, Medical University of Varna

Mila Boyadzhieva
Second Department of Internal Diseases, Faculty of Medicine, Medical University of Varna Clinic of Endocrinology and Metabolic Diseases, St. Marina University Hospital, Medical University of Varna

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