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Endogenous Sex Hormones and Cardiovascular Disease in Men

Julius Center for Health Sciences and Primary Care (M.M., Y.T.v.d.S., D.E.G.) and Endocrinology Laboratory (J.H.H.T.), University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands

Address all correspondence and requests for reprints to: Yvonne T. van der Schouw, Ph.D., Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, D01.335, 3508 GA Utrecht, The Netherlands. E-mail: y.t.vanderschouw{at}jc.azu.nl.

Unlike women, men do not experience an abrupt reduction in endogenous sex hormone production. It has, however, become clear that an age-associated decrease in the levels of (bioactive) sex hormones does occur. Whether endogenous sex hormones have an impact on cardiovascular disease has for many years remained largely unknown, but during the last decade more attention has been drawn to the importance of testosterone, estrogens, and adrenal androgens in etiology, prevention, and treatment of male cardiovascular disease. The purpose of this article is to summarize the evidence currently available on the association between endogenous sex hormones and cardiovascular disease in males. Published studies dealing with the relationship between circulating levels of sex hormones and cardiovascular disease in males were reviewed. The studies reviewed in this article suggest that circulating endogenous sex hormones and estrogens have a neutral or beneficial effect on cardiovascular disease in men.

This work was supported by the International Health Foundation, Geneva, Switzerland.

Abbreviations: BT, Bioactive (bioavailable) T; CHD, coronary heart disease; CI, confidence interval; CVD, cardiovascular disease; DHEA, dehydroepiandrosterone; DHEA-S, DHEA sulfate; HDL, high-density lipoprotein; LDL, low-density lipoprotein; Lpa, lipoprotein-a; MI, myocardial infarction; NO, nitric oxide; OR, odds ratio; PWV, pulse wave velocity; T, testosterone; tHcy, homocysteine.

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