Testosterone replacement and cardiovascular disease risk: what do endocrinologists need to know?

Testosterone deficiency (or hypogonadism) affects millions of men worldwide. Consensus regarding an appropriate biochemical cutoff for the definition and treatment of hypogonadism has been challenging. Several recent, well-publicized studies have called into question the long recognized benefits of testosterone replacement therapy. The aim of the current article is to review the data on testosterone treatment, paying specific attention to the potential cardiovascular effects of this increasingly common therapy. We examine some of the most common cardiovascular diseases including hypertension, metabolic syndrome, coronary artery disease, atherosclerosis, congestive heart failure, myocardial infarction, and stroke. This review will also investigate the potential effect of testosterone replacement therapy on cardiovascular and all-cause mortality and address a growing fear among the medical community about the safety of testosterone replacement.