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Endogenous sex hormones and cardiovascular disease incidence in men.

Publication ,  Journal Article
Arnlöv, J; Pencina, MJ; Amin, S; Nam, B-H; Benjamin, EJ; Murabito, JM; Wang, TJ; Knapp, PE; D'Agostino, RB; Bhasin, S; Vasan, RS
Published in: Ann Intern Med
August 1, 2006

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.

Duke Scholars

Published In

Ann Intern Med

DOI

EISSN

1539-3704

Publication Date

August 1, 2006

Volume

145

Issue

3

Start / End Page

176 / 184

Location

United States

Related Subject Headings

  • Testosterone
  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Massachusetts
  • Male
  • Incidence
  • Humans
  • General & Internal Medicine
  • Follow-Up Studies
 

Citation

APA
Chicago
ICMJE
MLA
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Arnlöv, J., Pencina, M. J., Amin, S., Nam, B.-H., Benjamin, E. J., Murabito, J. M., … Vasan, R. S. (2006). Endogenous sex hormones and cardiovascular disease incidence in men. Ann Intern Med, 145(3), 176–184. https://doi.org/10.7326/0003-4819-145-3-200608010-00005
Arnlöv, Johan, Michael J. Pencina, Shreyasee Amin, Byung-Ho Nam, Emelia J. Benjamin, Joanne M. Murabito, Thomas J. Wang, et al. “Endogenous sex hormones and cardiovascular disease incidence in men.Ann Intern Med 145, no. 3 (August 1, 2006): 176–84. https://doi.org/10.7326/0003-4819-145-3-200608010-00005.
Arnlöv J, Pencina MJ, Amin S, Nam B-H, Benjamin EJ, Murabito JM, et al. Endogenous sex hormones and cardiovascular disease incidence in men. Ann Intern Med. 2006 Aug 1;145(3):176–84.
Arnlöv, Johan, et al. “Endogenous sex hormones and cardiovascular disease incidence in men.Ann Intern Med, vol. 145, no. 3, Aug. 2006, pp. 176–84. Pubmed, doi:10.7326/0003-4819-145-3-200608010-00005.
Arnlöv J, Pencina MJ, Amin S, Nam B-H, Benjamin EJ, Murabito JM, Wang TJ, Knapp PE, D’Agostino RB, Bhasin S, Vasan RS. Endogenous sex hormones and cardiovascular disease incidence in men. Ann Intern Med. 2006 Aug 1;145(3):176–184.

Published In

Ann Intern Med

DOI

EISSN

1539-3704

Publication Date

August 1, 2006

Volume

145

Issue

3

Start / End Page

176 / 184

Location

United States

Related Subject Headings

  • Testosterone
  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Massachusetts
  • Male
  • Incidence
  • Humans
  • General & Internal Medicine
  • Follow-Up Studies