Testosterone deficiency: a risk factor for heart failure
This review summarizes the available evidence on the role of low testosterone levels (also known as testosterone deficiency syndrome [TDS] or hypogonadism) as a modifiable risk factor for heart failure. It also underlines the benefits and potential side effects of testosterone therapy in men suffering from chronic heart failure (CHF).
CHF is a growing health problem worldwide, the prevalence of which increases with age. TDS (hypogonadism) is characterized by low testosterone levels, especially low levels of which have been linked to the severity of symptoms in men with CHF – 25% of patients with CHF have testosterone levels below the normal range. On the other hand, it is noteworthy that heart failure itself can affect testosterone metabolism. Furthermore, patients affected by metabolic diseases such as diabetes, obesity and metabolic syndrome, which on their own may lead to the onset and progression of CHF, often have low circulating levels of testosterone.
A reduction in circulating testosterone levels may contribute to specific features of CHF such as fatigue, weakness, shortness of breath, weight loss and deterioration in physical condition. Testosterone therapy is often used to treat men with TDS, and recent evidence suggests that Testosterone therapy may improve muscle strength and lung capacity in patients with CHF, especially those with TDS. However, large clinical trials are required to assess the long-term effectiveness and safety of Testosterone therapy in these patients.