Андрология и генитальная хирургия (Dec 2014)
Impact of hormone replacement therapy on cardiac metabolic indicators in men with high cardiovascular risk and hypogonadism
Abstract
The paper evaluates the impact of hormone replacement therapy (HRT) with androgens on cardiac metabolic indicators in men with high cardiovascular risk (CVR) and androgen deficiency state. An open-label randomized clinical trial enrolled 52 men aged 30–64 years with high CVR and detected androgen-deficiency state. The men were randomized into 2 groups: a control group (CG) (n = 26) continued to receive the pre-trial therapy; during the previous therapy, a study group (SG) (n = 26) had daily applications of transdermal gel with testosterone (AndroGel) in a daily dose of 50 mg of testosterone in 5 g of the gel. The trial lasted 180 days. The changes in the indicators under study were traced 90 days after treatment initiation at an intermediate visit and 180 days after the initiation of treatment – at the end of its treatment.At the end of the trial, HRT in men with androgen deficiency and high CVR led to normalization of testosterone levels in all the SG patients and to improvement in erectile function by 12 %. Androgen therapy caused a statistically significant reduction in blood pressure by 10 %; no changes were virtually observed in the CG. HRT promoted a slight, but significant weight loss (by an average of 2.8 kg) and waist circumference (by an average of 1.7 cm). The therapy performed also lowered the concentration of total cholesterol by an average of 11 % and that of triglycerides by 22 %. During the therapy, there was a significant decrease in fasting insulin and glucose levels. Overall, the course therapy with transdermal gel in combination with testosterone resulted in a reduction in the expected total CVR by 30 %. Thus, HRT using testosterone preparations in men with hypogonadism and high CVR led to normalization of testosterone levels and major cardiac metabolic indicators and to improvement in erectile function.
