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DC Field | Value | Language |
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dc.contributor.author | Yeap, Bu B. | en |
dc.contributor.author | Hyde, Zoe | en |
dc.contributor.author | Almeida, Osvaldo P. | en |
dc.contributor.author | Norman, Paul E. | en |
dc.contributor.author | Chubb, S. A. Paul | en |
dc.contributor.author | Jamrozik, Konrad | en |
dc.contributor.author | Flicker, Leon | en |
dc.contributor.author | Hankey, Graeme J. | en |
dc.date.issued | 2009 | en |
dc.identifier.citation | Journal of Clinical Endocrinology and Metabolism, 2009; 94(7):2353-2359 | en |
dc.identifier.issn | 0021-972X | en |
dc.identifier.uri | http://hdl.handle.net/2440/54887 | - |
dc.description.abstract | Context: Lower circulating testosterone concentrations are associated with metabolic syndrome, type 2 diabetes, carotid intima-media thickness, and aortic and lower limb arterial disease in men. However, it is unclear whether lower testosterone levels predict major cardiovascular events. Objective: We examined whether lower serum testosterone was an independently significant risk factor for symptomatic cerebrovascular events in older men. Design: This was a prospective observational study with median follow-up of 3.5 yr. Setting: Community-dwelling, stroke-free older men were studied. Participants: A total of 3443 men at least 70 yr of age participated in the study. Main Outcome Measures: Baseline serum total testosterone, SHBG, and LH were assayed. Free testosterone was calculated using mass action equations. Incident stroke or transient ischemic attack (TIA) was recorded. Results: A first stroke or TIA occurred in 119 men (3.5%). Total and free testosterone concentrations in the lowest quartiles (<11.7 nmol/liter and Context: Lower circulating testosterone concentrations are associated with metabolic syndrome, type 2 diabetes, carotid intima-media thickness, and aortic and lower limb arterial disease in men. However, it is unclear whether lower testosterone levels predict major cardiovascular events. Objective: We examined whether lower serum testosterone was an independently significant risk factor for symptomatic cerebrovascular events in older men. Design: This was a prospective observational study with median follow-up of 3.5 yr. Setting: Community-dwelling, stroke-free older men were studied. Participants: A total of 3443 men at least 70 yr of age participated in the study. Main Outcome Measures: Baseline serum total testosterone, SHBG, and LH were assayed. Free testosterone was calculated using mass action equations. Incident stroke or transient ischemic attack (TIA) was recorded. Results: A first stroke or TIA occurred in 119 men (3.5%). Total and free testosterone concentrations in the lowest quartiles (<11.7 nmol/liter and <222 pmol/liter) were associated with reduced event-free survival (P = 0.014 and P = 0.01, respectively). After adjustment including age, waist-hip ratio, waist circumference, smoking, hypertension, dyslipidemia, and medical comorbidity, lower total testosterone predicted increased incidence of stroke or TIA (hazard ratio = 1.99; 95% confidence interval, 1.33–2.99). Lower free testosterone was also associated (hazard ratio = 1.69; 95% confidence interval, 1.15–2.48), whereas SHBG and LH were not independently associated with incident stroke or TIA. Conclusions: In older men, lower total testosterone levels predict increased incidence of stroke or TIA after adjusting for conventional risk factors for cardiovascular disease. Men with low-normal testosterone levels had increased risk. Further studies are warranted to determine whether interventions that raise circulating testosterone levels might prevent cerebrovascular disease in men.222 pmol/liter) were associated with reduced event-free survival (P = 0.014 and P = 0.01, respectively). After adjustment including age, waist-hip ratio, waist circumference, smoking, hypertension, dyslipidemia, and medical comorbidity, lower total testosterone predicted increased incidence of stroke or TIA (hazard ratio = 1.99; 95% confidence interval, 1.33–2.99). Lower free testosterone was also associated (hazard ratio = 1.69; 95% confidence interval, 1.15–2.48), whereas SHBG and LH were not independently associated with incident stroke or TIA. Conclusions: In older men, lower total testosterone levels predict increased incidence of stroke or TIA after adjusting for conventional risk factors for cardiovascular disease. Men with low-normal testosterone levels had increased risk. Further studies are warranted to determine whether interventions that raise circulating testosterone levels might prevent cerebrovascular disease in men. | en |
dc.description.statementofresponsibility | Bu B. Yeap, Zoë Hyde, Osvaldo P. Almeida, Paul E. Norman, S. A. Paul Chubb, Konrad Jamrozik, Leon Flicker and Graeme J. Hankey | en |
dc.language.iso | en | en |
dc.publisher | Endocrine Society | en |
dc.title | Lower Testosterone Levels Predict Incident Stroke and Transient Ischemic Attack in Older Men | en |
dc.type | Journal article | en |
dc.contributor.school | School of Population Health and Clinical Practice : Public Health | en |
dc.identifier.doi | 10.1210/jc.2008-2416 | en |
Appears in Collections: | Public Health publications |
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