Abstract
Testosterone level in men declines with age and if symptomatic, testosterone substitution is indicated. Low testosterone level in aging male is associated with increased prevalence of cardiovascular risk factors (obesity, hyperlipidaemia, decreased insulin sensitivity, increased inflammatory markers) and in some studies also with increased total and cardiovascular mortality.
In majority of interventional studies testosterone substitution improves these risk factors and in some the decrease of cardiovascular mortality was described. However, recent studies have raised concerns that testosterone therapy may increase cardiovascular risk.
This review summarizes these data with conclusion that testosterone therapy can be safely considered in men with increased cardiovascular risk and practical recommendations are given.