THE RELATIONSHIP OF NATURAL ANDROGENS TO CORONARY HEART-DISEASE IN MALES - A REVIEW

Published studies dealing with the relationship between circulating le vels of testosterone and dehydroepiandrosterone (sulfate) (DHEA(S)) an d coronary heart disease (CHD) in males, as well as corresponding expe rimental animal studies are reviewed. One randomized intervention stud y, eight prospective and 30 cross-sectional studies have evaluated thi s relationship. In the intervention study, testosterone undecanoate gi ven orally significantly improved angina pectoris in 62 patients with CHD as compared to placebo. No significant association between serum t estosterone and CHD was reported in the prospective studies, whereas t hose studies concerning DHEAS found either no or an inverse associatio n with CHD. Of 30 cross-sectional studies, 18 reported reduced concent rations of testosterone (primarily), and/or DHEA(S) in CHD patients as compared to normals, 11 found similar circulating levels of these and rogens in controls and patients with CHD, and one study found elevated levels of DHEA(S) in patients. Animal studies (six in male rabbits an d one in male chicks) suggest an anti-atherogenic effect of testostero ne and DHEA. In conclusion, one intervention, eight cohort and several cross-sectional studies suggest either a neutral or a favourable effe ct of testosterone and DHEA(S) on CHD in males.