Low dehydroepiandrosterone and ischemic heart disease in middle-aged men: Prospective results from the Massachusetts male aging study

The adrenal steroid dehydroepiandrosterone (DHEA) and its sulfate (DHEAS) h ave been characterized as "protective" against ischemic heart disease (IHD) , especially in men, on the basis of sparse epidemiologic evidence. The aut hors used data from the Massachusetts Mate Aging Study, a random sample pro spective study of 1,709 men aged 40-70 years at baseline, to test whether s erum levels of DHEA or DHEAS could predict incident IHD over a 9-year inter val. At baseline (1987-1989) and follow-up (1995-1997), an interviewer-phle botomist visited each subject in his home to obtain comprehensive health in formation, body measurements, and blood samples for hormone and lipid analy sis. Incident IHD between baseline and follow-up was ascertained from hospi tal records and death registries, supplemented by self-report and evidence of medication. In the analysis sample of 1,167 men, those with serum DHEAS in the lowest quartile at baseline (<1.6 <mu>g/ml) were significantly more likely to incur IHD by follow-up (adjusted odds ratio = 1.60, 95 percent co nfidence interval: 1.07, 2.39; p = 0.02), independently of a comprehensive set of known risk factors including age, obesity, diabetes, hypertension, s moking, serum lipids, alcohol intake, and physical activity. Low serum DHEA was similarly predictive. These results confirm prior evidence that low DH EA and DHEAS can predict IHD in men.