This review assesses the evidence of the physiological effects of testosterone on cardiovascular health, the association between male hypogonadism and cardiovascular health, and the effects of testosterone therapy on cardiovascular health in male hypogonadism. Preclinical studies suggest complex effects of testosterone on cardiovascular risk by acting on skeletal muscle, cardiomyocytes, vasculature, adipocytes, insulin action, and erythropoiesis. Furthermore, low testosterone has a bi-directional association with cardiometabolic risk. Observational studies have reported worse metabolic profiles in men with organic hypogonadism. However, a consistent association between major cardiovascular events and male hypogonadism has not been established. Hematocrit increases with testosterone therapy; however, most studies do not report an increase in venous thromboembolism risk. Although some observational studies and a small randomized controlled study reported an increased risk of cardiovascular disease, recent data confirm the medium-term cardiovascular safety of testosterone therapy in middle-aged and older men with low testosterone.

中文翻译：

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男性性腺功能减退症的心血管疾病和睾酮治疗


本综述评估了睾酮对心血管健康的生理影响的证据，男性性腺功能减退症与心血管健康之间的关联，以及睾酮治疗对男性性腺功能减退症心血管健康的影响。临床前研究表明，睾酮通过作用于骨骼肌、心肌细胞、脉管系统、脂肪细胞、胰岛素作用和红细胞生成对心血管风险的复杂影响。此外，低睾酮与心脏代谢风险呈双向关联。观察性研究报告称，患有器质性腺功能减退症的男性的代谢特征较差。然而，主要心血管事件与男性性腺功能减退症之间的一致关联尚未确定。睾酮治疗后血细胞比容增加;然而，大多数研究并未报告静脉血栓栓塞风险增加。尽管一些观察性研究和一项小型随机对照研究报告了心血管疾病的风险增加，但最近的数据证实了睾酮治疗对低睾酮的中老年男性的中期心血管安全性。