Abstract

ORTUNO, María Victoria  and  KNOBLOVITS, Pablo. Hormone replacement therapy and cardiovascular disease in the hypogonadal adult men. Rev. argent. endocrinol. metab. [online]. 2018, vol.55, n.3, pp.41-50. ISSN 1851-3034.

The diagnosis of hypogonadism requires of the presence of symptoms and signs suggestive of testosterone deficiency associated with confirmation by laboratory studies of testosterone below the normal value. It has been described an increase in the prescription of androgenic therapy in late onset hypogonadism (associated with aging) and there is concern of its potential adverse effects, especially on cardiovascular events. The proposed physiopathological mechanisms, related to the adverse effects of testosterone on the cardiovascular system include: increased expression of thromboxane A2 receptors (TXA2), increased expression of vascular cell adhesion molecule-1 (VCAM1), stimulation of erythropoiesis with the development of polycythemia, as well as an increase in the incidence of sleep apnea syndrome. On the other hand, evidence exists on the association of not treated hypogonadism with an increase in cardiovascular disease and mortality.

It is suggested to consider the use of testosterone therapy in patients with symptomatic hypogonadism, always taking into account the possible risks and benefits associated with its use and being careful on its indication in fragile patients with high cardiovascular risk.

Keywords : Hypogonadism; Hormone replacement therapy; Testosterone; Cardiovascular disease.

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