Low-dose transdermal testosterone therapy improves angina threshold in men with chronic stable angina : A randomized, double-blind, placebo-controlled study

• Published in: Circulation (New York, N.Y.) Vol. 102; no. 16; pp. 1906 - 1911
• Main Authors: ENGLISH, Katherine M, STEEDS, Richard P, JONES, T. Hugh, DIVER, Michael J, CHANNER, Kevin S
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 17-10-2000; American Heart Association, Inc
• Subjects: Administration, Cutaneous; Analysis of Variance; Angina Pectoris - drug therapy; Biological and medical sciences; Cardiology. Vascular system; Chronic Disease; Coronary heart disease; Dose-Response Relationship, Drug; Double-Blind Method; Exercise Test - drug effects; Gonadal Steroid Hormones - administration & dosage; Gonadal Steroid Hormones - adverse effects; Heart; Humans; Male; Medical sciences; Middle Aged; Pain Threshold - drug effects; Pilot Projects; Quality of Life; Testosterone - administration & dosage; Testosterone - adverse effects; Treatment Outcome; Human; Pharmacologic test; Testosterone; Pain; Sex; Cardiovascular disease; Male; Angina pectoris; Coronary heart disease; Threshold; Percutaneous route
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.102.16.1906

Experimental studies suggest that androgens induce coronary vasodilatation. We performed this pilot project to examine the clinical effects of long-term low-dose androgens in men with angina.
Forty-six men with stable angina completed a 2-week, single-blind placebo run-in, followed by double-blind randomization to 5 mg testosterone daily by transdermal patch or matching placebo for 12 weeks, in addition to their current medication. Time to 1-mm ST-segment depression on treadmill exercise testing and hormone levels were measured and quality of life was assessed by SF-36 at baseline and after 4 and 12 weeks of treatment. Active treatment resulted in a 2-fold increase in androgen levels and an increase in time to 1-mm ST-segment depression from (mean+/-SEM) 309+/-27 seconds at baseline to 343+/-26 seconds after 4 weeks and to 361+/-22 seconds after 12 weeks. This change was statistically significant compared with that seen in the placebo group (from 266+/-25 seconds at baseline to 284+/-23 seconds after 4 weeks and to 292+/-24 seconds after 12 weeks; P:=0.02 between the 2 groups by ANCOVA). The magnitude of the response was greater in those with lower baseline levels of bioavailable testosterone (r=-0. 455, P:<0.05). There were no significant changes in prostate specific antigen, hemoglobin, lipids, or coagulation profiles during the study. There were significant improvements in pain perception (P:=0.026) and role limitation resulting from physical problems (P:=0.024) in the testosterone-treated group.
Low-dose supplemental testosterone treatment in men with chronic stable angina reduces exercise-induced myocardial ischemia.