Cardiovascular safety in middle-aged and older men under testosterone replacement therapy: a systematic review and meta-analysis.
EndocrineOct 6, 2026 (epub)
Hongzhuo Qin, Dandan Zuo, Zhan Wang et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the cardiovascular safety of testosterone replacement therapy (TRT) in middle-aged and older men, analyzing data from 31 randomized-controlled trials involving 9,437 participants. TRT was associated with significant reductions in total cholesterol, triglycerides, and low-density lipoprotein, while a potential arrhythmia safety signal was noted. The findings suggest TRT may lower cardiovascular risk factors.
Key findings
- TRT significantly reduced total cholesterol by 10.20 mg/dL compared to placebo.
- Triglycerides decreased by 7.03 mg/dL with TRT versus placebo.
- Exercise time to onset of 1-mm ST-segment depression increased by 67.37 seconds with TRT.
- A potential arrhythmia safety signal was observed with an odds ratio of 1.58.
Why it matters
Understanding the cardiovascular implications of TRT is crucial for clinicians managing middle-aged and older men with hypogonadism, as it may influence treatment decisions and patient safety.