Testosterone Therapy may help older men live longer

Restoring testosterone in older men to normal level through gels, patches, or injections may lower their risk of heart attack, stroke, or death from any cause, says a large study co-authored by an Indian-origin researcher.

The study also found that men who were treated but did not attain normal levels did not see the same benefits as those whose levels did reach normal.

“It is the first study to demonstrate that significant benefit is observed only if the dose is adequate to normalise the total testosterone levels,” said corresponding author of the study Rajat Barua, assistant professor of medicine at the University of Kansas in the US.

“Patients who failed to achieve the therapeutic range after testosterone replacement therapy did not see a reduction in (heart attack) or stroke and had significantly less benefit on mortality,” Barua noted.

The findings may sway the ongoing debate over testosterone therapy’s benefits and risks, especially for the heart.
So far, the medical community lacks results from any definitive clinical trial that might provide clear guidance.

Meanwhile, the US Food and Drug Administration (FDA) issued guidance earlier in 2015 advising clinicians about the over-use of testosterone therapy, and pointing to a possible increased risk of heart attack and stroke.

The new study looked at data on more than 83,000 men with documented low testosterone, all age 50 or above, who received care between 1999 and 2014.

The researchers divided the men into three clinical groups: those who were treated to the point where their total testosterone levels returned to normal, those who were treated but without reaching normal, and those who were untreated and remained at low levels.

The average follow-up across the groups ranged from 4.6 to 6.2 years. The sharpest contrast emerged between those who were treated and attained normal levels and those whose low testosterone went untreated.

The treated men were 56 percent less likely to die during the follow-up period, 24 per cent less likely to suffer a heart attack, and 36 per cent less likely to have a stroke.
The exact reasons for testosterone’s apparent benefits for the heart and overall survival are not known. Possible explanations, the researchers said, could involve body fat, insulin sensitivity, lipids, blood platelets, inflammation, or other biological pathways.

Source: indiatoday

Angry people ‘risking heart attacks


Having a hot temper may increase your risk of having a heart attack or stroke, according to researchers.

Rage often precedes an attack and may be the trigger, say the US researchers who trawled medical literature.

They identified a dangerous period of about two hours following an outburst when people were at heightened risk.

But they say more work is needed to understand the link and find out if stress-busting strategies could avoid such complications.

People who have existing risk factors, such as a history of heart disease, are particularly susceptible, they told the European Heart Journal.

In the two hours immediately after an angry outburst, risk of a heart attack increased nearly five-fold and risk of stroke increased more than three-fold, the data from nine studies and involving thousands of people suggests.

The Harvard School of Public Health researchers say, at a population level, the risk with a single outburst of anger is relatively low – one extra heart attack per 10,000 people per year could be expected among people with low cardiovascular risk who were angry only once a month, increasing to an extra four per 10,000 people with a high cardiovascular risk.

But the risk is cumulative, meaning temper-prone individuals will be at higher risk still.

Five episodes of anger a day would result in around 158 extra heart attacks per 10,000 people with a low cardiovascular risk per year, increasing to about 657 extra heart attacks per 10,000 among those with a high cardiovascular risk, Dr Elizabeth Mostofsky and colleagues calculate

Dr Mostofsky said: “Although the risk of experiencing an acute cardiovascular event with any single outburst of anger is relatively low, the risk can accumulate for people with frequent episodes of anger.”

It’s unclear why anger might be dangerous – the researchers point out that their results do not necessarily indicate that anger causes heart and circulatory problems.

Experts know that chronic stress can contribute to heart disease, partly because it can raise blood pressure but also because people may deal with stress in unhealthy ways – by smoking or drinking too much alcohol, for example.

The researchers say it is worth testing what protection stress-busting strategies, such as yoga, might offer.

Doireann Maddock, senior cardiac nurse at the British Heart Foundation, said: “It’s not clear what causes this effect. It may be linked to the physiological changes that anger causes to our bodies, but more research is needed to explore the biology behind this.

“The way you cope with anger and stress is also important. Learning how to relax can help you move on from high-pressure situations. Many people find that physical activity can help to let off steam after a stressful day.

“If you think you are experiencing harmful levels of stress or frequent anger outbursts talk to your GP.”

source: BBC news


Testosterone-heart disease link explained

In recent months, there has been a great deal of contradictory information regarding testosterone. So much so that it is hard for any man to decipher what level is right, and whether seeking an “optimal” level is the preferred course of action.

In 2011, 5.3 million prescriptions for testosterone were written in the United States. The rate of prescriptions has tripled since 2000, and sales reached $1.6 billion in 2011. There has obviously been a lot of marketing for testosterone and low-T syndrome, but what exactly is testosterone is and what would are the benefits of treatment?

Testosterone is a hormone which helps regulate heart function and plays a part in sperm production, bone health, energy levels, concentration and muscle mass. This essential hormone does much more than just fuel a man’s sex drive. The problem is, most men experience a natural decline in testosterone as they age starting at 30, and testosterone supplementation is commonly prescribed to help these men regulate their hormone levels. The benefits and risks of the long-term use of testosterone therapy however, are not well known.

In a new study, the University of Texas looked at 9,000 male veterans who had undergone coronary angiography between 2005 and 2011, a procedure for testing the arteries when people have symptoms such as chest pain or are at high risk for heart problems.

The study found that men with signs of heart problems who take injections of testosterone or use gel containing the hormone had a 30 percent increased risk of heart attack, stroke or dying, compared with men who didn’t use the hormone. The study was stopped early due to higher rates of heart problems in the group receiving the hormone.

It is important to note that all of the men in the study more severe medical conditions including coronary artery disease, diabetes and previous heart attacks, than men in the general population. These risk factors may have been part of the reason testosterone treatments were harmful to them, but more research is needed to know for sure.

It is not hard to see why medical professionals would also be divided when it comes to testosterone treatment. Some side effects include acne, enlarged breasts, prostate problems, testicle shrinkage and limited sperm production. Similarly, once you start on it, you suppress your own production of testosterone and injections become a lifetime commitment.

As is the case with most hormones, testosterone needs to be kept in balance, and your physician can decide what level is right for you since this, too, can vary from man to man, and from lab to lab. A treatment program should be frequently monitored through lab tests, paying attention to potential side effects.

Men with prostate cancer should not receive testosterone as it could speed up cancer growth. Testosterone is not thought to cause prostate cancer, but may speed up the severity of the disease.

Source news.nom

New imaging method ‘predicts’ heart attack risk

The Centers for Disease Control and Prevention (CDC) states that around 715,000 Americans suffer a heart attack every year. Now, scientists have created a new imaging technique that could identify which patients are at high risk. This is according to a study published in the The Lancet.

Researchers from the University of Edinburgh in the UK say the test – carried out using positron emission tomography (PET) and computed tomography (CT) – is able to “light up” dangerous fatty plaques in the arteries that are in danger of rupturing. This is a process that can cause heart attacks.

To reach their findings, the researchers analyzed 80 patients. Of these, 40 patients recently had a heart attack, while the other 40 patients had angina – restricted blood supply to the heart posing a higher risk of heart attack.

‘First step’ towards heart attack prevention

Using the PET-CT scanner, the researchers found that 90% of patients who had a heart attack showed a “lit up” yellow area in one of their blood vessels. This area corresponded exactly to the location of the plaque that caused the patients’ heart attacks, the researchers say.

The scanner also showed lit up plaques in around 40% of the patients with angina. Furthermore, the researchers found “high-risk” features in these patients that suggested a heart attack may be imminent, meaning they were in need of aggressive drug treatment or surgery.

Dr. Marc Dweck, of the University of Edinburgh and lead study author, says their findings are a step toward heart attack prevention:

“We have developed what we hope is a way to ‘light up’ plaques on the brink of rupturing and causing a heart attack.

If we could know how close a person is to having a heart attack, we could step in with medication or surgery before the damage is done. This is a first step towards that goal.”

Potential for identifying ‘ticking time bomb’ patients

The researchers say the next stage of this research is to confirm the findings and to determine whether the PET-CT imaging technique can improve the management and treatment of patients with coronary artery disease.

Prof. Peter Weissburg, medical director at the British Heart Foundation in the UK, which part-funded the study, notes that the technique looks promising:

“Being able to identify dangerous fatty plaques likely to cause a heart attack is something that conventional heart tests can’t do. This research suggests that PET-CT scanning may provide an answer – identifying ‘ticking time bomb’ patients at risk of a heart attack.”

“We now need to confirm these findings, and then understand how best to use new tests like this in the clinic to benefit heart patients,” he adds.

Source: Medical News Today


Long-lasting chest pains indicator of heart attack!

Researchers have claimed that patients suffering long-lasting chest pain are likelier to have a heart attack than those with pain of a shorter duration.

James McCord, M.D., a cardiologist at Henry Ford Hospital on the research team, said that patients can experience varying strength, location, and duration of chest pain, asserting that the variety of symptoms any one patient may experience during a heart attack is a challenge to the physician who is trying to distinguish between patients who are having a heart attack and those who are not.

Of 426 patients included in the study, 38 (less than 9 percent) had a final diagnosis of heart attack, with average chest pain duration of 120 minutes, compared with 40 minutes in patients without heart attack.

In patients with chest pain lasting less than five minutes, there were no heart attacks and no deaths at 30 days.

McCord said that these findings suggest that patients with chest pain lasting less than five minutes may be evaluated as an out-patient in their doctor’s office; while patients with chest pain greater than 5 minutes, without a clear cause, should seek prompt medical evaluation in an emergency department.

Patients were interviewed during the study to determine medical history and demographics. Those with a diagnosis of heart attack were significantly older.

The study has been published in Critical Pathways in Cardiology.