Sheffield Teaching Hospital NHS Trust, Sheffield, UK.
Asian J Androl. 2012 May;14(3):428-35. doi: 10.1038/aja.2012.21. Epub 2012 Apr 23.
Despite regional variations in the prevalence of coronary artery disease (CAD), men are consistently more at risk of developing and dying from CAD than women, and the gender-specific effects of sex hormones are implicated in this inequality. This 'Perspectives' article reviews the current evidence regarding the cardiovascular effects of testosterone in men including an examination of the age-related decline in testosterone, the relationship between testosterone levels and coronary disease, coronary risk factors and mortality. We also review the vaso-active effects of testosterone, and discuss how these have been used in men with heart failure and angina. We discuss the 'cause' versus 'effect' controversy, regarding low testosterone levels in men with coronary heart disease, as well as concerns over the use of testosterone replacement therapy in middle aged and elderly men. The article concludes with a discussion regarding the future direction for work in this interesting area, including the relative merits of screening for, and treating hypogonadism with testosterone replacement therapy in men with heart disease.
尽管冠心病（CAD）的流行在地区上存在差异，但男性患 CAD 和死于 CAD 的风险始终高于女性，性激素的性别特异性影响与此不平等有关。这篇“观点”文章回顾了目前关于男性睾丸激素对心血管影响的证据，包括对睾丸激素随年龄下降的检查、睾丸激素水平与冠心病、冠心病危险因素和死亡率之间的关系。我们还回顾了睾丸激素的血管活性作用，并讨论了如何将其用于心力衰竭和心绞痛的男性。我们讨论了关于冠心病男性低睾丸激素水平的“原因”与“结果”争议，以及对中年和老年男性使用睾丸激素替代疗法的担忧。文章最后讨论了在这个有趣的领域开展工作的未来方向，包括对心脏病男性进行睾丸激素缺乏筛查和用睾丸激素替代疗法治疗的相对优势。
