Endogenous Sex Hormones and Progression of Carotid Atherosclerosis in Elderly Men

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Abstract
Background— The burden of atherosclerosis especially afflicts the increasing older segment of the population. Recent evidence has emphasized a protective role of endogenous sex hormones in the development of atherosclerosis in aging men. Methods and Results— We studied the association between endogenous sex hormones and progression of atherosclerosis in 195 independently living elderly men. Participants underwent measurements of carotid intima-media thickness (IMT) at baseline in 1996 and again in 2000. At baseline, serum concentrations of testosterone (total and free) and estradiol (total and free E 2 ) were measured. Serum free testosterone concentrations were inversely related to the mean progression of IMT of the common carotid artery after adjustment for age (β=−3.57; 95% CI, −6.34 to −0.80). Higher serum total and free E 2 levels were related to progression of IMT of the common carotid artery after adjustment for age (β=0.38; 95% CI, −0.11 to 0.86; and β=0.018; 95% CI, −0.002 to 0.038, respectively). These associations were independent of body mass index, waist-to-hip ratio, presence of hypertension and diabetes, smoking, and serum cholesterol levels Conclusions— Low free testosterone levels were related to IMT of the common carotid artery in elderly men independently of cardiovascular risk factors.