Testosterone and dihydrotestosterone and incident ischaemic stroke in men in the Cardiovascular Health Study

Molly M. Shores; Alice M. Arnold; Mary L. Biggs; W. T. Longstreth; Nicholas L. Smith; Jorge R. Kizer; Anne R. Cappola; Calvin H. Hirsch; Brett T. Marck; Alvin M. Matsumoto

doi:10.1111/cen.12452

Testosterone and dihydrotestosterone and incident ischaemic stroke in men in the Cardiovascular Health Study

Molly M. Shores, Alice M. Arnold, Mary L. Biggs, W. T. Longstreth, Nicholas L. Smith, Jorge R. Kizer, Anne R. Cappola, Calvin H. Hirsch, Brett T. Marck, Alvin M. Matsumoto

Medicine

Research output: Contribution to journal › Article › peer-review

55 Scopus citations

Abstract

Measurements Adjudicated ischaemic stroke. Results Among 1032 men (mean age 76, range 66-97), followed for a median of 10 years, 114 had an incident ischaemic stroke. Total T and free T were not significantly associated with stroke risk, while DHT had a nonlinear association with incident stroke (P = 0·006) in analyses adjusted for stroke risk factors. The lowest risk of stroke was at DHT levels of 50-75 ng/dl, with greater risk of stroke at DHT levels above 75 ng/dl or below 50 ng/dl.

Results were unchanged when SHBG was added to the model. Calculated free DHT had an inverse linear association with incident ischaemic stroke with HR 0·77 (95% CI, 0·61, 0·98) per standard deviation in analyses adjusted for stroke risk factors.

Conclusions Dihydrotestosterone had a nonlinear association with stroke risk in which there was an optimal DHT level associated with the lowest stroke risk. Further studies are needed to confirm these results and to clarify whether there is an optimal androgen range associated with the least risk of adverse outcomes in elderly men.

Objective Ischaemic stroke is a major cause of morbidity and mortality in elderly men. Our main objective was to examine whether testosterone (T) or dihydrotestosterone (DHT) was associated with incident ischaemic stroke in elderly men.

Design Cohort study.

Participants Elderly men in the Cardiovascular Health Study who had no history of stroke, heart disease or prostate cancer as of 1994 and were followed until December 2010.

Original language	English (US)
Pages (from-to)	746-753
Number of pages	8
Journal	Clinical Endocrinology
Volume	81
Issue number	5
DOIs	https://doi.org/10.1111/cen.12452
State	Published - Nov 1 2014

ASJC Scopus subject areas

Endocrinology, Diabetes and Metabolism
Endocrinology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/cen.12452

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@article{5531c72a433b47ebad7313f9670fa531,

title = "Testosterone and dihydrotestosterone and incident ischaemic stroke in men in the Cardiovascular Health Study",

abstract = "Measurements Adjudicated ischaemic stroke. Results Among 1032 men (mean age 76, range 66-97), followed for a median of 10 years, 114 had an incident ischaemic stroke. Total T and free T were not significantly associated with stroke risk, while DHT had a nonlinear association with incident stroke (P = 0·006) in analyses adjusted for stroke risk factors. The lowest risk of stroke was at DHT levels of 50-75 ng/dl, with greater risk of stroke at DHT levels above 75 ng/dl or below 50 ng/dl.Results were unchanged when SHBG was added to the model. Calculated free DHT had an inverse linear association with incident ischaemic stroke with HR 0·77 (95% CI, 0·61, 0·98) per standard deviation in analyses adjusted for stroke risk factors.Conclusions Dihydrotestosterone had a nonlinear association with stroke risk in which there was an optimal DHT level associated with the lowest stroke risk. Further studies are needed to confirm these results and to clarify whether there is an optimal androgen range associated with the least risk of adverse outcomes in elderly men.Objective Ischaemic stroke is a major cause of morbidity and mortality in elderly men. Our main objective was to examine whether testosterone (T) or dihydrotestosterone (DHT) was associated with incident ischaemic stroke in elderly men.Design Cohort study.Participants Elderly men in the Cardiovascular Health Study who had no history of stroke, heart disease or prostate cancer as of 1994 and were followed until December 2010.",

author = "Shores, {Molly M.} and Arnold, {Alice M.} and Biggs, {Mary L.} and Longstreth, {W. T.} and Smith, {Nicholas L.} and Kizer, {Jorge R.} and Cappola, {Anne R.} and Hirsch, {Calvin H.} and Marck, {Brett T.} and Matsumoto, {Alvin M.}",

note = "Publisher Copyright: {\textcopyright} 2014 John Wiley & Sons Ltd.",

year = "2014",

month = nov,

day = "1",

doi = "10.1111/cen.12452",

language = "English (US)",

volume = "81",

pages = "746--753",

journal = "Clinical Endocrinology",

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TY - JOUR

T1 - Testosterone and dihydrotestosterone and incident ischaemic stroke in men in the Cardiovascular Health Study

AU - Shores, Molly M.

AU - Arnold, Alice M.

AU - Biggs, Mary L.

AU - Longstreth, W. T.

AU - Smith, Nicholas L.

AU - Kizer, Jorge R.

AU - Cappola, Anne R.

AU - Hirsch, Calvin H.

AU - Marck, Brett T.

AU - Matsumoto, Alvin M.

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Measurements Adjudicated ischaemic stroke. Results Among 1032 men (mean age 76, range 66-97), followed for a median of 10 years, 114 had an incident ischaemic stroke. Total T and free T were not significantly associated with stroke risk, while DHT had a nonlinear association with incident stroke (P = 0·006) in analyses adjusted for stroke risk factors. The lowest risk of stroke was at DHT levels of 50-75 ng/dl, with greater risk of stroke at DHT levels above 75 ng/dl or below 50 ng/dl.Results were unchanged when SHBG was added to the model. Calculated free DHT had an inverse linear association with incident ischaemic stroke with HR 0·77 (95% CI, 0·61, 0·98) per standard deviation in analyses adjusted for stroke risk factors.Conclusions Dihydrotestosterone had a nonlinear association with stroke risk in which there was an optimal DHT level associated with the lowest stroke risk. Further studies are needed to confirm these results and to clarify whether there is an optimal androgen range associated with the least risk of adverse outcomes in elderly men.Objective Ischaemic stroke is a major cause of morbidity and mortality in elderly men. Our main objective was to examine whether testosterone (T) or dihydrotestosterone (DHT) was associated with incident ischaemic stroke in elderly men.Design Cohort study.Participants Elderly men in the Cardiovascular Health Study who had no history of stroke, heart disease or prostate cancer as of 1994 and were followed until December 2010.

AB - Measurements Adjudicated ischaemic stroke. Results Among 1032 men (mean age 76, range 66-97), followed for a median of 10 years, 114 had an incident ischaemic stroke. Total T and free T were not significantly associated with stroke risk, while DHT had a nonlinear association with incident stroke (P = 0·006) in analyses adjusted for stroke risk factors. The lowest risk of stroke was at DHT levels of 50-75 ng/dl, with greater risk of stroke at DHT levels above 75 ng/dl or below 50 ng/dl.Results were unchanged when SHBG was added to the model. Calculated free DHT had an inverse linear association with incident ischaemic stroke with HR 0·77 (95% CI, 0·61, 0·98) per standard deviation in analyses adjusted for stroke risk factors.Conclusions Dihydrotestosterone had a nonlinear association with stroke risk in which there was an optimal DHT level associated with the lowest stroke risk. Further studies are needed to confirm these results and to clarify whether there is an optimal androgen range associated with the least risk of adverse outcomes in elderly men.Objective Ischaemic stroke is a major cause of morbidity and mortality in elderly men. Our main objective was to examine whether testosterone (T) or dihydrotestosterone (DHT) was associated with incident ischaemic stroke in elderly men.Design Cohort study.Participants Elderly men in the Cardiovascular Health Study who had no history of stroke, heart disease or prostate cancer as of 1994 and were followed until December 2010.

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Testosterone and dihydrotestosterone and incident ischaemic stroke in men in the Cardiovascular Health Study

Abstract

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