Plasma testosterone is associated with Framingham risk score

Introduction: The Framingham risk score predicts a patient's 10-year risk of developing cardiovascular disease. Many risk factors included in its calculation influence or are influenced by circulating testosterone. To investigate the possible association between testosterone and cardiovascular risk, as defined by the Framingham score, a Veterans Affairs (VA) database was analyzed. Methods: A retrospective chart review was performed. Inclusion criteria were male sex and age ≥ 20 years. Exclusion criteria included pre-existing cardiovascular disease, stroke, and diabetes. Data were collected on veterans who had total plasma testosterone checked in the year 2008. Results: The study included 1,479 patients (mean age 61 years). Framingham score was negatively associated with both total testosterone (p<0.0001) and free testosterone (p=0.0003). There was a positive association between total testosterone and high-density lipoprotein and negative associations between total testosterone and body mass index (BMI), total cholesterol, triglycerides, and blood pressure medication use. Free testosterone was positively associated with total cholesterol, low-density lipoprotein, and current smoking status and negatively associated with age, BMI, and blood pressure medication use. The BMI was not associated with Framingham score. Conclusions: Lower plasma testosterone may suggest the presence of cardiovascular risk factors and potentially increased risk for heart disease.