This is claimed by the authors of a study carried out at the University of Western Australia in Perth.
Middle-aged and older men with large waist circumference and levels of testosterone low / normal do not gain better vascular health when using one cream to supplement the hormone, but will benefit from a supervised exercise program, according to new data published online in Hypertension.
–
This, along with a growing body of literature, is in stark contrast to the idea that testosterone therapy is justified by the fact that it is a “health-preserving restorative hormone,” the study authors write, led by Lauren C. Chasland, of the University of Western Australia in Perth. In 2015, the researchers recall, the Food and Drug Administration of the United States published a safety notice urging caution when using testosterone, followed by more studies suggesting the potential for harm, even when use is indicated.
For this analysis, the researchers hypothesized that testosterone and exercise could, through two mechanisms, have an additive and positive effect on vascular function. “Physical training primarily upregulates the endothelium, and some evidence suggests that testosterone treatment improves vascular function of smooth muscles in men with coronary artery disease,” they explain.
To the authors’ surprise, this was not the case. “We expected men who received both testosterone treatment and exercise training to have the greatest improvement in vascular function,” they say. Instead, we found that while physical training improved vascular function, testosterone treatment did not, nor did testosterone enhance the effect of physical exercise training. “
Involved 80 men aged between 50 and 75 years – The 12-week study enrolled 80 men between the ages of 50 and 75 who had a waistline that measured = /> 95 cm and serum testosterone levels of 6 to 14 nmol / L. In a 2 × 2 factorial design, participants were randomized to a transdermal preparation (testosterone 5.0% w / v, 100 mg / 2 mL) or corresponding placebo and supervised exercise (aerobic and strength, two to three times per week) or no additional exercise. Current smokers and men already being treated with testosterone or drugs that affect testosterone level were excluded.
Self-reported testosterone adherence was 97.6%, and 96.5% of those assigned to exercise participated at least twice a week. Hormone therapy increased serum testosterone levels, such that 62% of those who received it had levels above 14 nmol / L, compared with 29% of those who received placebo. In terms of risk factors, neither testosterone nor exercise affected body mass index, weight, waist circumference, glucose level, or HDL cholesterol level differently.
Changes found in the 2 × 2 factorial design study – Hemoglobin A1c decreased slightly in both testosterone groups (for example, with or without exercise). Total cholesterol decreased with testosterone plus exercise but increased with testosterone alone. The hormone increased systolic blood pressure, a difference the researchers attribute to a decrease in the placebo groups. Testosterone was also linked to increased diastolic blood pressure. With exercise, the resting heart rate was reduced.
Vascular outcomes data were available for 78 people. Flow-mediated dilation (FMD) increased with added exercise (P = 0.003) but not with testosterone compared to placebo (P = 0.111). Neither option affected the glyceryl trinitrate response. The researchers say the gains seen here with exercise are likely to be significant. As for what doctors should tell their patients, they say the main message is that “if men want to improve the health of their arteries, exercise (provided there are no medical concerns or physical limitations) would be the way to do it. Testosterone – they continue does not appear to improve vascular function, at least for a period of 12 weeks ”.
In their article, the authors go further, advising that “caution should be applied when prescribing testosterone if the primary goal is to improve arterial function and health.” The group hopes to do a larger and longer study looking at other heart health measures. “The important question remains: What is the effect of testosterone treatment on coronary arteries and the heart?” they write.
Michael Emery, of the Cleveland Clinic, not involved in the study, says the question is interesting. Importantly, he says, the study “It did not concern men who were truly pathologically hypogonadal but a type of ‘gray zone’ with low / normal testosterone was examined in older men, a huge target for advertising”.
Emery adds that while the observed effects of exercise training on endothelial function were small, this could be because the program included what “Appears to be moderate intensity exercise below current recommended levels” 150 minutes per week. “What I see is that the exercise continues to win”, he concludes, underlining that “Any amount of getting off the couch and moving around improves cardiovascular results”.
Nurse Times editorial staff
Fonte: PharmaStar
–
