What is the Origin of Cardiovascular Risk of TRT?

This term emerged from pharmacovigilance and large-scale epidemiological studies following the widespread clinical adoption of TRT for age-related testosterone decline. While testosterone's influence on cardiovascular health has long been studied, the focused discussion on "Cardiovascular Risk of TRT" intensified following publications that suggested an increased incidence of major adverse cardiovascular events in certain patient populations. The ongoing debate and regulatory scrutiny have established this as a key consideration in the contemporary practice of hormonal medicine.

What is the Mechanism of Cardiovascular Risk of TRT?

The proposed mechanisms linking TRT to cardiovascular risk are complex and remain under active investigation, involving both direct and indirect effects on the vascular system. Potential pathways include TRT-induced erythrocytosis, which increases blood viscosity and thrombotic risk, or changes in the lipid profile and inflammatory markers. Additionally, supraphysiological testosterone levels may accelerate atherosclerosis in vulnerable individuals, though physiological replacement doses are often cardioprotective in truly hypogonadal men. Clinical management requires monitoring hematocrit, blood pressure, and lipid parameters to mitigate these potential physiological changes.

Cardiovascular Risk of TRT

Meaning

The cardiovascular risk of Testosterone Replacement Therapy (TRT) refers to the potential for adverse effects on the heart and blood vessels associated with the administration of exogenous testosterone. This clinical concern encompasses a spectrum of potential complications, including myocardial infarction, stroke, venous thromboembolism, and changes in lipid profiles or blood pressure. Evaluating this risk requires a careful assessment of a patient’s pre-existing cardiac health, baseline hormonal status, and comorbidities before initiating any testosterone treatment. Clinicians must weigh the documented benefits of TRT for hypogonadism against the evidence, often conflicting, regarding its potential vascular impact.