Cardiovascular Risk In Men Research Articles

Cardiovascular Risk Distribution in Argentina in 2018

Background: Cardiovascular diseases are the main cause of disability and death globally. Total cardiovascular risk (CR) is the probabilityof having a cardiovascular event in a defined period and is determined by the combined effect of risk factors.Objectives: The aim of this study was to estimate CR and describe its distribution in Argentina in 2018.Methods: Cardiovascular risk was analyzed in 11,450 individuals over 30 years of age from the 4th National Risk Factor Survey(NRFS). The Framingham risk equations used to estimate and calibrate global CR classified the individuals into the following threegroups: optimum CR ( 20%). Bayesian prevalence and credibility intervals (BCI)were estimated under the non-informative beta prior distribution.Results: Nationally, 60.6% of the individuals presented moderate/high CR. Moderate CR by region was distributed homogeneously.When analyzing extreme CRs, the metropolitan (47.6%) and Pampean (28.6%) regions presented the greatest incidence of high CR.The highest prevalence of optimum CR was found in the Patagonian region, followed by the Northwest, Northeast and Cuyo, allabove 40%. The analysis by province showed that the greatest incidence of high CR was found in Buenos Aires (49.9%) and CABA(45.7%). At all levels, the prevalence of moderate/high CR is much higher in men, with the exception of the metropolitan region.Conclusions: Geographical differences position the metropolitan region as the one with maximum CR due to the great incidence ofhigh and moderate CR. Prevalence of high CR in men is almost 4 times greater than that registered in women.

SAT-041 Testosterone Reduces Atherosclerosis and Plaque Specific Inflammatory Markers in the ApoE-/- Mouse Model

Low serum testosterone in men is an established cardiovascular risk factor and epidemiological evidence demonstrates an association between low testosterone and with coronary events. Clinical evidence suggests that testosterone therapy (Tth) can improve key cardiovascular risk factors in men and surrogate measures of atherosclerosis, the chronic inflammatory process underlying cardiovascular disease. Atherosclerotic plaque-specific testosterone actions are not fully understood. The present study investigates the influence of testosterone on mediators of vascular inflammation and plaque burden in an in vivo model of atherosclerosis. ApoE-/- mice were either sham operated, castrated or castrated and received fortnightly intramuscular injections of physiological doses of testosterone (mixed testosterone esters, Sustanon 100) to create 3 experimental groups; normal testosterone, testosterone deficient and testosterone replaced respectively. All groups were fed a high-fat ‘Western’ diet for 16 weeks. Lipid deposition in the aortic root was assessed by Oil Red O as an indication of atherosclerotic burden. Plaque composition was assessed immunohistochemically for indicators of stability including collagen content via Masson’s trichrome, and α-smooth muscle actin (αSMA) as well as markers of inflammation including vascular cell adhesion molecule-1 (VCAM-1), intracellular adhesion molecule-1 (ICAM-1), endothelial-leukocyte adhesion molecule 1 (E-Selectin), and a pan monocyte/macrophage marker (MOMA2). Testosterone deficient castrated mice had significantly increased lipid accumulation in the aortic root compared to testosterone replete sham-operated littermates (48% intima-media area vs 40%, p<0.05). Tth in castrated mice reversed this effect (39%, p<0.05). Plaque stability was not altered between groups. MOMA2 staining indicated increased infiltration and localisation of monocytes/macrophages in the plaques of castrated mice compared to sham-operated (positive staining (% of plaque) 77% vs 59%, P=0.062) and Tth treatment reduced this (77% vs 63%, P=0.1). Vascular cell adhesion molecule-1 (VCAM-1) and intracellular adhesion molecule-1 (ICAM-1) expression were reduced in castrated mice receiving Tth compared to castrated mice receiving saline (33% vs 46%, p<0.05; and 39% vs 58%, P=0.084 respectively). No significant difference in expression of E-Selectin and αSMA were observed between groups. These findings demonstrate that low testosterone increases aortic root lipid deposition and inflammatory composition in a mouse model of atherosclerosis. Increasing testosterone levels through Tth reduces plaque specific inflammatory markers and atherosclerotic burden. This indicates an anti-inflammatory mechanism by which testosterone can protect against the development and progression of atherosclerosis to reduce cardiovascular risk in men.

Cardiovascular Risk in Men with Prostate Cancer: Insights from the RADICAL PC Study.

We describe the cardiovascular risk profile in a representative cohort of patients with prostate cancer treated with or without androgen deprivation therapy. We prospectively characterized in detail 2,492 consecutive men (mean age 68 years) with prostate cancer (newly diagnosed or with a plan to prescribe androgen deprivation therapy for the first time) from 16 Canadian sites. Cardiovascular risk was estimated by calculating Framingham risk scores. Most men (92%) had new prostate cancer (intermediate risk 41%, high risk 50%). The highest level of education achieved was primary school in 12%. Most (58%) were current or former smokers, 22% had known cardiovascular disease, 16% diabetes, 45% hypertension, 31% body mass index 30 kg/m2 or greater, 24% low levels of physical activity, mean handgrip strength was 37.3 kg and 69% had a Framingham risk score consistent with high cardiovascular risk. Participants in whom androgen deprivation therapy was planned had higher Framingham risk scores than those not intending to receive androgen deprivation therapy, and this risk was abolished after adjustment for confounders. Two-thirds of men with prostate cancer are at high cardiovascular risk. There is a positive association between a plan to use androgen deprivation therapy and baseline cardiovascular risk factors. However, this association is explained by confounding factors.

P6293Assessment of testosterone/estradiol ratio, DHEA-S level and correlation with coronary inflammatory markers IL-1 &amp; 6, TNF-1 and hsCRP predict 5 years risk of cardiovascular disease in men

Abstract Background Previous data showed the adrenal sex hormone dehydroepiandrosterone (DHEA) which is present in serum mainly as the sulfate DHEA-S is the most abundant steroid hormone and another hormones like testosterone, estradiol are related to cardiovascular risk in men. Literatures revealed vascular and metabolic actions of DHEA/-S, evidence for an association between DHEA/-S levels and cardiovascular events is controversy. Objectives Our aim is to review and clear the contradictory point regarding cardiovascular risk and correlation of testeosterone/ estradiol ratio, DHEA-S level with coronary inflammatory markers in men. Methods Large population based cohort study done at multi centre of cardiology from 2013- 2018 in India. We enrolled total 23631 normal healthy male population age between 40 to 60 years and divided into two groups based on testosterone/estradiol ratio (Group A (n=2450) lower value of T/E ratio and Group B (n=21181) normal or higher T/E ratio. We did cohort analysis for 5 years and evaluated DHEA-S level and correlated it with coronary inflammatory markers and cardiovascular risk. Results In group A (low T/E ratio) we found low level of DHEA-S (98% of individual) and higher value of interleukins IL-1 (68%),IL-6 (74%) and tumor necrosis factor TNF-1 (71%) and high sensitive C-reactive protein (hsCRP) (73% of individual). Data revealed two fold increase of high blood pressure and LDL cholesterol level as compared to group B (normal or high T/E ratio and normal or high value of DHEA-S). 2.5 fold higher rate of coronary heart disease (CHD) found in group A versus in group B. We did not found as much significant difference in stroke, carotid and peripheral artery disease. T/E ratio and DHEA-S levels were inversely associated with the age-adjusted risk of a CHD event; the hazard ratios and 95% confidence intervals per standard deviation (SD) increase were 0.76 (0.66 to 0.91) and 0.82 (0.72 to 0.93), respectively. Conclusions Decrease ratio of testosterone/estradiol levels correlate decreased levels of DHEA-S which may increase the risk of CHD in men. For future aspect, correction of T/E ratio, DHEA-S and increase its awareness should be at mass level for prevention of CHD.

Fertility and Cardiovascular Risk in Men With Metabolic Syndrome

Fertility and Cardiovascular Risk in Men With Metabolic Syndrome

Statins for the treatment of hypercholesterolaemia in post menopausal women - solution or problem?

Studies have demonstrated that statins reduce cardiovascular risk in men and women, but the effectiveness of statins among low-risk women continues to be contentious. One reason is that the number of women enrolled in statin trials has been small relative to men, limiting statistical inferences. Also, for any given age women have a lower absolute risk of cardiovascular disease when compared to men. When absolute benefit is low, the risk of adverse effects becomes more important. Myopathy and rhabdomyolysis are rare but established side-effects of statin therapy, and concern is growing that statins could increase the risk of development of diabetes mellitus.

Could chronic Vardenafil administration influence the cardiovascular risk in men with type 2 diabetes mellitus?

IntroductionAppropriate algorithms for the prediction of cardiovascular risk are strongly suggested in clinical practice, although still controversial. In type 2 diabetes mellitus (T2DM), the beneficial effect of phosphodiesterase (PDE)-5 inhibitors is demonstrated on endothelial function but not on the estimation of cardiovascular risk.AimTo study whether the chronic Vardenafil administration to men with T2DM influences variables correlated with the predicted long-term cardiovascular risk calculated by different validated algorithms.MethodsPer-protocol analysis of a longitudinal, prospective, randomized, placebo-controlled, double-blind, investigator-started, clinical trial. 54 male patients affected by T2DM were assigned to study (26patients) and control-group (28patients), respectively. The study included a treatment phase (24weeks) (Vardenafil/placebo 10mg twice-daily) and a follow-up phase (24weeks). Three time points were considered: baseline(V0), end of treatment(V1) and end of the study(V2). Parameters evaluated: endothelial health-related parameters and cardiovascular risk, assessed by calculating the Framingham (coronary hart disease [CHD], myocardial infarction [MI], stroke and cardiovascular disease [CVD]), ASSIGN and CUORE equations.ResultsPredicted cardiovascular risk at ten years resulted different using the three algorithms chosen, without differences between study and control groups and among visits. IL-6 was directly related to CHD, CVD and CUORE scores at V1 and with MI and STROKE at V2. Similarly, hs-CRP was directly related to CHD, MI, STROKE and CUORE only at V1 in the study group. Testosterone serum levels were inversely related to CHD and MI at V1 in study group.DiscussionThe predicted cardiovascular risk is different depending on the algorithm chosen. Despite no predictive risk reduction after six months of treatment, a possible effect of Vardenafil could be hypothesized through its action on inflammation markers reduction and through restoration of normal testosterone levels.

Validity of a method for the self-screening of cardiovascular risk.

BackgroundThe validity of a cardiovascular risk self-screening method was assessed. The results obtained for self-measurement of blood pressure, a point-of-care system’s assessment of lipid profile and glycated hemoglobin, and a self-administered questionnaire (sex, age, diabetes, tobacco consumption) were compared with the standard screening (gold standard) conducted by a health professional.MethodsCrossover clinical trial on a population-based sample from Girona (north-eastern Spain), aged 35–74, with no cardiovascular disease at recruitment. Participants were randomized to one of the two risk assessment sequences (standard screening followed by self-screening or vice versa). Cardiovascular risk was estimated with the Framingham-REGICOR function. Concordance between methods was estimated with the intraclass correlation coefficient (ICC). Sensitivity, specificity, and positive and negative predictive values were estimated, considering 5% cardiovascular risk as the cutoff point. ClinicalTrials.gov Registration #NCT02373319. Clinical Research Ethic Committee of the Parc de Salut Mar Registration #2014/5815/I.ResultsThe median cardiovascular risk in men was 2.56 (interquartile range: 1.42–4.35) estimated by standard methods and 2.25 (1.28–4.07) by self-screening with ICC=0.92 (95% CI: 0.90–0.93). In women, the cardiovascular risk was 1.14 (0.61–2.10) by standard methods and 1.10 (0.56–2.00) by self-screening, with ICC=0.89 (0.87–0.90). The sensitivity, specificity, and positive and negative predictive values for the self-screening method were 0.74 (0.63–0.82), 0.97 (0.95–0.99), 0.86 (0.77–0.93), and 0.94 (0.91–0.96), respectively, in men. In women, these values were 0.50 (0.30–0.70), 0.99 (0.98–1), 0.81 (0.54–0.96), and 0.97 (0.95–0.99), respectively.ConclusionThe self-screening method for assessing cardiovascular risk provided similar results to the standard method. Self-screening had high clinical performance to rule out intermediate or high cardiovascular risk.

0445 Different Mechanisms of Cardiovascular Risk in Men with OSA: The Role of the Arousal Threshold

0445 Different Mechanisms of Cardiovascular Risk in Men with OSA: The Role of the Arousal Threshold

Trace Elements in Saliva as Markers of Type 2 Diabetes Mellitus.

To analyze Mg, Ca, and Zn levels in saliva, comparing patients with type 2 diabetes mellitus and a control group of healthy subjects. This transversal, observational, clinical study included a total sample of 147 patients, 74 with type 2 diabetes mellitus and a control group of 73 healthy subjects. Socio-demographic, anthropometric, diabetological, and metabolic variables were registered. Trace elements in non-stimulated basal saliva were measured using inductively coupled plasma mass spectrometry (ICP-MS): Mg, Ca, and Zn. Concentrations of zinc, calcium, and magnesium were significantly higher in the diabetic group than the control group (p< 0.001). A relation was observed between waist circumference and high cardiovascular risk in men (based on two categories: waist circumference < 102cm; waist circumference ≥ 102cm), and magnesium levels in saliva (p= 0.003). Magnesium, zinc, and calcium levels in saliva could be useful markers for differentiating patients with type 2 diabetes mellitus from non-diabetics. The salivary magnesium could be used as a marker of high cardiovascular risk when associated with abdominal obesity represented by a waist circumference ≥ 102cm in men. The present results do suggest that salivary zinc levels could act as a good marker of type 2 diabetes mellitus, in light of zinc's well-known role as a co-marker of insulin and its relationship to carbohydrate metabolism.

Testosterone Protects Against Atherosclerosis in Male Mice by Targeting Thymic Epithelial Cells-Brief Report.

Androgen deprivation therapy has been associated with increased cardiovascular risk in men. Experimental studies support that testosterone protects against atherosclerosis, but the target cell remains unclear. T cells are important modulators of atherosclerosis, and deficiency of testosterone or its receptor, the AR (androgen receptor), induces a prominent increase in thymus size. Here, we tested the hypothesis that atherosclerosis induced by testosterone deficiency in male mice is T-cell dependent. Further, given the important role of the thymic epithelium for T-cell homeostasis and development, we hypothesized that depletion of the AR in thymic epithelial cells will result in increased atherosclerosis. Prepubertal castration of male atherosclerosis-prone apoE-/- mice increased atherosclerotic lesion area. Depletion of T cells using an anti-CD3 antibody abolished castration-induced atherogenesis, demonstrating a role of T cells. Male mice with depletion of the AR specifically in epithelial cells (E-ARKO [epithelial cell-specific AR knockout] mice) showed increased thymus weight, comparable with that of castrated mice. E-ARKO mice on an apoE-/- background displayed significantly increased atherosclerosis and increased infiltration of T cells in the vascular adventitia, supporting a T-cell-driven mechanism. Consistent with a role of the thymus, E-ARKO apoE-/- males subjected to prepubertal thymectomy showed no atherosclerosis phenotype. We show that atherogenesis induced by testosterone/AR deficiency is thymus- and T-cell dependent in male mice and that the thymic epithelial cell is a likely target cell for the antiatherogenic actions of testosterone. These insights may pave the way for new therapeutic strategies for safer endocrine treatment of prostate cancer.

Erectile Dysfunction and Subclinical Cardiovascular Disease.

An association between erectile dysfunction (ED) and cardiovascular (CV) disease (CVD) has long been recognized, and studies suggest that ED is an independent marker of CVD risk. More significantly, ED is a marker for both obstructive and non-obstructive coronary artery disease (CAD) and may reveal the presence of subclinical CAD in otherwise asymptomatic men. To discuss the role of ED as an early marker of subclinical CVD; describe an approach to quantifying that burden; and propose an algorithm for the evaluation and management of CV risk in men 40-60 years of age with vasculogenic ED, those presumed to have the highest risk for a CV event. A comprehensive review of original literature and expert consensus documents was conducted and incorporated into clinical recommendations for ED management in the context of CV risk. Assessment and management of ED may help identify and reduce the risk of future CV events. Initial evaluation should distinguish between vasculogenic ED and ED of other etiologies. For men with predominantly vasculogenic ED, we recommend that initial CV risk stratification be based on the 2013 American College of Cardiology/American Heart Association atherosclerotic CV disease risk score. Management of men with ED who are at low risk for CVD should focus on risk factor control; men at high risk, including those with CV symptoms, should be referred to a cardiologist. Intermediate-risk men should undergo non-invasive evaluation for subclinical atherosclerosis. Evidence supports use of a prognostic markers, particularly coronary calcium score, to further understand CV risk in men with ED. Clinicians must assess the presence or absence of ED in every man >40 years of age, especially those men who are asymptomatic for signs and symptoms of CAD. We support CV risk stratification and CVD risk factor reduction in all men with vasculogenic ED. Miner M, Parish SJ, Billups KL, etal. Erectile Dysfunction and Subclinical Cardiovascular Disease. Sex Med Rev 2018;7:455-463.

Testosterone and its metabolites: differential associations with cardiovascular and cerebrovascular events in men.

As men grow older, circulating testosterone declines while the incidence of cardiovascular disease increases. Thus, the role of sex hormones as biomarkers, and possibly contributing factors to clinical manifestations of cardiovascular disease in the increasing demographic of aging men, has attracted considerable interest. This review focuses on observational studies of endogenous androgens, namely circulating testosterone and dihydrotestosterone, which have examined their associations with cardiovascular events such as myocardial infarction and stroke. Studies which have examined the associations of endogenous estrogens, namely circulating estradiol, with these outcomes are also discussed. In large prospective cohort studies of predominantly middle-aged and older men, lower circulating testosterone consistently predicts higher incidence of cardiovascular events. Of note, both lower circulating testosterone and lower dihydrotestosterone are associated with higher incidence of stroke. These associations are less apparent when myocardial infarction is considered as the outcome. Results for estradiol are inconsistent. Lower circulating testosterone has been shown to predict higher cardiovascular disease-related mortality, as has lower circulating dihydrotestosterone. It is possible that the relationship of circulating androgens to cardiovascular events or mortality outcomes may be U-shaped rather than linear, with an optimal range defining men at lowest risk. Epidemiological studies are observational in nature and do not prove causality. Associations observed in studies of endogenous androgens need not necessarily translate into similar effects of exogenous androgens. Rigorous randomized controlled trials are needed to clarify the effects of testosterone treatment on cardiovascular risk in men.

Serum Sortilin Associates With Aortic Calcification and Cardiovascular Risk in Men.

Genome-wide association studies and preclinical studies demonstrated a role of sortilin in lipid metabolism, inflammation, and vascular calcification-all cardiovascular risk factors. We evaluated the association of serum sortilin levels with the risk of major adverse cerebrovascular and cardiovascular events (MACCE) and the severity of abdominal aortic calcification (AAC). A cohort of community-dwelling men aged ≥50 years (n=830) was assessed. At baseline, sortilin levels were measured by ELISA, and AAC was assessed on lateral spine scans obtained by dual-energy X-ray absorptiometry. Men aged ≥60 years (n=745) were followed up prospectively for the incidence of MACCE. During the median follow-up of 7.9 years, 76 MACCE occurred. The unadjusted incidence of MACCE across increasing sortilin quartiles was 8.0, 7.4, 19.8, and 20.3 per 1000 person-years. In multivariate-adjusted analysis, sortilin associated with increased risk of MACCE (hazard ratio, 1.70 per SD; 95% confidence interval, 1.30-2.20; P<0.001). The third and fourth quartiles associated with 3.42-fold (95% confidence interval, 1.61-7.25; P<0.005) and 3.82-fold (95% confidence interval, 1.77-8.26; P<0.001) higher risk of MACCE compared with the first quartile. High sortilin also predicted MACCE independent of traditional Framingham risk factors. Higher sortilin associated with higher odds of severe AAC (score>5) after adjustment for confounders (odds ratio, 1.43 per SD; 95% confidence interval, 1.10-1.85; P<0.01). The highest sortilin quartile associated with 2-fold higher odds of severe AAC (versus 3 lower quartiles combined). After adjustment for low-density lipoprotein cholesterol, the odds of severe AAC remained significant. In older men, higher serum sortilin levels associated with higher MACCE risk and severe AAC independently of relevant confounders, including C-reactive protein and low-density lipoprotein cholesterol. This finding, however, needs to be validated in other cohorts.

New version of the European guidelines on cardiovascular disease prevention in clinical practice

In 2016 a new edition of the European guidelines on cardiovascular disease prevention in clinical practice was published. Guidelines based on evidence-based medicine are a guide to primary and secondary prevention of cardiovascular diseases for health workers. The ofcial translation of the Russian version is expected in July 2017. This article is devoted to a review of the main provisions of these guidelines. In the updated version, compared with the version of 2012, more attention is paid to the population approach, specifc interventions, special groups of patients, the classes of evidence have been changed for a number of recommendations, and emphasis is placed on a multidisciplinary approach to the prevention of cardiovascular diseases. For the frst time, experts point out the inexpediency of assessing cardiovascular risk in men under 40 and women under 50 without known risk factors due to possible false positive results. Patients with erectile dysfunction are not recommended to conduct routine screening of cardiovascular diseases. In addition, much attention is paid to the defnition of quality of life, diagnosis and treatment of anxiety and depression of the patient, as these conditions increase cardiovascular risk and affect patient adherence to therapy.

Age-Related Testosterone Decline: Whom Do We Treat and Why?

Late-onset hypogonadism (LOH) is characterized by hypogonadal symptoms, together with low serum testosterone values, in men of advancing age. For a variety of reasons, LOH has become popular in both the lay press and the scientific community. While the overall prevalence of LOH is relatively low, the potential sequelae of untreated LOH can be considerable for affected men. The diagnosis of LOH can be challenging, as symptoms are generally nonspecific and overlap with a variety of medical and psychological problems. Testosterone therapy (TTh) for affected men has become increasingly controversial after several recent observational studies observed an increased cardiovascular risk associated with TTh. However, prior studies have observed little or no cardiovascular risk associated with TTh, and recent studies also support a low cardiovascular risk in men on TTh. In this review, we discuss the LOH patient and controversy surrounding this condition and outline potential risks and benefits of treatment.

Taking the opportunity to assess cardiovascular risk in men

Taking the opportunity to assess cardiovascular risk in men

The Association of Erectile Dysfunction and Cardiovascular Disease: A Systematic Critical Review.

Despite strong association between erectile dysfunction (ED) and cardiovascular disease (CVD), there is a paucity of clear clinical guidelines detailing when and how to evaluate for ED in patients with known CVD, or vice versa. This systematic review discuss the role of cardiologists and urologists in the characterization of risk and management of CVD in the setting of ED, as well as contrasting the current evaluation of CVD and ED from the standpoint of published consensus statements. A comprehensive literature review utilizing MEDLINE®, the Cochrane Library® Central Search, and the Web of Science was performed to identify all published peer-reviewed articles in the English language describing ED and CVD across various disciplines. There is strong consensus that men with ED should be considered at high risk of CVD. Available risk assessment tools should be used to stratify the coronary risk score in each patient. The 2012 Princeton III Consensus Conference expanded on existing cardiovascular recommendations, proposing an approach to the evaluation and management of cardiovascular risk in men with ED and no known CVD. This systematic review highlights the similarities and differences of the existing clinical guidelines and recommendations regarding assessment and management of ED and CVD, as well as the pathophysiological linkage between ED and CVD, which may permit physicians, including urologists, to perform opportunistic screening and initiate secondary prophylaxis with regard to cardiovascular risk factors, particularly in young, nondiabetic men with ED.

Cardiovascular Risk in Men Aged Over 40 in Boa Vista, Brazil.

Background:Cardiovascular disease is the most common cause of disease in the developed world. Early detection and risk prediction are a key component in reducing cardiovascular mortality. The Framingham Risk Score uses age, sex, cholesterol, blood pressure, diabetes, and smoking to calculate the 10-year risk probability of developing cardiovascular disease for a given patient. The aim of this study was to examine cardiovascular disease risk in men aged over 40 years in Boa Vista, Brazil and identify socioeconomic factors contributing to the risk.Methods:This was an epidemiological, cross-sectional, descriptive study. Physical examination and questionnaire survey were conducted on the participants.Results:Of the 598 participants (average age = 55.38 ± 10.77 years), 346 completed all the examinations and answered the survey, while 252 completed the survey and the physical examinations but did not undertake the laboratory tests. A large proportion of participants were overweight (42.6%) or obese (23.6%), 14.5% were hypertensive, and 71.9% were prehypertensive. Consumption of red meat and junk food was high, while participation in the exercise was low. Framingham scores ranged from −3 to 13 (mean score: 3.86 ± 3.16). A total of 204 participants (34.1%) had a low risk of cardiovascular disease, 98 (16.4%) had a medium risk, and 44 (7.4%) possessed high risk. Increased abdominal circumference (P = 0.013), resting pulse (P = 0.002), and prostate-specific antigen levels (P < 0.001) were associated with increased risk of cardiovascular disease.Conclusions:Our study highlights a worrying trend in increasing obesity and hypertension, most likely associated with increasingly poor diet and reduced participation in exercises. As the Brazilian population ages, this will drive increasing rates of cardiovascular mortality unless these trends are reversed. This study suggests that such campaigns should focus on men over the age of 40, who are married or divorced and of lower income.

Differential effects of strength training and testosterone treatment on soluble CD36 in aging men: Possible relation to changes in body composition

Purpose. We measured soluble CD36 (sCD36) and body composition to determine the effects of testosterone treatment (TT) and/or strength training (ST) on cardiovascular risk in men with low normal testosterone levels. Methods. Double-blinded, placebo-controlled study in 54 men aged 60–78 years with bioavailable testosterone < 7.3 nmol/L and waist > 94 cm randomized to TT (gel, 50–100 mg/day, n = 20), placebo (n = 18) or ST (n = 16) for 6 months. Moreover, the ST group was randomized to TT (ST + TT, n = 7) or placebo (ST + placebo, n = 9) after 3 months. Outcomes. sCD36, total and regional fat mass were established by Dual X-ray absorptiometry and magnetic resonance imaging. Data are presented as median (quartiles). Kruskal-Wallis and Mann-Whitney tests were performed on delta values at 0, 3 and 6 months. Results. ST + placebo decreased sCD36 levels by 21% [from 0.80 (0.68–1.22) to 0.63 (0.51–0.73) rel. units] vs. TT and vs. placebo (p < 0.05). ST + placebo did not change bioavailable testosterone and lean body mass. Fat mass measures significantly improved during ST + placebo, ST + TT, and TT vs. placebo. During ST + placebo, delta sCD36 was associated with delta total fat mass (r = 0.81) and delta central fat mass (r = 0.84). Conclusions. Compared to testosterone treatment, six months of strength training reduced sCD36 levels suggesting decreased cardiovascular risk, possibly due to a reduction in central fat mass.