Testosterone Therapies & Heart Attack Risks

Testosterone replacement therapy has been linked to an increased risk of serious cardiovascular side effects. Men who took testosterone therapies for “low-T” may have had a higher than normal heart attack risk, blood clot risk and risk of other serious events.

Quick Summary
Testosterone Heart Attack Risk

Testosterone replacement therapy has been promoted and used for a non-medical condition called “Low-T”. Men who used testosterone may have unknowingly been placed at increased risk for serious side effects including heart attack, stroke and other complications.

Testosterone may increase the risk of heart attack in two ways, by changes in cholesterol metabolism which can promote Coronary Artery Disease and by increased blood clot formation. Either condition may increase the risk of a sudden blockage of arteries which supply oxygen to heart muscle. If the blood and oxygen supply is cut off, heart tissue may be damaged or even result in myocardial infarction or heart attack and may also lead to death.

Testosterone is a male hormone that is naturally occurring in the human body. It is approved as a medication to treat low testosterone levels caused by hypogonadism. Even though it has not been approved to treat age-related testosterone decline or “Low-T”, many men have used it for this reason. Drug manufacturers have been accused of improper marketing and of hiding the risks of heart attack, cardiovascular disorders and other side effects.

Testosterone and Heart Attack

Testosterone use can increase the chances of heart attack through development of coronary artery disease (CAD) because of changes in the body’s metabolism of cholesterol. Testosterone use has also been shown to increase the risk of heart attack due to blood clot development. Either of these conditions can block off the blood flow to the heart muscle, resulting in myocardial infarction or heart attack.

Symptoms of heart attack include:

  • Sudden pain in the chest, back, arm, shoulder or jaw on one or both sides
  • Sudden pressure sensation of the chest
  • Sudden anxiety
  • Shortness of breath
  • Nausea
  • Lightheadedness or dizziness
  • Sweating with cold, clammy skin

Symptoms of heart attack should be treated as a medical emergency.

Coronary Artery Disease and Heart Attack

Coronary artery disease (CAD) is caused by a narrowing of the arteries that supply blood and oxygen to the heart tissue. CAD is usually caused by development of cholesterol-based deposits, known as plaques, along the inside of the arteries, also called atherosclerosis or arteriosclerosis. Testosterone is known to cause changes in the metabolism of lipids and cholesterol, making development of CAD more likely.

Over time, narrowing of the arteries supplying blood and oxygen will cause weakening of the heart muscle. These blood vessels may eventually become completely blocked, requiring medical intervention. The vessels may be opened to restore blood supply by performance of a balloon dilation procedure known as angioplasty. If angioplasty is not possible, a heart bypass procedure may be required to reroute blood vessels and restore arterial blood flow.

Myocardial infarction (MI) or heart attack is caused by a sudden blockage of the blood flow to the heart muscle. If the cardiac muscle does not have oxygen supply, the tissue will die. In some cases, CAD may lead to heart attack but in other cases, heart attack may be caused by a blood clot which has developed elsewhere in the body.

Blood Clots and Heart Attack

Blood clots are formed in the body when a tissue is injured or when blood cells are travelling too slowly or are too close together. Testosterone increases blood clot formation in two ways, by restriction of blood vessels in the case of coronary artery disease or due to changes in blood clotting mechanisms.

Testosterone causes increases in hemoglobin and hematocrit levels, making the blood slightly “thicker” than normal. Testosterone also increases the production of a body chemical known as thromboxane which increases the blood pressure through vasoconstriction. CAD-related narrowing of blood vessels may cause the blood cells to “bump” into each other near plaque deposits leading to clot development. When the blood is thicker and under greater pressure, blood cells will more easily begin to clump together and develop a clot.

Clots can be formed anywhere in the body but often develop as deep vein thrombosis (DVT) in the legs. No matter where they are formed, they may break free and travel to the brain, heart, or lungs. Clots that travel to the heart may cause a heart attack.

Based on two studies which showed an increased risk of cardiovascular events including heart attack, in January of 2014, the Food and Drug Administration announced an investigation regarding testosterone use and heart attack. In 2015, the agency required changes to drug labeling which included a warning about heart attack risks. This was followed shortly by addition of a risk about blood clot formation.

Testosterone Replacement Side Effects

In addition to heart attack, use of testosterone therapy may cause serious side effects, including others that are life-threatening.

Serious side effects of testosterone replacement may include:

Testosterone replacement also causes a number of less-serious effects which may be mild to moderate but are not life-threatening.

Testosterone Heart Attack Lawsuits

Men who experienced heart attack or loved ones of those who died after using testosterone replacement therapy products have filed testosterone lawsuits against drug manufacturers. Drug companies have been accused of improperly marketing testosterone replacement products for “Low-T” or encouraging practitioners to prescribe the medications for normal symptoms of aging. Many of the men who were prescribed testosterone, have never had laboratory testing to check testosterone levels.

Plaintiffs may be eligible for monetary awards for actual damages due to serious injury or death and for punitive damages.

Notwithstanding claims relating to this product, the drug/medical device remains approved by the U.S. FDA. 

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