Low testosterone concentrations and prediction of future heart failure in men and in women: evidence from the large FINRISK97 study

TY - JOUR

T1 - Low testosterone concentrations and prediction of future heart failure in men and in women: evidence from the large FINRISK97 study

AU - Schäfer, Sarina

AU - Aydin, Muhammet Ali

AU - Appelbaum, Sebastian

AU - Kuulasmaa, Kari

AU - Palosaari, Tarja

AU - Ojeda, Francisco

AU - Blankenberg, Stefan

AU - Jousilahti, Pekka

AU - Salomaa, Veikko

AU - Karakas, Mahir

N1 - © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

PY - 2021/8

Y1 - 2021/8

N2 - AIMS: The increased incidence of heart failure in men suggests that endogenous sex hormones might play a role in the development of heart failure, but epidemiological data remain sparse. Here, we evaluated the predictive value of low testosterone levels on future heart failure in the large population-based FINRISK97 study.METHODS AND RESULTS: Baseline serum testosterone concentrations were measured in 7855 subjects (3865 men and 3990 women) of the FINRISK97 study. During a median follow-up (FU) of 13.8 years, a total of 564 heart failure events were recorded. The age-adjusted baseline testosterone levels did not differ significantly between subjects developing incident heart failure during FU and those without incident events during FU (men: 16.6 vs. 17.1 nmol/L, P = 0.75; women: 1.15 vs. 1.17 nmol/L, P = 0.32). Relevant statistically significant correlations of testosterone levels were found with high-density lipoprotein cholesterol levels (R = 0.22; P < 0.001), body mass index (R = -0.23; P < 0.001), and waist-to-hip ratio (R = -0.21; P < 0.001) in men, while statistically significant correlations in women were negligible in effect size. In sex-stratified Cox regression analyses, taking age into account, a quite strong association between low testosterone and incident heart failure was found in men [hazard ratio (HR) 1.51 (95% confidence interval, CI: 1.09-2.10); P = 0.020 for lowest vs. highest quarter], but not in women [HR 0.70 (95% CI: 0.49-0.98); P = 0.086 for lowest vs. highest quarter]. Nevertheless, this association turned non-significant after full adjustment including body mass index and waist-to-hip ratio, and testosterone levels were no longer predictive for incident heart failure-neither in men [HR 0.99 (95% CI: 0.70-1.42); P = 0.77 for lowest vs. highest quarter] nor in women [HR 0.92 (95% CI: 0.64-1.33); P = 0.99 for lowest vs. highest quarter]. Accordingly, Kaplan-Meier analyses did not reveal significant association of testosterone levels with heart failure.CONCLUSIONS: Low levels of testosterone do not independently predict future heart failure.

AB - AIMS: The increased incidence of heart failure in men suggests that endogenous sex hormones might play a role in the development of heart failure, but epidemiological data remain sparse. Here, we evaluated the predictive value of low testosterone levels on future heart failure in the large population-based FINRISK97 study.METHODS AND RESULTS: Baseline serum testosterone concentrations were measured in 7855 subjects (3865 men and 3990 women) of the FINRISK97 study. During a median follow-up (FU) of 13.8 years, a total of 564 heart failure events were recorded. The age-adjusted baseline testosterone levels did not differ significantly between subjects developing incident heart failure during FU and those without incident events during FU (men: 16.6 vs. 17.1 nmol/L, P = 0.75; women: 1.15 vs. 1.17 nmol/L, P = 0.32). Relevant statistically significant correlations of testosterone levels were found with high-density lipoprotein cholesterol levels (R = 0.22; P < 0.001), body mass index (R = -0.23; P < 0.001), and waist-to-hip ratio (R = -0.21; P < 0.001) in men, while statistically significant correlations in women were negligible in effect size. In sex-stratified Cox regression analyses, taking age into account, a quite strong association between low testosterone and incident heart failure was found in men [hazard ratio (HR) 1.51 (95% confidence interval, CI: 1.09-2.10); P = 0.020 for lowest vs. highest quarter], but not in women [HR 0.70 (95% CI: 0.49-0.98); P = 0.086 for lowest vs. highest quarter]. Nevertheless, this association turned non-significant after full adjustment including body mass index and waist-to-hip ratio, and testosterone levels were no longer predictive for incident heart failure-neither in men [HR 0.99 (95% CI: 0.70-1.42); P = 0.77 for lowest vs. highest quarter] nor in women [HR 0.92 (95% CI: 0.64-1.33); P = 0.99 for lowest vs. highest quarter]. Accordingly, Kaplan-Meier analyses did not reveal significant association of testosterone levels with heart failure.CONCLUSIONS: Low levels of testosterone do not independently predict future heart failure.

KW - Body Mass Index

KW - Female

KW - Forecasting

KW - Heart Failure/epidemiology

KW - Humans

KW - Incidence

KW - Male

KW - Testosterone

U2 - 10.1002/ehf2.13384

DO - 10.1002/ehf2.13384

M3 - SCORING: Journal article

C2 - 33934533

VL - 8

SP - 2485

EP - 2491

JO - ESC HEART FAIL

JF - ESC HEART FAIL

SN - 2055-5822

IS - 4

ER -