The relationship between androgens and arterial stiffness in older men

Objectives: To assess the relationship between endogenous androgen levels and arterial stiffness in older men. Design: A retrospective, cross-sectional study. Setting: A London hospital-based, clinical research unit for the elderly. Participants: Fifty-five men (mean age±standard deviation=71.1±8.0). Intervention: Sex hormone-binding globulin (SHBG), testosterone, and dehydroepiandrosterone sulfate (DHEAS) were measured in all subjects who had a stored serum sample drawn the same day as arterial stiffness measures were performed. Free testosterone index (FTI) was calculated ((total testosterone/SHBG)×100 (%)). The measures of arterial stiffness used were pulse wave velocity (PWV) using the Complior system and systemic arterial compliance (SAC) using the area method. Measurements: Relationship between arterial stiffness and serum androgens. Results: FTI showed a strong positive relationship with SAC (r=0.507, P<.001) and, correspondingly, an inverse relationship with carotid-femoral (C-F) and carotid-radial (C-R) PWV (r=–0.427 and –0.402, respectively, P=.002). With multiple regression, including age, blood pressure, cholesterol, body mass index, and waist/hip ratio, FTI remained a significant determinant of SAC and C-R PWV but not C-F PWV. In the subgroup of men without cardiovascular disease or vasoactive medication use (n=37), all three relationships remained significant. DHEAS was inversely related to C-F PWV only (r=–0.304, P=.041). Conclusion: The known association between lower androgenicity and increased cardiovascular risk in men might be explained by altered vascular stiffness.