Testosterone Deficiency Strongly Linked to Heart Attack Risk in New Study

Posted by Dr. Michael White, Updated on December 16th, 2023
Reading Time: 6 minutes

There has been a lot of debate over the last decade regarding the effects of both Low-T and Testosterone Deficiency on the heart. Depending on the study and the manner in which the study was conducted, the results can come out quite differently.

A study published in Heart Rhythm, a peer-reviewed medical journal regarding cardiovascular health, provides strong evidence that a patient's Estradiol and Testosterone Levels are powerful indicators for sudden cardiac arrest, a lethal condition with a 95% mortality rate.

What researchers found was that men that experienced cardiac arrest had average Testosterone Levels which were significantly lower than normal. It was also discovered that patients with elevated Estradiol Levels were more likely to experience cardiac arrest regardless of gender.

What is Cardiac Arrest?

Cardiac Arrest is a condition in which the heart loses the ability to contract normally, which completely restricts blood flow. This prevents the body from circulating oxygen through the bloodstream which quickly leads to death if not treated.

Sudden Cardiac Arrest refers to Cardiac Arrest which occurs without warning. Because of the severity of the condition, under most circumstances, there is no way to provide effective treatment in time to save the patient, nor return the heart to working function in time to save the patient.

Cardiac Arrest as a whole has a lower mortality rate, though is still quite lethal because the condition often occurs in a hospital environment where immediate treatment can be provided. It's important to understand that Cardiac Arrest and Heart Attack are two specific conditions.

Cardiac Arrest vs. Heart Attack

A heart attack is a condition in which blood flow is restricted to the heart, but the muscle is still functional, whereas, in the case of Cardiac Arrest, blood is available for circulation, but the heart is not functioning properly, if at all.

Heart Attacks are referred to as medically and scientifically as Myocardial Infarctions. Both of these conditions are distinct from heart failure, a condition in which the heart is limited in its capacity to encourage healthy circulation but can still support the survival of the patient.

Because of the limited treatment options and the incredibly high mortality rate for Sudden Cardiac Arrest, there is an emphasis on medical research to find ways to reduce the risk of the condition in order to improve the long-term outcomes for at-risk patients.

How Widespread is Sudden Cardiac Arrest?

Sudden Cardiac Arrest is one of the leading killers of Americans and men and women all across the world. As many as 300,000 people die of Sudden Cardiac Arrest in the United States annually, and the number is as high as five million globally.

Why is Cardiac Arrest So Much Worse than Heart Attack?

The majority of heart attacks happen because the Coronary Artery becomes so blocked that blood cannot adequately reach the heart. In many cases, this is not a total blockage, although in some cases, such as in the case of clotting, this blockage can become total.

Because Heart Attacks don't always lead to total blockages, the patient can frequently survive long enough to receive treatment, because there is just enough blood circulation to keep them going. On the other hand, Cardiac Arrest completely stalls blood circulation, which must be treated in a matter of minutes before organ death starts to take place rapidly.

Also, Sudden Cardiac Arrest is a more complex issue than a heart attack. A heart attack is like having a fuel pump with a clog in it. If you can flush the tube and free the blockage, the engine will still function normally as fuel returns to circulation.

On the other hand, Sudden Cardiac Arrest is a problem with electrical signaling, and, outside of a clinical setting, or the lack of a defibrillator, blood circulation completely stops with no recourse.

Despite Decades of Research, Cardiac Arrest is Still Extremely Lethal

Generations of medical research have gone into trying to discover a means by which to effectively treat and resuscitate patients that experience sudden cardiac arrest, but survival rates are still particularly grim.

For patients with known heart issues, the best way to protect against cardiac arrest is with an ICD or implantable cardioverter-defibrillator. This device constantly monitors the heart, making sure that it sends electrical signals in its normal pattern. If something happens in which the heart falls out of pattern or goes into cardiac arrest, the ICD shocks the heart to restore normal rhythm patterns.

Using Medical Records to Uncover Cardiac Arrest Risk Factors

Researchers were able to come to these conclusions regarding Testosterone, Estradiol, and Sudden Cardiac Arrest by analyzing data collected from the Oregon Sudden Unexpected Death Study, conducted in Portland, Oregon. The study spanned sixteen hospitals and collected comprehensive data regarding patients that passed unexpectedly.

The study was largely funded by the National Heart, Lung, and Blood Institute, and the research leader was Dr. Sumeet Chugh. By analyzing data collected from patients that died unexpectedly, researchers hoped to uncover genetic defects, triggers, and other risk factors for sudden cardiac arrest and heart death.

Although previous studies have linked Testosterone Deficiency and Elevated Estradiol to increased cardiovascular risk in other ways, this is the first study that provides evidence that abnormal hormone balance is correlated with sudden cardiac arrest.

Although the research needs to be corroborated through future studies, this is strong evidence that Hormone Balance with regard to Testosterone and Estrogen may have a protective effect on the heart which helps to prevent Sudden Cardiac Arrest.

Chugh and his associates accumulated health data from 149 men and women that died of Sudden Cardiac Arrest.

In order to establish control data, they also collected health information from 149 men and women that suffered from Coronary Artery Disease, but did not experience Sudden Cardiac Arrest.

Cardiac Arrest Risk and Testosterone in Men

What they discovered when analyzing the data was that men that died of Cardiac Arrest had average Serum Testosterone Concentration of 44 ng/dl, whereas patients that did not experience Cardiac Arrest had average levels of 54 ng/dl.

Cardiac Arrest Risk and Estradiol in Men

With regard to Estradiol Levels in men, those that died from Cardiac Arrest had Serum Estradiol Concentrations of 68 pg/ml, whereas those that did not experience the fatal condition had estradiol levels of 52 pg/ml.

Cardiac Arrest Risk and Estradiol in Women

The link between Estradiol and Cardiac Arrest Risk was also notable in female patients as well. Women that experienced Cardiac Arrest had Serum Estradiol Levels of 54 pg/ml, and the controls had an average of 36 pg/ml.

What Does This Data Mean?

Based on this data, there is a definite link between Cardiac Arrest Risk and Testosterone Deficiency / Elevated Estradiol Levels. Of course, the evidence does not point out the source of the correlation.

It is equally feasible that conditions associated with Sudden Cardiac Arrest depress levels of Testosterone and increase Estrogen Levels in the bloodstream, and it is also very possible that Low-T and Elevated Estrogen Levels create a cardiovascular environment more conducive to Sudden Cardiac Arrest.

If Testosterone and Estrogen Levels directly contribute to Sudden Cardiac Arrest risk, then Testosterone Replacement Therapy for men and Estrogen Blockers for both sexes may be a means by which to improve cardiovascular outcomes and reduce the risk of Sudden Cardiac Arrest.

In the case that Testosterone Deficiency and Elevated Estrogen Levels are an indicator of Sudden Cardiac Arrest Risk, these levels may provide evidence that helps point future researchers in the right direction to discover further, direct causes of these lethal heart malfunctions.

Further still, Testosterone Therapy or Estrogen Blockers may still protect the heart by protecting against these other more direct causes of heart malfunction.

Could Hormone Therapy Improve Heart Health and Reduce Cardiovascular Risk?

Of course, there are still important questions that have to be more sufficiently answered with regard to Testosterone Therapy's effects upon the cardiovascular system, as well as those of Estrogen Blockers.

For example, some studies have shown that Testosterone Therapy increases the risk of heart attack, especially in the initial months of treatment. Most of these studies, however, suggest that the heart attack risk is caused by an associated increase in Estradiol Levels caused by the Testosterone Therapy itself, or the result of Polycythemia, which increases the risk of blood clotting.

In both of these cases, Testosterone itself still seems to have a protective effect upon cardiovascular function, but it's benefits are suppressed by the effects of Polycythemia and increased Estradiol Levels.

Both of these side-effects can be effectively treated, however, which still provides hope that Testosterone Therapy can be an effective weapon at the disposal of medical doctors in their efforts to protect the hearts of their patients.

Estrogen Blockers can keep Estradiol Levels in check, suppressing the conversion process which causes excess Testosterone from being converted into Estrogen. Polycythemia can also be effectively treated as well, in this case, without medication.

The best treatment to keep Red Blood Cell Count in check is simply blood donation.

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