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.