Testosterone Replacement Therapy and Heart Attacks

Testosterone Replacement Therapy and Heart Attacks – is it true that TRT increases the risk of heart attacks and strokes?

‘Testosterone’ is a topic that carries a lot of stigma.

Many people associate it with massive, vein covered bodybuilders who abuse steroids.

These huge men look like they are about to have a heart attack or stroke at any minute!

On top of this, with occasional news reports on bodybuilders who abuse steroids and die young from heart issues, you can see why people might think that testosterone increases the risk of cardiovascular issues.

Testosterone Replacement Therapy and Heart Attacks Man
Many doctors still think that this is the case, as they are often reading out of date research on the topic.

Thankfully, the reality is that testosterone replacement therapy is unlikely to increase your risk of cardiovascular problems if managed well by an experienced professional!

In this article we will look at the research, discuss what increases your risk of heart attacks and strokes, and consider how a well designed TRT program can actually reduce your risk of heart attacks and strokes.

Old research suggests testosterone replacement therapy and heart attacks / strokes are linked

Medical research is very important.

It tells us a lot about new treatments and their safety.

It can help us to understand risks and make decisions about certain treatments.

Unfortunately it is frequently conducted either with poor methodology or inappropriate study designs.

This can lead to medical communities making assumptions based on the results of a poorly designed study with inaccurate findings.

Often the results, which are heralded as medical truths, turn out to be much less credible than originally suspected.

Later research doesn’t show the same results, or can even contradict previous studies when different factors are taken into account.

Testosterone and Heart Attacks Man
Unfortunately, the initial study results can often become ingrained in the medical community – particularly if they fit with ‘common wisdom’ or stereotypes.

This appears to be what has happened with testosterone replacement therapy and heart attacks research.

The association between testosterone replacement therapy and hearts attacks & strokes spread, after one or two studies in the early 2000’s appeared to indicate an link to increased risk of heart attacks or strokes.

The medical community pounced on these studies as a way to vilify TRT, whilst there was a mounting stigma around testosterone.

New research has come out since, indicating that the risk was exaggerated or incorrect, but most of the medical community is still slow to update their views.

Even today, it remains a commonly held belief by many doctors as well as amongst the wider population, that TRT is linked to heart attacks.

New research suggests testosterone replacement therapy and heart attacks / strokes are not linked

As more and more research is completed on this issue it becomes more and more evident that previous research is likely to be incorrect.
“a 2014 study reported that testosterone therapy might increase the risk of a heart attack in men age 65 and older…however, more recent studies show no increase in cardiovascular disease in men taking testosterone therapy.

Some research even shows a lower risk of death in men receiving testosterone therapy compared with those not receiving therapy. A large 2016 study following more than 1,000 men for three years found that testosterone therapy did not increase the risk of cardiovascular events”

A recent study (2017) in the JAMA journal which looked at over 44,000 men suffering with androgen deficiency and showed a 33% lower risk of cardiovascular events in men who supplemented with TRT compared to those who didn’t.

That is a huge difference in a large sample size of men. And it’s not just one or two studies; these results are stacking up and are bourne out in several other recent papers.

“The study found that TRT was not linked with any increased risk for MI (HR=0.84 [95% CI=0.69~1.02]).

In contrast, men at greater risk for heart problems who underwent TRT actually had a lower rate of heart attacks than similar men who did not receive this treatment.”

How does testosterone replacement therapy reduce these risks?

There are several theories and explanations that clearly affect the improvements in cardiovascular health in men taking TRT.

Additionally, men with low testosterone appear to be at higher risk of these conditions.

Low endogenous (naturally produced) testosterone levels have been shown to be associated with higher rates of all-cause and cardiovascular-related deaths in men.

Men who are obese, have type 2 diabetes, and who already have coronary artery disease all have lower endogenous testosterone levels then healthy men.

Testosterone replacement therapy has been shown to increase exercise tolerance without increasing left ventricular ejection fraction (linked to growth of the left side of the heart which can lead to cardiac complications). 

It has also been shown to improve the homeostatic model of insulin resistance and hemoglobin A1c in diabetics as well as lowering the BMI of obese patients.

Clearly TRT has a myriad of positive effects on male health beyond improving muscle, sexual function and mood.

High Testosterone Man on the Beach


There is little evidence that Testosterone Replacement Therapy and heart attacks / strokes are linked. In fact, most recent studies suggest the opposite – TRT has been shown to improve several factors that increase life span and general health.

Old and discredited studies are still influencing many doctors and patients. This is preventing millions of men from seeking or acquiring the treatment they deserve.