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Nathan Goodyear

Blood Lead Below 0.48 μmol/L (10 μg/dL) and Mortality Among US Adults - 0 views

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    Lead levels lead to increased risk of cardiovascular events at lower than previous thought levels.  Levels as low as 2mcg/dl found to be associated with increased cardiovascular mortality.  This equates to 38% of Americans.  The author concludes with this statement, "Although a 10-fold decline in blood lead levels has occurred in the United States in recent decades, current levels remain orders of magnitude higher than in pre industrialized times".
Nathan Goodyear

Testosterone and the Cardiovascular System: A Comprehensive Review of the Clinical Lite... - 0 views

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    Some startling statistics in this 2013 review on Testosterone in men.  Studies reflect an inverse relationship between Testosterone and CAD severity.  That is, the lower the Testosterone levels, the increase in severity of CAD. This same association was also found with CHF.  Low Testosterone is common in those with CAD, CHF, type II diabetes, increased IMT in carotids and aorta, and obesity when compared to "healthy" individuals.  Testosterone therapy in those with CAD found benefits: prolongation of ST segment depression, coronary vasodilation, improved exercise capacity in those with CHF, shift to type I muscle fibers, shorten the QTc interval.  Testosterone therapy has been shown to improve insulin resistance, improve HgbA1c and decrease waist circumference and fat loss in obese individuals.  Otherwise, a good review of the association between a declining Testosterone and cardiovascular disease.
Nathan Goodyear

Testosterone Deficiency, Cardiac Health, and Older Men - 0 views

  • Studies have shown pharmacological doses of testosterone to relax coronary arteries when injected intraluminally [39] and to produce modest but consistent improvement in exercise-induced angina and reverse associated ECG changes [40]. The mechanism of action is via blockade of calcium channels with effect of similar magnitude to nifedipine
    • Nathan Goodyear
       
      This directly refutes the recent studies (3) that Testosterone therapy increases cardiovascular events.
    • Nathan Goodyear
       
      Testosterone acts as a calcium channel blocker inducing vasodilation.
  • men with chronic stable angina pectoris, the ischaemic threshold increased after 4 weeks of TRT and a recent study demonstrates improvement continuing beyond 12 months [
  • Exercise capacity in men with chronic heart failure increased after 12 weeks
  • ...36 more annotations...
  • Studies have shown an inverse relationship between serum testosterone and fasting blood glucose and insulin levels
  • Medications such as chronic analgesics, anticonvulsants, 5ARIs, and androgen ablation therapy are associated with increased risk of testosterone deficiency and insulin resistance
  • Women with T2D or metabolic syndrome characteristically have low SHBG and high free testosterone
    • Nathan Goodyear
       
      This stands in polar opposite of that with men.
  • Hypogonadism is a common feature of the metabolic syndrome
  • The precise interaction between insulin resistance, visceral adiposity, and hypogonadism is, as yet, unclear but the important mechanisms are through increased aromatase production, raised leptin levels, and increase in inflammatory kinins
  • levels of testosterone are reduced in proportion to degree of obesity
  • Men should be encouraged to combine aerobic exercise with strength training. As muscle increases, glucose will be burned more efficiently and insulin levels will fall. A minimum of 30 minutes exercise three times weekly should be advised
  • Testosterone increases levels of fast-twitch muscle fibres
  • By increasing testosterone, levels of type 2 fibres increase and glucose burning improves
  • Weight loss will increase levels of testosterone
  • studies now clearly show that low testosterone leads to visceral obesity and metabolic syndrome and is also a consequence of obesity
  • In the case of MMAS [43], a baseline total testosterone of less than 10.4 nmol/L was associated with a greater than 4-fold incidence of type 2 diabetes over the next 9 years
  • There is high level evidence that TRT improves insulin resistance
  • Low testosterone predicts increased mortality and testosterone therapy improves survival in 587 men with type 2 diabetes
  • A similar retrospective US study involved 1031 men with 372 on TRT. The cumulative mortality was 21% in the untreated group versus 10% ( ) in the treated group with the greatest effect in younger men and those with type 2 diabetes
  • the presence of ED has been shown to be an independent risk factor, particularly in hypogonadal men, increasing the risk of cardiac events by over 50%
  • A recent online publication on ischaemic heart disease mortality in men concluded optimal androgen levels are a biomarker for survival
  • inverse associations between low TT or FT (Table 2) and the severity of CAD
  • A recent 10 year study from Western Australia involving 3690 men followed up from 2001–2010 concluded that TT and FT levels in the normal range were associated with decreased all-cause and cardiovascular mortality, for the first time suggesting that both low and DHT are associated with all-cause mortality and higher levels of DHT reduced cardiovascular risk
  • TDS is associated with increased cardiovascular and all-cause mortality
  • The effect of treatment with TRT reduced the mortality rate of treated cohort (8.4%) to that of the eugonadal group whereas the mortality for the untreated remained high at 19.2%
  • hypogonadal men had slightly increased triglycerides and HDL
  • Men with angiographically proven CAD (coronary artery disease) have significantly lower testosterone levels [29] compared to controls ( ) and there was a significant inverse relationship between the degree of CAD and TT (total testosterone) levels
  • TRT has also been shown to reduce fibrinogen to levels similar to fibrates
  • men treated with long acting testosterone showed highly significant reductions in TC, LDL, and triglycerides with increase in HDL, associated with significant reduction in weight, BMI, and visceral fat
  • Low androgen levels are associated with an increase in inflammatory markers
  • In the Moscow study, C-reactive protein was reduced by TRT at 30 weeks versus placebo
  • In some studies, a decline in diastolic blood pressure has been observed, after 3–9 months [24, 26] and in systolic blood pressure
  • A decline was noted in IL6 and TNF-alpha
  • No studies to date show an increase in LUTS/BPH symptoms with higher serum testosterone levels
  • TRT has been shown to upregulate PDE5 [65] and enhance the effect of PDE5Is (now an accepted therapy for both ED and LUTS), it no longer seems logical to advice avoidance of TRT in men with mild to moderate BPH.
    • Nathan Goodyear
       
      What about just starting with normalization of Testosterone levels first.
  • Several meta-analyses have failed to show a link between TRT and development of prostate cancer [66] but some studies have shown a tendency for more aggressive prostate cancer in men with low testosterone
    • Nathan Goodyear
       
      And if one would have looked at their estrogen levels, I guarantee they would have been found to be elevated.
  • low bioavailable testosterone and high SHBG were associated with a 4.9- and 3.2-fold risk of positive biopsy
  • Current EAU, ISSAM, and BSSM guidance [1, 2] is that there is “no evidence TRT is associated with increased risk of prostate cancer or activation of subclinical cancer.”
  • Men with prostate cancer, treated with androgen deprivation, develop an increase of fat mass with an altered lipid profile
  • Erectile dysfunction is an established marker for future cardiovascular risk and the major presenting symptom leading to a diagnosis of low testosterone
Nathan Goodyear

Vitamin D Deficiency and Risk of Cardiovascular Disease -- Wang et al. 117 (4): 503 -- ... - 0 views

  • Vitamin D Deficiency and Risk of Cardiovascular Disease
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    Vitamin D deficiency and CardioVascular disease
Nathan Goodyear

C-Reactive Protein as a Cardiovascular Risk Factor : More Than an Epiphenomenon? -- Lag... - 0 views

  • CRP constitutes an independent cardiovascular risk factor
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    CRP is an independent marker for future cardiovascular disease
Nathan Goodyear

Prospective Study of C-Reactive Protein and the Risk of Future Cardiovascular Events Am... - 0 views

  • CRP is a strong independent risk factor for cardiovascular disease that adds to the predictive value of risk models based on usual factors alone.
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    CRP is marker for cardiovascular risk in women
Nathan Goodyear

Assessment of cardiovascular risk in collegiate fo... [J Am Coll Health. 2010 Nov-Dec] ... - 0 views

  • the increased prevalence of the metabolic syndrome and its components in the collegiate linemen may increase cardiovascular disease risk.
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    college lineman with increased cardiovascular disease risk
Nathan Goodyear

Abstract 21277: Homocysteine and Cardiovascular Risk in Low Risk Healthy Adults - An An... - 0 views

  • Homocysteine significantlyimproves risk prediction of cardiovascular events in healthyadults
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    homocysteine found to be helpful in predicting cardiovascular events in healthy adults
Nathan Goodyear

Folates and Cardiovascular Disease -- Verhaar et al. 22 (1): 6 -- Arteriosclerosis, Thr... - 0 views

  • benefits of folates independent of homocysteine lowering have also been reported. Potential mechanisms include antioxidant actions, effects on cofactor availability, or direct interactions with the enzyme endothelial NO synthase
  • beneficial effects of folates on cardiovascular risk
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    Folate improves cardiovascular disease risk
Nathan Goodyear

Testosterone therapy, thrombosis, thrombophilia, ... [Metabolism. 2014] - PubMed - NCBI - 0 views

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    Only abstract available here.  I can't find the full print.  For some, there is inherent thrombosis risk with Testosterone. HOWEVER, it is due to metabolism of Testosterone i.e. aromatase activity, and to supra physiologic dosing that is prevalent through the medical community.  For those with pre-existing cardiovascular disease, a full biochemical evaluation of cardiovascular risk must be undertaken prior to the initiation of Testosterone therapy.  
Nathan Goodyear

Menopausal Complaints Are Associated With Cardiovascular Risk Factors - 0 views

  • women with complaints of flushing or night sweats have an unfavorable cardiovascular risk profile compared with women without vasomotor complaints and with increased cholesterol levels, systolic and diastolic blood pressures, and BMI.
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    Women with hot flashes and night sweats have increased cardiovascular risk compared to women that do not.
Nathan Goodyear

Androgen Deprivation Therapy and the Re-em... [Oncol Hematol Rev. 2014] - PubMed - NCBI - 0 views

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    Sometimes I think medicine has lost its mind.  Or at least, it is not thinking things through.  To give IV estrogen to decrease Testosteorne in men with prostate cancer is devoid of the pathophysiology of prostate cancer and cardiovascular disease in men.  Elevated Estradiol in men increases CRP, IL-1beta, and TNF-alpha to name a few cytokines.  The proported purpose of the IV estrogen is to prevent the cardiovascular complications associated with ADT.  Yet, elevated aromatase activity and low T in men are both shown to be associated with increased CVD in men.
Nathan Goodyear

In vivo transcriptomic profile after a Mediterranean diet in high-cardiovascular risk p... - 0 views

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    Diet is a language that interacts with out DNA.  Study finds that Mediterranean diet + extra virgin olive oil alters genetic expression to reduce cardiovascular risk.
Nathan Goodyear

Chronic stress impacts the cardiovascular system: animal models and clinical outcomes |... - 0 views

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    Chronic stress increases cardiovascular disease.  Of note, chronic stress reduces eNOS activity and NO bioavailability, increased lipid oxidation (oxLDL) via a reduction in antioxidant protection, increased pro-inflammatory cytokines, increased thrombosis and clotting risk, increased blood pressure and reduced HRV.
Nathan Goodyear

Hypogonadism as a risk factor for cardiovascular mortality in men: a meta-analytic study - 0 views

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    meta-analysis finds that low T associated with increased cardiovascular mortality in men.  Additionally, higher Estradiol is associated with increased CVD and CV mortality
Nathan Goodyear

Hypogonadism as a risk factor for cardiovascular mortality in men: a meta-analytic study - 0 views

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    Good article. Discusses the association between low Testosterone and cardiovascular risk in men. The conclude that no direct cause effect relationship has been provided, but a clear association is seen. Numerous studies have shown this association.
Nathan Goodyear

Effects of Green Tea and EGCG on Cardiovascular and Metabolic Health - 0 views

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    good review of health benefits of EGCG with cardiovascular health.
Nathan Goodyear

ESC | Congresses | HEART FAILURE 2013 | Scientific Programme - 0 views

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    CoQ10 in those with prior MIs, found to have reduced hospital readmission, less heart failure, and lower cardiovascular death.  Enough said.
Nathan Goodyear

Potential Adverse Cardiovascular Effects From Excessive Endurance Exercise - 0 views

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    Unintended cardiovascular consequences of extreme training.  
Nathan Goodyear

Testosterone: a vascular hormone in health and disease - 0 views

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    testosterone therapy has tremendous cardiovascular benefit in men with low T.  The key here is physiologic replacement of Testosterone.  Testosterone is a vasodilator and anti-inflammatory agent in men with low T.  Testosterone therapy improves cardiac function in those with DHF and angina.  Testosterone is found to be a Ca++ channel blocker--anyone say hypertension treatment?
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