Such a concept is based on the higher incidence of cardiovascular events in men than in women. However, this may be much more readily explicable by the protective effects of oestrogen, a hormone found in much higher quantities in women. There is little data to support a causal relationship between high testosterone levels and heart disease. In fact, a significant body of evidence suggests the opposite may be true – men with low testosterone levels may be at higher cardiovascular risk. There are reports testosterone replacement can improve symptoms of chronic stable angina. There are direct observations showing vasodilation following intra- coronary injections of testosterone. There are no reports of increasing incidence of cardiovascular disease including myocardial infarction, stroke or angina in reports of testosterone replacement therapy.
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