Could androgens protect middle-aged women from cardiovascular events? A population-based study of Swedish women: The Women's Health in the Lund Area (WHILA) Study

Abstract

Objective The aim of this analysis was to delineate perceived associations between androgens and cardiovascular events in perimenopausal women.

Design A cross-sectional, population-based study of 6440 perimenopausal women aged 50–59 years, living in Southern Sweden. In all, 461 (7.1%) women were premenopausal (PM), 3328 (51.7%) postmenopausal without hormone therapy (HT) (PM0) and 2651 (41.2%) postmenopausal with HT (PMT). For further comparisons, 104 women (1.6%) who reported cardiovascular disease (CVD) were studied in detail; 49 had had a myocardial infarction, 49 a stroke and six women both events. For each woman with CVD, two matched controls were selected (n = 208).

Results In the matched controlled series, androstenedione levels were lower (p < 0.005) in cases. Cases with hormone therapy had also lower testosterone levels than matched controls (p = 0.05). In the total cohort, by using multiple logistic regression analyses, testosterone was positively associated with low density lipoprotein cholesterol (p < 0.001) and high density lipoprotein cholesterol (HDL-C) (p < 0.001) in all women, but negatively associated with levels of triglycerides in both the PM0 (p < 0.001) and PMT (p < 0.001) groups. Androstenedione levels were positively associated with HDL-C (p < 0.05) and negatively with triglycerides (p < 0.05) in the PM group.

Conclusion Women with cardiovascular disease had lower serum androgen levels, particularly women using hormone replacement therapy, even when controlled for lipids and other potential risk factors.

Key words:

• Testosterone
• Androstenedione
• High density lipoprotein cholesterol
• Low density lipoprotein cholesterol
• Sex hormone binding globulin