Background: Low testosterone levels and increased aortic stiffness are predictive markers for those at high risk of cardiovascular disease. The influence of androgen level on the age/aortic stiffness relationship is unknown.

Methods: Total testosterone (TT) levels were measured in 382 men with no evidence of clinical atherosclerosis. Carotid-femoral Pulse Wave Velocity (PWVc-f) was measured as an index of aortic stiffness.

Results: Figure 1 illustrates the exponential increase in PWVc-f values with linearly decreasing total testosterone concentration. The inverse correlation between PWVc-f values and TT remained significant in multivariate analysis after adjustment for confounders (β=−0.170, P<0.001). Subjects were then categorized by age decade and further subdivided according to presence/absence of hypogonadism (TT<3.4 ng/ml). PWVc-f values of each age/testosterone category after adjustment for confounders are shown in figure 2. In the first two age categories, patients with hypogonadism (HypG) had higher adjusted PWVc-f (by 0.80 m/s, P<0.01 and 0.45 m/s, P<0.05, respectively) compared to subjects with TT concentration above the cut off level for biochemical definition of HypG. On the contrary, in older age categories, PWVc-f between patients with HypG and men with normal levels did not differ. It can be noted also that young men (<50 yrs and 50–59 yrs) with HypG had already elevated PWVc-f as compared to older men (50–59 and 60–69 yrs, respectively) with normal TT levels.

Conclusion: TT levels are independently associated with aortic stiffening. The effect of low testosterone concentration on aortic stiffness is emphasized in young men. These findings underline the important role of testosterone as a marker of arterial damage.