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Endogenous sex hormone levels in men are not associated with risk of venous thromboembolism: the Tromsø study

¹ Section of Endocrinology, Department of Medicine, University Hospital of North Norway, 9038 Tromsø, Norway² Department of Medicine, Institute of Clinical Medicine, University of Tromsø, 9037 Tromsø, Norway³ Department of Medicine, Institute of Clinical Medicine, Center for Atherothrombotic Research in Tromsø (CART), University of Tromsø, 9037 Tromsø, Norway⁴ Department of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California 92093, USA

(Correspondence should be addressed to J Svartberg; Email: johan.svartberg{at}unn.no)

Objectives: Low testosterone levels in men have been associated with cardiovascular risk factors and atherosclerosis and lately also an increased risk of both cardiovascular disease (CVD) and all-cause mortality. As arterial CVDs and venous thromboembolism (VTE) have been shown to share common risk factors, the purpose of the present study was to determine the impact of endogenous sex hormone levels on the incidence of VTE in a cohort of men.

Design: A prospective, population-based study.

Methods: Sex hormone measurements were available in 1350 men, aged 50–84, participating in the Tromsø study in 1994–1995. First, lifetime VTE-events during the follow-up were registered up to September 1 2007.

Results: There were 63 incident VTE-events (4.5 per 1000 person-years) during a mean of 10.4 years of follow-up. Age was significantly associated with increased risk of VTE; men 70 years or older had a 2.5-fold higher risk of VTE (HR 2.47, 95% CI 1.19–5.12), compared with those between 50 and 60 years of age. In age-adjusted analyses, endogenous sex hormones levels were not associated with risk of VTE; for each S.D. increase, hazards ratios (95% CI) were 1.06 (0.83–1.35) for total testosterone, 1.02 (0.79–1.33) for free testosterone, and 1.27 (0.94–1.71) for ln-estradiol. In dichotomized analyses comparing men in the lowest total and free testosterone quartile with men in the higher quartiles, hypoandrogenemia was not associated with risk of VTE.

Conclusions: In this population-based study of middle-aged and older men, endogenous sex hormone levels were not associated with 10-year risk of VTE.