1
Dehydroepiandrosterone replacement therapy in older adults improves indices of arterial stiffness.
Aging Cell. 2012 Jun 19
All selected articles haveThis article has been added to your saved articles
You can follow/unfollow articles via MyF1000 or via the article or browse pages.
18 Jul 2012
Clinical Trial
DOI: 10.3410/f.717948100.793453150
This is a rare, well conducted study on a generic androgen precursor readily available in the US. Dehydroepiandrosterone (DHEA) may be a viable alternative to testosterone replacement for many patients without the need for prescription medication. Smaller studies of shorter duration had shown positive...Continue reading
This is a rare, well conducted study on a generic androgen precursor readily available in the US. Dehydroepiandrosterone (DHEA) may be a viable alternative to testosterone replacement for many patients without the need for prescription medication. Smaller studies of shorter duration had shown positive benefit for sexual function in both men and women.
A 12-month double-blind placebo-controlled study of 92 men and women aged 65-75 showed showed a marked reduction of markers of arterial stiffness (carotid artery index and pulse wave form) in both men and women. There were also marked reductions in the vascular inflammatory markers interleukin (IL)6 and tumor necrosis factor (TNF)-alpha. The reduction in arterial index was considered equivalent to 20 years of arterial ageing. There were also modest reductions in total and low-density lipoprotein (LDL) cholesterol plus triglycerides and modest increases in testosterone levels in men and slight increases in women. Diabetic patients were excluded, but many with hypertension and dyslipidaemia were included. There were no significant treatment-related adverse events.
There is no need for a change in medical practice but this study provides clinical evidence that may help advise patients on dietary supplements.
For further reading, please see {1,2}.
A 12-month double-blind placebo-controlled study of 92 men and women aged 65-75 showed showed a marked reduction of markers of arterial stiffness (carotid artery index and pulse wave form) in both men and women. There were also marked reductions in the vascular inflammatory markers interleukin (IL)6 and tumor necrosis factor (TNF)-alpha. The reduction in arterial index was considered equivalent to 20 years of arterial ageing. There were also modest reductions in total and low-density lipoprotein (LDL) cholesterol plus triglycerides and modest increases in testosterone levels in men and slight increases in women. Diabetic patients were excluded, but many with hypertension and dyslipidaemia were included. There were no significant treatment-related adverse events.
There is no need for a change in medical practice but this study provides clinical evidence that may help advise patients on dietary supplements.
For further reading, please see {1,2}.
References
1.
Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis.
Eur Heart J. 2010 Aug; 31(15): 1865-71
PMID: 20197424
DOI: 10.1093/eurheartj/ehq024
2.
Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis.
J Am Coll Cardiol. 2010 Mar 30; 55(13): 1318-27
PMID: 20338492
DOI: 10.1016/j.jacc.2009.10.061
Disclosures
None declared
Add Comment
Hackett G: F1000Prime Recommendation of [Weiss EP et al., Aging Cell 2012]. In F1000Prime, 18 Jul 2012; DOI: 10.3410/f.717948100.793453150. F1000Prime.com/717948100#eval793453150
F1000Prime Recommendations, Dissents and Comments for [Weiss EP et al., Aging Cell 2012]. In F1000Prime, 22 May 2013; F1000Prime.com/717948100
Only registered/signed-in users can make comments.
Sign in or Subscribe to create your user account and join the discussion.
Sign in or Subscribe to create your user account and join the discussion.
No comments yet.
Background: Serum dehydroepiandrosterone (DHEA) concentrations decrease ∼80% between ages 25 and 75 yr. Aging also results in an increase in arterial stiffness, which is an independent predictor of cardiovascular disease (CVD) risk and mortality. Therefore, it is conceivable that DHEA replacement in older adults could reduce arterial stiffness. We sought to determine if DHEA replacement therapy in older adults reduces carotid augmentation index (AI) and carotid-femoral pulse wave velocity (PWV) as indices of arterial stiffness. Methods: A randomized, double-blind trial was conducted to study the effects of 50 mg/d DHEA replacement on AI (n=92) and PWV (n=51) in women and men aged 65-75 yr. Inflammatory cytokines and sex hormones were measured in fasting serum. Results: AI decreased in the DHEA group but not in the placebo group (difference between groups, -6±2 AI units, p=0.002). PWV also decreased (difference between groups, -3.5±1.0 m/sec, p=0.001); however, after adjusting for baseline values, the between-group comparison became non-significant (p=0.20). The reductions in AI and PWV were accompanied by decreases in inflammatory cytokines (TNFα and IL-6, p<0.05) and correlated with increases in serum DHEAS (r = -0.31 and -0.37, respectively, p<0.05). The reductions in AI also correlated with free testosterone index (r = -0.23, p=0.03). Conclusion: DHEA replacement in elderly men and women improves indices of arterial stiffness. Arterial stiffness increases with age and is an independent risk factor for CVD. Therefore the improvements observed in the present study suggest that DHEA replacement might partly reverse arterial aging and reduce CVD risk. © 2012 The Authors Aging Cell © 2012 Blackwell Publishing Ltd/Anatomical Society of Great Britain and Ireland.
Copyright © 2012 Blackwell Publishing Ltd/Anatomical Society of Great Britain and Ireland.
DOI: 10.1111/j.1474-9726.2012.00852.x
PMID: 22712469
