Andropausal syndrome in men with systolic heart failure

INTRODUCTION Andropausal syndrome (AS) is an element of male aging, being associated with the age-related decline in circulating androgens.
OBJECTIVES We investigated the prevalence of AS, the severity of andropausal symptoms, and their clinical and hormonal determinants in men with heart failure (HF) and healthy peers.
PATIENTS AND METHODS We examined 232 men with systolic HF aged from 40 to 80 years (New York Heart Association [NYHA] class I/II/III–IV: 17%/54%/29%, left ventricular ejection fraction: 30% ±8%) and 362 healthy peers. The severity of 17 andropausal symptoms were assessed using the Aging Males’ Symptoms Rating Scale.
RESULTS In men with HF aged from 40 to 59 years, the prevalence of AS and the severity of andropausal symptoms were greater than in healthy peers (28% vs. 7%; 40 ±14 vs. 35 ±10 points; both P <0.001), while in the age group of 60 to 80 years, there were no differences in the prevalence of AS and the severity of andropausal symptoms between men with HF and healthy peers (31% vs. 40%; 44 ±12 vs. 46 ±10 points; respectively; both P >0.1). In men with HF aged from 40 to 59 years, advanced NYHA class, low hemoglobin, increased platelet number, and low serum dehydroepiandrosterone sulphate were independently associated with the greater prevalence of AS (all P <0.05). In men aged from 60 to 80 years, only reduced hemoglobin was borderline related to the higher prevalence of AS (P = 0.07).
CONCLUSIONS AS affects almost one-third of men with HF regardless of the age group. The clinical and hormonal determinants of the severity of andropausal symptoms differ between younger and older male patients. Endocrinological and sexual counseling is recommended in men with HF.