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- Title
TESTOSTERONE DEFICIENCY SYNDROME AND CARDIOVASCULAR HEALTH: AN ASSESSMENT OF BELIEFS, KNOWLEDGE AND PRACTICE PATTERNS OF GENERAL PRACTITIONERS AND CARDIOLOGISTS IN VICTORIA, BC.
- Authors
Wallis, Christopher J. D.; Nelson, Hilary L.; Pommerville, Peter J.
- Abstract
Testosterone deficiency syndrome (TDS) or late-onset hypogonadism is a clinical syndrome marked by symptoms including a reduction in muscle mass and increase in adiposity, decreased sexual function, depressed mood, hot flushes, and fatigue, most often in association with laboratory evidence of decreased testosterone. There is an emerging body of evidence that TDS is an independent cardiovascular risk factor in addition to being a predisposing factor for the development of the metabolic syndrome, dyslipidemia, insulin resistance and type 2 diabetes, hypertension, atherosclerosis, and vascular dysfunction. We sought to assess the knowledge, beliefs and practice patterns of a cohort of general practitioners and cardiologists in Victoria BC with respect to TDS and cardiac health. A questionnaire was distributed to all 20 cardiologists and a cohort of 120 family practitioners in Victoria BC. Of the 13 questions, 10 assessed their knowledge and beliefs with respect to TDS and 3 assessed their current practice patterns. Appropriate statistical analysis was undertaken. Most respondents believed that TDS was medical condition and could have an adverse affect on body composition but a similar majority was unsure to whether it was a cardiac risk factor. While most believed that testosterone replacement therapy (TRT) could improve exercise tolerance, the majority were unsure as to if it was beneficial in patients with congestive heart failure, following myocardial infarction, or to improve myocardial perfusion. Cardiologists were statistically significantly more likely to believe that TRT was not beneficial in preventing recurrent myocardial infarction and improving myocardial perfusion (p = 0.0133, 0.00186, respectively). The vast majority (88%) did not screen male cardiac patients for TDS. If a patient was identified as having TDS, only10% of those surveyed would refer to a urologist. Despite being remarkably common in cardiac patients, both general practitioners and cardiologists lack knowledge as to the significant deleterious cardiovascular effects of testosterone deficiency. In their role as men's health advocates, urologists should consider promoting continuing medical education seminars to inform other relevant medical specialists regarding the correlation between TDS and cardiovascular mortality and risk factors.
- Subjects
TESTOSTERONE; HYPOGONADISM; CARDIOLOGISTS; HEART disease risk factors; CARDIAC patients; OBESITY
- Publication
UBC Medical Journal, 2011, Vol 2, Issue 2, p6
- ISSN
1920-7425
- Publication type
Abstract