JAMA : the journal of the American Medical Association
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Rates of testosterone therapy are increasing and the effects of testosterone therapy on cardiovascular outcomes and mortality are unknown. A recent randomized clinical trial of testosterone therapy in men with a high prevalence of cardiovascular diseases was stopped prematurely due to adverse cardiovascular events raising concerns about testosterone therapy safety. ⋯ Among a cohort of men in the VA health care system who underwent coronary angiography and had a low serum testosterone level, the use of testosterone therapy was associated with increased risk of adverse outcomes. These findings may inform the discussion about the potential risks of testosterone therapy.
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Are β-blockers associated with lower rates of all-cause mortality and cardiovascular events when used as initial treatment in individuals with hypertension compared with placebo, no treatment, or other drugs? ⋯ Initial therapy of hypertension with β-blockers is not associated with reduced all-cause mortality but is associated with modest reductions in cardiovascular events compared with placebo or no treatment. Calcium channel blockers and renin-angiotensin system inhibitors are associated with greater reductions in cardiovascular event rates than β-blockers. This evidence derives from trials of traditional β-blockers (eg, atenolol and propranolol), because there are currently no mortality and cardiovascular event data on the new vasodilating β-blockers (eg, carvedilol and nebivolol).