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Testosterone deficiency link to AF risk

Sex hormones testosterone and oestradiol are associated with incident atrial fibrillation (AF) in a cohort of older men, with testosterone deficiency in men ≥80 strongly associated with AF risk, according to a study published recently in Circulation.1

Researchers examined testosterone, oestradiol, and dehydroepiandrosterone sulfate [DHEA-S]) in relation to incident AF in men participating in the Framingham Heart Study. They assessed the 10-year risk of AF in multivariable-adjusted hazard models. The cohort consisted of 1,251 men (age 68.0±8.2), of whom 275 developed incident AF.

The authors identified a significant interaction between age and testosterone, and therefore stratified men into age 55–69 (n=786), 70–79 (n=351), and ≥80 (n=114). In men 55–69 each 1-standard deviation (SD) decrease in testosterone was associated with hazard ratio (HR) 1.30 (95% confidence interval [CI], 1.07 to 1.59) for incident AF.

The association between testosterone and 10-year incident AF in men 70–79 did not reach statistical significance. In men ≥80 years a 1-SD decrease in testosterone was associated with HR 3.53 (95% CI, 1.96 to 6.37) for AF risk. Oestradiol was associated with incident AF (HR, 1.12; 95% CI, 1.01 to 1.26). DHEA-S had a borderline association with risk of AF that was not statistically significant (HR, 1.12; 95% CI, 0.99 to 1.28).

The clinical and electrophysiologic mechanisms underlying the associations between sex hormones and AF in older men merit continued investigation, the authors conclude.


1. Magnani JW, Moser CB, Murabito JM, et al. Association of sex hormones, aging and atrial fibrillation in men: the Framingham Heart Study. Circulation 2014.​CIRCEP.113.001322

Published on: March 28, 2014

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