Johan Ärnlöv, MD, PhD; Michael J. Pencina, PhD; Shreyasee Amin, MD; Byung-Ho Nam, PhD; Emelia J. Benjamin, MD, ScM; Joanne M. Murabito, MD, ScM; Thomas J. Wang, MD; Philip E. Knapp, MD; Ralph B. D'Agostino, PhD; Shalendar Bhasin, MD; Ramachandran S. Vasan, MD
Acknowledgments: The authors acknowledge the assistance of Ms. Pamela Bacharach, who performed all the sex hormone assays, and Clark Sawin, MD, who supervised the assays. Dr. Sawin passed away in August 2004.
Grant Support: By a Bergmarks travel grant, a Viking Björks Hedersledamotstipendium, a Capio travel grant, and the Thuréus Foundation and through research grants (National Heart, Lung, and Blood Institute contracts N01-HC-25195, 6R01-NS 17950, K23 HL074077, and 2K24 HL04334) from the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Potential Financial Conflicts of Interest: Consultancies: T.J. Wang (Novartis Institutes for Biomedical Research); Grants received: S. Bhasin (Solvay Pharmaceuticals).
Requests for Single Reprints: Ramachandran S. Vasan, MD, Boston University School of Medicine, Framingham Heart Study, 73 Mount Wayte Avenue, Suite 2, Framingham, MA 01702-5803; e-mail, email@example.com.
Current Author Addresses: Dr. Ärnlöv: Section of Geriatrics, Uppsala University, PO Box 609, 75215 Uppsala, Sweden.
Drs. Pencina and D'Agostino Sr.: Mathematics Department, Boston University, 111 Cummington Street, Boston, MA 02215.
Dr. Amin: Division of Rheumatology, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55902.
Drs. Nam, Benjamin, Murabito, Wang, and Vasan: Boston University School of Medicine, Framingham Heart Study, 73 Mount Wayte Avenue, Suite 2, Framingham, MA 01702-5803.
Drs. Knapp and Bhasin: Endocrinology Division, Department of Medicine, Boston University School of Medicine, 670 Albany Street, 2nd Floor, Boston, MA 02118.
Author Contributions: Conception and design: J. Ärnlöv, B.-H. Nam, J.M. Murabito, R.S. Vasan.
Analysis and interpretation of the data: J. Ärnlöv, M.J. Pencina, S. Amin, B.-H. Nam, J.M. Murabito, R.B. D'Agostino Sr., S. Bhasin, R.S. Vasan.
Drafting of the article: J. Ärnlöv, M.J. Pencina, B.-H. Nam, S. Bhasin, R.S. Vasan.
Critical revision of the article for important intellectual content: J. Ärnlöv, M.J. Pencina, S. Amin, B.-H. Nam, E.J. Benjamin, T.J. Wang, P.E. Knapp, R.B. D'Agostino Sr., S. Bhasin, R.S. Vasan.
Final approval of the article: J. Ärnlöv, M.J. Pencina, S. Amin, B.-H. Nam, E.J. Benjamin, J.M. Murabito, T.J. Wang, R.B. D'Agostino Sr., S. Bhasin, R.S. Vasan.
Statistical expertise: M.J. Pencina, B.-H. Nam, R.B. D'Agostino Sr.
Obtaining of funding: R.S. Vasan.
Administrative, technical, or logistic support: R.B. D'Agostino Sr., R.S. Vasan.
Collection and assembly of data: S. Amin, R.S. Vasan.
Ärnlöv J, Pencina MJ, Amin S, Nam B, Benjamin EJ, Murabito JM, et al. Endogenous Sex Hormones and Cardiovascular Disease Incidence in Men. Ann Intern Med. 2006;145:176-184. doi: 10.7326/0003-4819-145-3-200608010-00005
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Published: Ann Intern Med. 2006;145(3):176-184.
Male sex is an independent risk factor for cardiovascular disease (CVD) (1). Scientists have postulated that the 5- to 10-year lag period in CVD incidence in women (compared with men) may be related to differences in endogenous sex hormones (2-7). Indeed, substantial evidence suggests that sex hormones (testosterone, estrogen, and dehydroepiandrosterone sulfate [DHEA-S]) influence traditional and newer CVD risk factors (2-7). Interest in the role of sex hormones in the pathogenesis of CVD has been rekindled by the observation that men with genetic defects of estrogen synthesis (8) or action (9) develop premature atherosclerosis. In addition, genetic variation in estrogen receptor-α has been associated with prevalent CVD (10-11), and androgen and estrogen receptor expression in coronary arteries has been reported to influence coronary atherosclerosis in men (12).
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