Low and high levels of hormone in men with heart failure associated with increased risk of death

Men with systolic chronic heart failure who have low or high levels of estradiol, a form of the hormone estrogen, have an increased risk of death compared with men with moderate levels of this hormone, according to a study in the May 13 issue of JAMA.

Estrogens have numerous biological effects in men and have a complex effect on the normal cardiovascular system, including cardioprotective effects, which may explain the link between low estradiol concentrations and an increased risk of cardiovascular events in men, according to background information in the article.

Ewa A. Jankowska, M.D., Ph.D., of the Center for Heart Disease, Military Hospital, Wroclaw, Poland, and colleagues examined the relationship between estradiol concentrations in the blood and the rate of death in men with chronic heart failure (HF) and reduced left ventricular ejection fraction (LVEF; a measure of how well the left ventricle of the heart pumps with each contraction). The study, conducted at two cardiology centers in Poland, included 501 men (average age, 58 years). The patients were divided into 5 groups (quintiles), determined by the level of estradiol in their blood. Quintile 3 was considered the reference group.

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