Hormone tied to death

Blood levels of oestradiol, a potent form of oestrogen, that are too high or too low are linked to an increased risk of death in men with heart failure, according to a report in the Journal of the American Medical Association.

Although oestradiol is often thought of as a female hormone, it is also present in men. In women, the hormone is largely produced in the ovaries, whereas in men, it is produced in the testes and at other body sites, such as in the adrenal glands.

Low levels of testosterone and other male hormones have been linked to death in men with heart failure, Dr Ewa A. Jankowska, from Military Hospital, Wroclaw, Poland, and colleagues note in their report. Because oestrogens come from the conversion of these hormones, it would be expected that oestrogen metabolism is abnormal in these patients as well.

Results alarming
To investigate, the research team analysed data from 501 men with heart failure seen at two cardiology centres in Poland. The subjects were divided into five groups based on the oestradiol level in their blood.

During 3 years of follow-up, 34% of men died, the report indicates.

The investigators found that men with the lowest and highest levels of estradiol were 4.17- and 2.33-times more likely to die, respectively, than their peers with mid-range levels.

On final analysis, the 3-year survival rates for each successive group with higher oestradiol levels were 44.6%, 65.8%, 82.4%, 79.0%, and 63.6%.

"Further studies," the authors conclude, "are needed to explain the origin of these hormonal derangements." At this point, they emphasize, it is premature to treat men with heart failure with agents that increase or decrease estradiol levels. - (Reuters Health)

SOURCE: Journal of the American Medical Association, May 13, 2009.

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