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Cardiovascular risk with androgen deprivation therapy for prostate cancer: Potential mechanisms.

  • Åsa Tivesten
  • Jehonathan H Pinthus
  • Noel Clarke
  • Wilhelmina Duivenvoorden
  • Jan Nilsson
Publishing year: 2015
Language: English
Pages: 464-475
Publication/Series: Urologic Oncology
Volume: 33
Issue: 11
Document type: Journal article review
Publisher: Elsevier

Abstract english

Androgen deprivation therapy (ADT) is frequently used for the treatment of advanced prostate cancer. ADT is associated with numerous side effects related to its mode of action, namely the suppression of testosterone to castrate levels. Recently, several large retrospective studies have also reported an increased risk of diabetes and cardiovascular disease in men receiving ADT, although these risks have not been confirmed by prospective randomized trials. We review the literature to consider the risk of cardiovascular disease with different forms of ADT and examine in detail potential mechanisms by which any such risk could be mediated. Mechanisms discussed include the metabolic syndrome resulting from low testosterone level and the potential roles of testosterone flare, gonadotropin-releasing hormone receptors outside the pituitary gland, and altered levels of follicle-stimulating hormone. Finally, the clinical implications for men prescribed ADT for the treatment of advanced prostate cancer are considered.


  • Urology and Nephrology


  • Cardiovascular Research - Immunity and Atherosclerosis
  • ISSN: 1873-2496
E-mail: jan [dot] nilsson [at] med [dot] lu [dot] se

Lund University Diabetes Centre, CRC, SUS Malmö, Jan Waldenströms gata 35, House 91:12. SE-214 28 Malmö. Telephone: +46 40 39 10 00