CARDIOVASCULAR MANIFESTATIONS IN PATIENTS WITH MALE HYPOGONADISM: CLINICAL COMPLICATIONS AND SURGICAL EVALUATION

Abstract

Introduction: Male hypogonadism, characterized by inadequate production of sex hormones, has been shown to be a condition with significant implications for cardiovascular health. Studies have shown that low testosterone levels are associated with an increased risk of cardiovascular diseases, such as hypertension, myocardial infarction, and heart failure. The relationship between hypogonadism and cardiovascular complications can be explained by factors such as insulin resistance, obesity, and changes in endothelial function. Therefore, understanding these manifestations is crucial for adequate clinical management and evaluation of surgical interventions in affected patients. Objective: To evaluate the existing literature on cardiovascular manifestations in patients with male hypogonadism, focusing on their clinical complications and surgical approach. Methodology: The methodology was based on the PRISMA checklist, using the PubMed, SciELO, and Web of Science databases. The five descriptors used were: "male hypogonadism", "cardiovascular health", "testosterone", "cardiovascular diseases", and "surgical evaluation". The search was restricted to articles published in the last ten years. Inclusion criteria consisted of clinical studies with men diagnosed with hypogonadism, articles that addressed cardiovascular complications, and studies that discussed surgical interventions. Exclusion criteria included non-systematic reviews, studies that did not focus on men, and articles with data not available in English, Portuguese, or Spanish. Results: The results indicated that male hypogonadism was associated with a high prevalence of adverse cardiovascular events. It was observed that testosterone replacement therapy could improve cardiovascular parameters in some patients, but also raised concerns about potential risks. Surgical interventions, when necessary, required careful assessment of cardiovascular risk. Conclusion: Male hypogonadism has a significant impact on cardiovascular manifestations, which requires a comprehensive clinical approach. The literature review highlighted the importance of monitoring these complications and considering testosterone replacement therapy with caution, emphasizing the need for further research to elucidate best practices in the surgical management of these patients.