• Open Access

Dehydroepiandrosterone replacement therapy in older adults improves indices of arterial stiffness

Authors

  • Edward P. Weiss,

    1. Division of Geriatrics and Nutritional Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
    2. Department of Nutrition and Dietetics, Saint Louis University, St. Louis, MO 63104, USA
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  • Dennis T. Villareal,

    1. Division of Geriatrics and Nutritional Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
    2. Division of Geriatrics, University of New Mexico School of Medicine and New Mexico VA Health Care System, Albuquerque, NM 87131, USA
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  • Ali A. Ehsani,

    1. Division of Geriatrics and Nutritional Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
    2. Cardiology Division, Saint Louis Veterans Administration Medical Center – John Cochran Division, Saint Louis, MO 63106, USA
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  • Luigi Fontana,

    1. Division of Geriatrics and Nutritional Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
    2. Department of Medicine, Salerno University Medical School, Salerno, Italy
    3. CEINGE Biotecnologie Avanzate, Napoli, Italy
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  • John O. Holloszy

    1. Division of Geriatrics and Nutritional Sciences, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
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  • Clinical trial registration: Clinicaltrials.gov (identifier NCT00182975).

Edward P. Weiss, Department of Nutrition and Dietetics, Saint Louis University, 3437 Caroline Street, Room 3076, St. Louis, MO 63104, USA; Tel.: +314 9778523; fax: +314 977 8520; e-mail: eweiss4@slu.edu

Summary

Serum dehydroepiandrosterone (DHEA) concentrations decrease approximately 80% between ages 25 and 75 year. Aging also results in an increase in arterial stiffness, which is an independent predictor of cardiovascular disease (CVD) risk and mortality. Therefore, it is conceivable that DHEA replacement in older adults could reduce arterial stiffness. We sought to determine whether DHEA replacement therapy in older adults reduces carotid augmentation index (AI) and carotid–femoral pulse wave velocity (PWV) as indices of arterial stiffness. A randomized, double-blind trial was conducted to study the effects of 50 mg day−1 DHEA replacement on AI (n = 92) and PWV (n = 51) in women and men aged 65–75 year. Inflammatory cytokines and sex hormones were measured in fasting serum. AI decreased in the DHEA group, but not in the placebo group (difference between groups, −6 ± 2 AI units, P = 0.002). Pulse wave velocity also decreased (difference between groups, −3.5 ± 1.0 m s−1, P = 0.001); however, after adjusting for baseline values, the between-group comparison became nonsignificant (P = 0.20). The reductions in AI and PWV were accompanied by decreases in inflammatory cytokines (tumor necrosis factor α and IL-6, P < 0.05) and correlated with increases in serum DHEAS (r = −0.31 and −0.37, respectively, P < 0.05). The reductions in AI also correlated with free testosterone index (r = −0.23, P = 0.03). In conclusion, DHEA replacement in elderly men and women improves indices of arterial stiffness. Arterial stiffness increases with age and is an independent risk factor for CVD. Therefore, the improvements observed in this study suggest that DHEA replacement might partly reverse arterial aging and reduce CVD risk.

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