Presentation Authors: Taylor P. Kohn, Baltimore, MD, Katherine M. Rodriguez*, Houston, TX, Daniel Pichardo, William Meeks, Linthicum, MD, Larry I. Lipshultz, Houston, TX, James M. Hotaling, Alexander Pastuszak, Salt Lake City, UT
Introduction: Multiple studies have assessed the risk between hypogonadism (HG) and cardiovascular disease (CVD). Insurance claims data capture care across multiple clinical and inpatient settings giving a more complete picture than can be found in single clinic data. Here we utilize a national claims database to examine the association between diagnoses of HG and CVD.
Methods: We analyzed subjects from the IBM MarketScan insurance claims database for 2005, 2008, 2010, 2012, and 2014. Men with HG diagnoses were identified using diagnosis (ICD-9) code, and were matched based on age, year of presentation, and percent with relevant comorbidities, to control men without a diagnosis of HG in a 1:30 ratio. Association between HG, other diseases, and medications was assessed using chi-squared and a Benjamini-Yekutieli adjustment was applied to decrease the false discovery rate.
Results: A total of 65,584 men with a diagnosis of HG and 1,967,520 men without a diagnosis of HG were included. The groups were matched by average age (49.7 years); percent hypertension, hyperlipidemia, and diabetes; and percent with history of heart attack (Table 1A). Overall, an increased risk of death was observed in men with HG (OR: 2.01; CI: 1.95-2.08), but a decreased risk of heart disease, atherosclerosis, cardiac dysrhythmias, cardiac conductive disorders, congestive heart failure, or ischemic stroke was observed in men with HG (Table 1B). Diagnoses of erectile dysfunction (OR: 6.15) and testosterone use (OR: 16.7) were included as comparative controls.
Conclusions: Men with HG have an increased mortality risk, but this does not appear to be due to an increased CV risk in these men. In this large population of men with HG and age and co-morbidity matched controls, we find that HG may be associated with lower risk of CVD.
Source of Funding: A.W.P. is a National Institutes of Health K08 Scholar supported by a Mentored Career Development Award (K08DK115835-01) from the from the National Institute of Diabetes and Digestive and Kidney Diseases. This work is also supported in part through a Urol