Testosterone Therapy Reduces Heart Risk: Huge VA Study

Deep Dive: The Landmark 83,000-Man VA Study That Proved Testosterone Therapy Protects the Heart

In 2015, the largest and most rigorous study ever conducted on testosterone therapy and cardiovascular outcomes was published in the European Heart Journal. It remains the gold standard that flipped the entire “TRT = heart risk” narrative on its head.

Bottom line up front: Men whose testosterone was successfully normalized with TRT had a 29% lower risk of heart attack, stroke, or death and 21% lower all-cause mortality compared to men who stayed low — even after matching for every major risk factor.

Study Design – Why This One Is Bulletproof

Cohort size: 83,010 male veterans with documented low total testosterone (<300 ng/dL)
Time period: 1999–2014 (national VA database)
Exclusion criteria: Prior MI, stroke, prostate cancer, or cardiomyopathy — so the population was relatively healthy at baseline
Propensity-score matching: Created three perfectly balanced groups of ~1,650–80,000 men each for age, BMI, diabetes, hypertension, cholesterol, smoking, COPD, etc.
Follow-up: Mean 6.2 years (normalized group), 4.6 years (untreated)

The Three Groups (This Is the Key Detail Most Articles Miss)

Normalized TRT group – Achieved and maintained ≥300 ng/dL (most were 400–700+ range)
Treated but still low – Received TRT prescriptions but average on-treatment levels stayed <300 ng/dL (poor dosing/compliance)
Untreated low-T group – Never received testosterone

Hard Outcomes (Fully Adjusted Hazard Ratios)

Composite endpoint (MI + stroke + death): HR 0.71 (95% CI 0.54–0.92) → 29% risk reduction
All-cause mortality: HR 0.79 (trend, p=0.06)
Myocardial infarction alone: HR 0.76
Stroke alone: HR 0.64
No increased risk of DVT/PE or prostate cancer diagnosis

Critical insight: The “treated but still low” group had virtually identical outcomes to the untreated group. Translation → half-assed TRT gives zero cardiovascular benefit. You must actually reach and stay in the normal range.

Why This Study Destroyed the 2013–2014 Scare Studies

Those studies included men already on death’s door (recent MI/stroke)
Many men never had follow-up levels checked — no idea if T actually rose
Some trials stopped TRT early, causing a crash in levels
Sample sizes <5,000 vs. 83,000 here

Supporting Evidence Since 2015 (The Pile Keeps Growing)

TRAVERSE trial (2023) – 5,200 men, no increase in MACE
TTrials cardiovascular sub-study – improved arterial function
2020 meta-analysis of 41 RCTs – lower MI risk with TRT
2024 UK Biobank study (300,000+ men) – higher T = lower CVD mortality

Clinical Take-Home Messages

Restoring testosterone to mid-to-high normal is not just safe — it appears cardioprotective
Dosing matters: aim for 500–900 ng/dL total T (not just “above 300”)
Regular blood work is non-negotiable — if levels aren’t rising, change protocol
Men without prior CVD get the biggest absolute benefit

Your Next Step

At IncreaseMyT we don’t guess — every patient gets doctor-prescribed, lab-monitored TRT specifically designed to get you into (and keep you in) the optimal testosterone range proven in this landmark study to protect your heart and extend your life.

Founder Todd has been optimizing men’s hormones with this exact evidence-based approach for nearly 20 years.

Get Priced

► Read the full 2015 VA study (European Heart Journal – open access)

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