Higher DHEA levels may protect against coronary events

Tuesday, November 18, 2014. The October 28, 2014 issue of the Journal of the American College of Cardiology published the findings of researchers at Sweden's University of Gothenburg of an association between higher levels of dehydroepiandrosterone (DHEA) and a reduced risk of coronary heart disease events in men. DHEA, which is produced by the adrenal glands, is considered a prohormone, and declines during aging.

The study included 2,614 Swedish subjects between 69 and 80 years of age enrolled in the Osteoporotic Fractures in Men study. Blood samples obtained upon enrollment were analyzed for DHEA and DHEA sulfate. National register data were used to obtain cardiovascular clinical outcomes over a five year period.

Over the follow-up period, coronary heart disease events occurred among 302 men and 225 men experienced a cerebrovascular disease event. A decline in DHEA as well as DHEA sulfate was associated with an elevation in the risk of coronary heart disease events. The association remained significant following adjustment for cardiovascular risk and other factors.

"Endogenous production of DHEA appears to be a protective factor against coronary heart disease," stated lead researcher Åsa Tivesten, of the University of Gothenburg's Wallenberg Laboratory for Cardiovascular and Metabolic Research. "High DHEA levels may also be a biomarker of generally good health in elderly men."

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Decreased DHEA sulfate levels linked to greater stroke risk in women

In the American Heart Association journal Stroke, researchers from Brigham and Women's Hospital and Harvard School of Public Health report an association between lower levels of the hormone dehydroepiandrosterone sulfate (DHEAS) and a greater risk of stroke in older women. Their findings appeared online in the journal on May 23, 2013.

The study included women who had no history of stroke upon enrollment in the Nurses' Health Study in 1976. Stored blood samples obtained between 1989 and 1990 were analyzed for DHEA sulfate levels. Four hundred sixty-one participants in whom stroke had occurred over follow-up were matched for age, race, menopausal status and other factors with an equal number of control subjects.

Women who experienced a stroke were likelier to be diabetic and have a history of high blood pressure in comparison with the control group. Among women whose DHEAS levels were among the lowest 25% of participants in the current study, the adjusted risk of experiencing an ischemic stroke was 33% higher than that of women whose levels were among the top 25%. Further adjustment of the analysis increased the percentage to 41%.

Authors Kathryn M. Rexrode MD, MPH and colleagues note that DHEA could influence the development of cardiovascular disease and stroke through mechanisms that include inhibition of the migration and proliferation of vascular wall cells, and stimulation of vascular smooth muscle cell apoptosis, which reduces vascular remodeling subsequent to injury.

"To our knowledge, this is the first report to evaluate DHEAS levels and risk of ischemic stroke," the authors announce. "In this cohort of older women, these results suggest evidence for an inverse association between DHEAS and risk of ischemic stroke, where lower levels of DHEAS were associated with an increased risk of ischemic stroke."

"Additional research is warranted to confirm these associations in other populations," they conclude.

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DHEA Restoration Therapy

As a precursor to androgens (male hormones) and estrogens (female hormones), DHEA plays a fundamental role in the maintenance of hormonal balance and youthful vitality. It also modulates a variety of pathways throughout the body involved in various aspects of health and disease via direct actions independent of its role as a precursor to androgens and estrogens (Samaras 2013; Traish 2011; Savineau 2013).

Aging disrupts hormonal balance, with the levels of several critical hormones dramatically reduced in comparison with youthful levels, and DHEA is no exception. By age 80, levels of DHEA fall by as much as 80%–90% compared to what they were during young adulthood (Samaras 2013). The gravity of this becomes clear after understanding the roles DHEA plays in supporting healthy, youthful physiology across several body systems. Studies have shown that reduced levels of DHEA-S are linked with the pathophysiology underlying numerous age-associated disease states, including cognitive decline, cardiovascular disease, bone loss, cancer, depression, sexual dysfunction, and various inflammatory disorders (Samaras 2013; Traish 2011; Savineau 2013; Dong 2012; Zaluska 2009; Labrie 2009; Straub 2000; Krysiak 2008; Lopez-Marure 2011).

In addition to its role as a hormone precursor, DHEA also modulates inflammation, which is a driving force in many diseases. This multifunctional hormone also promotes the production of the cell-signaling molecule nitric oxide within the delicate lining of blood vessels by activating an enzyme called endothelial nitric oxide synthase (eNOS). Nitric oxide is a pivotal regulator of blood flow via its ability to stimulate blood vessel dilation. Thus, it is not surprising that low DHEA levels have been linked to cardiovascular disease in the medical literature (Samaras 2013; Traish 2011).

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