Studies over the past 30 years have repeatedly shown an inverse correlation between cardiovascular disease and DHEA (dehydroepiandrosterone), a weak adrenal androgen, and its metabolite DHEA-sulfate (DHEAS). Renewed interest followed a report by Barrett-Connor (NEJM, 1986) implicating low DHEAS as a predictor of cardiovascular mortality. Some investigators continue to question the association, citing small samples of poorly characterized subjects, largely men; emphasis on mortality rather than on chronic disease; confounders (medication, comorbidity, smoking, exercise level, alcohol consumption); and variable field methods, measurements, and assay techniques (Contoreggi, 1990; Gray, 1991). Data from the Massachusetts Male Aging Study (MMAS) and Massachusetts Women's Health Study (MWHS), both random-sample, community-based, in-home surveys of middle-aged adults conducted between 1986 and 1990, will permit definitive assessment of the relationship between DHEA and cardiovascular risk, while controlling for important confounders. MMAS produced the largest male endocrine data base presently available, comprising 1709 men aged 39-70. MMAS gathered detailed information on a large number of factors linked to DHEA and cardiovascular disease including comorbidity, medication, blood pressure, obesity, smoking, alcohol usage, exercise level, personality type, and serum lipids. Fifteen serum hormones in addition to DHEA and DHEAS were assayed by a CDC-certified laboratory. MWHS produced similarly comprehensive data on 427 women, with the addition of menstrual history and menopausal status. Cardiovascular risk will be estimated in MMAS and MWHS subjects by means of a sophisticated predictive model developed from Framingham Study data (Anderson, 1991). The following specific questions will be addressed: 1. What is the relationship between DHEA levels and cardiovascular risk in MMAS and MWHS subjects 2. Does this relationship vary between the sexes? 3. How is the association influenced by variables known to affect DHEA level, such as smoking, blood pressure, obesity, and personality type? 4. In men, does the association change in quality or magnitude between ages 40-70? 5. In women, is DHEA related to menopausal status?
| Feldman, H A; Johannes, C B; Araujo, A B et al. (2001) Low dehydroepiandrosterone and ischemic heart disease in middle-aged men: prospective results from the Massachusetts Male Aging Study. Am J Epidemiol 153:79-89 |
| Johannes, C B; Stellato, R K; Feldman, H A et al. (1999) Relation of dehydroepiandrosterone and dehydroepiandrosterone sulfate with cardiovascular disease risk factors in women: longitudinal results from the Massachusetts Women's Health Study. J Clin Epidemiol 52:95-103 |
| Feldman, H A; Johannes, C B; McKinlay, J B et al. (1998) Low dehydroepiandrosterone sulfate and heart disease in middle-aged men: cross-sectional results from the Massachusetts Male Aging Study. Ann Epidemiol 8:217-28 |
