Cardiovascular Disease and Androgens: Clinical Trends, Potential Mechanisms, and Considerations for Engineering Solutions

This review summarizes the current understanding of androgen physiology, relationships between androgens and cardiovascular (CV) diseases, and novel engineering approaches to study the effect of androgens on CV system. Testosterone (T), the primary sex hormone in biological males and a potent sex hormone in females, is the androgen of focus for this review. In the cardiovascular system, T signaling is seen through varying genomic and non-genomic mechanisms, which are further detailed in this review. Varying androgen levels in aging adults can significantly impact CVD outcomes, particularly for males. We also consider the implication of exogenous T treatment and androgen deprivation treatments on CVD. Furthermore, androgen-related trends in different CVD processes such as cardiac hypertrophy, congestive heart failure, atherosclerosis, calcific aortic valve disease, and aneurysms are explored. To that end, we present opportunities for novel tissue engineered approaches to discovering mechanisms and potential therapeutic pathways for androgen-related CV conditions.