Does TRT affect cardiovascular health?
The TRAVERSE trial and subsequent longitudinal evidence indicate that provider-reviewed testosterone optimization in candidates with confirmed hypogonadism is not associated with increased major cardiovascular events. Hematocrit, lipids, blood pressure, and ApoB are read on the recalibration cadence as part of the standardized panel.
Full answer
The TRAVERSE trial — the largest randomized cardiovascular safety trial of testosterone optimization to date — reported that provider-reviewed TRT in candidates with confirmed hypogonadism did not increase the incidence of major adverse cardiovascular events compared to placebo. This aligns with the broader longitudinal literature. Provider-reviewed optimization treats cardiovascular safety as continuous oversight rather than a single sign-off: hematocrit, lipids (including ApoB where indicated), blood pressure, body composition, and metabolic markers are read on the recalibration cadence. Erythrocytosis is the most common cardiovascular-relevant adjustment driver and is managed through modality, dose, or therapeutic phlebotomy as appropriate.
Educational. Not a substitute for individualized provider review.
- Testosterone optimization pathway — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29