{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:48:24Z","timestamp":1789778904485,"version":"4.0.1"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,5,5]],"date-time":"2014-05-05T00:00:00Z","timestamp":1399248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,11]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Ischaemic stroke is a major cause of morbidity and mortality in elderly men. Our main objective was to examine whether testosterone (T) or dihydrotestosterone (\n                      <jats:styled-content style=\"fixed-case\">DHT<\/jats:styled-content>\n                      ) was associated with incident ischaemic stroke in elderly men.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Elderly men in the Cardiovascular Health Study who had no history of stroke, heart disease or prostate cancer as of 1994 and were followed until December 2010.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>Adjudicated ischaemic stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1032 men (mean age 76, range 66\u201397), followed for a median of 10\u00a0years, 114 had an incident ischaemic stroke. Total T and free T were not significantly associated with stroke risk, while DHT had a nonlinear association with incident stroke (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00\u00b7006) in analyses adjusted for stroke risk factors. The lowest risk of stroke was at DHT levels of 50\u201075\u00a0ng\/dl, with greater risk of stroke at DHT levels above 75\u00a0ng\/dl or below 50\u00a0ng\/dl. Results were unchanged when SHBG was added to the model. Calculated free DHT had an inverse linear association with incident ischaemic stroke with HR 0\u00b777 (95% CI, 0\u00b761, 0\u00b798) per standard deviation in analyses adjusted for stroke risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Dihydrotestosterone had a nonlinear association with stroke risk in which there was an optimal\n                      <jats:styled-content style=\"fixed-case\">DHT<\/jats:styled-content>\n                      level associated with the lowest stroke risk. Further studies are needed to confirm these results and to clarify whether there is an optimal androgen range associated with the least risk of adverse outcomes in elderly men.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cen.12452","type":"journal-article","created":{"date-parts":[[2014,3,19]],"date-time":"2014-03-19T12:52:48Z","timestamp":1395233568000},"page":"746-753","source":"Crossref","is-referenced-by-count":55,"title":["Testosterone and dihydrotestosterone and incident ischaemic stroke in men in the\n                    <scp>C<\/scp>\n                    ardiovascular\n                    <scp>H<\/scp>\n                    ealth\n                    <scp>S<\/scp>\n                    tudy"],"prefix":"10.1111","volume":"81","author":[{"given":"Molly M.","family":"Shores","sequence":"first","affiliation":[{"name":"VA Puget Sound Health Care System Seattle WA USA"},{"name":"Department of Psychiatry and Behavioral Sciences University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice M.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary L.","family":"Biggs","sequence":"additional","affiliation":[{"name":"Department of Biostatistics University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"W.T.","family":"Longstreth","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Washington Seattle WA USA"},{"name":"Department of Epidemiology University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas L.","family":"Smith","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System Seattle WA USA"},{"name":"Department of Epidemiology University of Washington 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California\u2010Davis Davis CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett T.","family":"Marck","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System Seattle WA USA"},{"name":"Geriatric Research, Education and Clinical Care (GRECC) VA Puget Sound Health Care System Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvin M.","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"VA Puget Sound Health Care System Seattle WA USA"},{"name":"Geriatric Research, Education and Clinical Care (GRECC) VA Puget Sound Health Care System Seattle WA USA"},{"name":"Division of Gerontology &amp; Geriatric Medicine Department of Medicine University of Washington Seattle WA 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