The US Veterans Affairs database study of more than 83,000 patients also found that men who were treated but did not attain normal levels did not see the same benefits as those whose levels did reach normal.
"It is the first study to demonstrate that significant benefit is observed only if the dose is adequate to normalise the total testosterone levels," said corresponding author Rajat Barua, assistant professor of medicine at the University of Kansas and his colleagues.
"Patients who failed to achieve the therapeutic range after testosterone replacement therapy did not see a reduction in (heart attack) or stroke and had significantly less benefit on mortality," said Barua, who is also with the Kansas City Veterans Affairs Medical Centre.
The study team looked at data on more than 83,000 men in US with low testosterone, all age 50 or above, who received care in Veteran Affairs between 1999 and 2014.
While the study results do seem to advocate for testosterone replacement therapy, Barua stressed the need for "appropriate screening, selection, dosing, and follow-up of patients to maximise the benefit of testosterone therapy."
The study was published in the European Heart Journal.


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