Lower DHEA-S level ups risk for heart failure, death in older adults

Low levels of dehydroepiandrosterone-sulfate (DHEA-S) may increase the risk for heart failure (HF) and mortality but not coronary heart disease (CHD), a study has found.

The investigators measured DHEA-S in stored plasma from visits 4 (1996–1998) and 5 (2011–2013) of the Atherosclerosis Risk in Communities Study. The follow-up for incident events was 18 years for DHEA-S level and 5.5 years for DHEA-S change.

A total of 8,143 individuals without prevalent cardiovascular disease (mean age, 63 years) in a general community setting were included in this study. The investigators then assessed the associations between DHEA-S and incident HF hospitalization, CHD, or mortality, and that between 15-year change in DHEA-S (n=3,706) and cardiovascular events.

DHEA-S levels below the 15th sex-specific percentile of the study population (men: 55.4 µg/dL; women: 27.4 µg/dL) correlated with a higher risk for HF hospitalization (men: hazard ratio [HR], 1.30, 95 percent confidence interval [CI], 1.07–1.58; women: HR, 1.42, 95 percent CI, 1.13–1.79).

Furthermore, DHEA-S below the 25th sex-specific percentile (men: 70.0 µg/dL; women: 37.1 µg/dL) correlated with increased mortality risk (men: HR, 1.12, 95 percent CI, 1.01–1.25; women: HR, 1.19, 95 percent CI, 1.03–1.37).

Greater percentage decrease in DHEA-S further increased the risk for HF hospitalization in men (HR, 1.94, 95 percent CI, 1.11–3.39) but not in women. On the other hand, low DHEA-S and change in DHEA-S did not correlate with incident CHD.

“Further investigation is warranted to evaluate mechanisms underlying these associations,” the investigators said.