Dehydroepiandrosterone replacement therapy in older adults improves indices of arterial stiffness

Summary Serum dehydroepiandrosterone (DHEA) concentrations decrease approximately 80% between ages 25 and 75 year. Aging also results in an increase in arterial stiffness, which is an independent predictor of cardiovascular disease (CVD) risk and mortality. Therefore, it is conceivable that DHEA replacement in older adults could reduce arterial stiffness. We sought to determine whether DHEA replacement therapy in older adults reduces carotid augmentation index (AI) and carotid–femoral pulse wave velocity (PWV) as indices of arterial stiffness. A randomized, double‐blind trial was conducted to study the effects of 50 mg day−1 DHEA replacement on AI (n = 92) and PWV (n = 51) in women and men aged 65–75 year. Inflammatory cytokines and sex hormones were measured in fasting serum. AI decreased in the DHEA group, but not in the placebo group (difference between groups, −6 ± 2 AI units, P = 0.002). Pulse wave velocity also decreased (difference between groups, −3.5 ± 1.0 m s−1, P = 0.001); however, after adjusting for baseline values, the between‐group comparison became nonsignificant (P = 0.20). The reductions in AI and PWV were accompanied by decreases in inflammatory cytokines (tumor necrosis factor α and IL‐6, P