Hypogonadism in males is associated with increased atherosclerotic disease. Physiologically, testosterone appears to have both positive and negative effects on the cardiovascular system. Testosterone decreases angina and may improve the cardiac healing response after myocardial infarction. Testosterone enhances function in males with heart failure (HF). Testosterone causes water retention and oedema is common in older persons. Oedema should not be used to diagnose HF in older persons. Studies in older persons with HF and frailty have shown a non-statistically lower mortality rate compared to those receiving placebo.