Both low and high testosterone levels in hypertension linked to higher CV risk: Study
China: High blood pressure (BP) is associated with decreased free testosterone (FT), total testosterone (TT), and sex hormone–binding globulin (SHBG) in elderly and middle-aged men, finds a recent study. The study, published in the Journal of the American Heart Association, found lower TT to be a promising risk marker for prevalent hypertension. Both low and high testosterone levels are associated with higher cardiovascular risk.
A decline in testosterone levels with age is thought to be of great importance for male aging and cardiovascular disease. However, data on whether abnormal sex hormones are linked to the presence of cardiovascular diseases is uncertain. Also, it is uncertain how BP modifies the association between testosterone levels and major cardiovascular diseases.
To fill this knowledge gap, Xuejun Shang, Nanjing University, Nanjing, China, and colleagues conducted a multicenter, population‐based, cross‐sectional study that included 6296 men between 2013 and 2016. Using patient-filled questionnaires, basic information and clinical symptoms were obtained.
Blood pressure and plasma levels of total testosterone, sex hormone–binding globulin, luteinizing hormone, and free testosterone were determined in men in a multistage random, cluster sampling in 6 provinces of China.
The researchers included a total of 5786 Chinese men (mean [SD] age 55.0 [10.1] years); 37.2% (2150) of them were diagnosed with hypertension.
Key findings of the study include:
- Total testosterone, free testosterone, and sex hormone–binding globulin were inversely associated with the prevalence of hypertension.
- Age >65 years or body mass index ≥24 negatively impacted the inverse correlation between testosterone levels and hypertension, whereas smoking and family history of hypertension strengthened the correlation.
- In participants with grade 2 hypertension, total testosterone was positively associated with the presence of stroke, and luteinizing hormone was also positively correlated with cardiovascular and cerebrovascular diseases.
"Lower total testosterone could be a promising risk marker for prevalent hypertension. Both low and high levels of testosterone are associated with greater cardiovascular risk," wrote the authors. "Primary hypogonadism may be a risk marker for major cardiovascular diseases in men with severe hypertension."
The study titled, "Association of Serum Testosterone and Luteinizing Hormone With Blood Pressure and Risk of Cardiovascular Disease in Middle‐Aged and Elderly Men," is published in the Journal of the American Heart Association.