Believe it or not, testosterone levels can affect blood pressure; this phenomenon is highly relevant for men over age 45 due to natural declines in testosterone that typically occur with aging. Furthermore, about half of the adults in the United States have high blood pressure, many of whom don't know they have it.
This article discusses the impact, potential treatments, and lifestyle considerations regarding the link between testosterone and blood pressure.
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What Is Testosterone?
Testosterone is a chemical messenger critical to male and female body functions. Testosterone impacts mental, sexual, and physical health. Testosterone contributes to:
- Sense of well-being
- Red blood cell formation
- Muscle mass
- Bone health
- Sex organ functioning
- Reproduction
- Sex drive
Maintaining testosterone balance lessens the risk of bothersome symptoms and complications, including high blood pressure.
What Is Low Testosterone (Low T)?
Low testosterone, also referred to as low T or male hypogonadism, is a condition in which the body doesn't produce enough testosterone. The clinical threshold for having low testosterone is less than 300 ng/dL.
What Are The Causes of Low Testosterone?
Causes of male hypogonadism may be primary or secondary.
Primary Causes
- Undescended testicles or absence of testicles
- Genetic/inherited conditions
- Testicular injuries or inflammation
- Chemotherapy and radiation therapy
- Tumors
- Anabolic steroid use
Secondary Hypogonadism
- Congenital conditions
- Iron overload or malnutrition
- Pituitary gland problems, Cushing's syndrome, adrenal insufficiency, or excess prolactin production
- Kidney failure
- Cirrhosis of the liver
- Alcohol use disorder
- Obesity and poorly managed diabetes
- Sleep apnea
- Head or brain injury
- HIV/AIDS
- Aging
- Stress
- Certain medications
- In women: Ovarian insufficiency, amenorrhea (lack of menstrual periods due to extreme exercise, weight loss, or stress), premature menopause, and estrogen therapy
What Are The Symptoms of Low Testosterone?
The symptoms of low testosterone include:
- Erectile dysfunction (ED)
- Reduced sex drive
- Shrinking testicles, low sperm count, and infertility
- Reduced pubic and armpit hair
- Reduced muscle mass, strength, and endurance, as well as increased body fat or enlarged male breast tissue
- Hot flashes
- Poor concentration, memory, and mood changes
- Fatigue and trouble sleeping
- Depression and anxiety
- Brittle, dry skin and thinning hair
- In women: Irregular menstrual cycles, vaginal dryness, and poor libido
Low testosterone in boys can negatively affect their growth, development, and strength.
What Is Blood Pressure?
Blood pressure measures the pressure blood exerts inside blood vessel walls.
- Systolic blood pressure: The first (top) number measures the pressure blood exerts against artery walls when the heart contracts.
- Diastolic blood pressure: The second (bottom) number measures the pressure blood exerts against blood vessel walls as the heart muscle rests between contractions.
A healthy blood pressure reading is less than 120/80 mm Hg. About 70% of Americans have high blood pressure at some point in their lifetime.
High blood pressure is a risk factor for heart disease, heart attack, heart failure, and stroke.
The Link Between Testosterone and Blood Pressure
Low testosterone can lead to conditions that indirectly increase blood pressure, such as higher body fat and insulin resistance.
Studies show that lower total testosterone is a risk factor for high blood pressure, and both low and high testosterone levels are linked to a higher risk of heart problems.
Therefore, it is essential to maintain total testosterone levels that are within acceptable ranges, which are:
- Males: 240-950 ng/dL
- Females: 8-60 ng/dL
Research has shown that hypogonadal men who underwent testosterone therapy experienced reductions in blood pressure, with the most significant improvements occurring in men with higher baseline hypertension.
Impact of Low T on Cardiovascular Health
Testosterone influences cardiovascular function and blood vessel health, as heart muscle cells and blood vessels have receptors that latch to testosterone.
Studies have found that low T concentrations are linked to premature coronary artery disease (CAD) and unfavorable effects on heart disease risk factors. Additional research has found that testosterone replacement therapy (TRT) protects against heart issues and mortality in men with testosterone deficiency.
Testosterone also plays a critical role in healthy weight management and metabolism, impacting blood pressure and the risk of heart problems linked to hypertension.
Managing and Treating Low T
Managing and treating low T typically involves making healthy lifestyle changes, undergoing TRT, or both.
TRT
The different forms of TRT include:
- Injections
- Gels
- Patches
- Pellets
- Creams
- Pills
- Buccal tablets
The benefits of TRT include normalized testosterone levels and a lower risk of hypertension, heart disease, and bothersome symptoms like fatigue and muscle weakness.
However, not everyone is a candidate for TRT. Individuals with the following health history may not be eligible to receive this therapy:
- Prostate cancer
- Prostate lump
- Uncontrolled heart failure
- Breast cancer
- Untreated obstructive sleep apnea
Furthermore, TRT may cause several side effects:
- Oily skin, acne, or skin irritation
- Fluid retention
- Difficulty urinating
- Worsening sleep apnea
- Smaller testicles
- Breast tenderness or changes
Patients should consult with a provider regarding side effects or medical concerns.
Preventive Measures and Lifestyle Choices
There are several prevention measures and healthy lifestyle changes that can maximize heart health and testosterone production.
Testosterone-Boosting Foods
The following foods appear to support healthy testosterone levels:
- Whole grains, such as whole-grain cereals, brown rice, oatmeal, quinoa
- Protein, such as poultry, seafood, lean meats, fatty fish, eggs
- Fruits and vegetables, including dark green vegetables, leafy greens, berries, and more
- Legumes like chickpeas, navy beans, black beans, lentils, kidney beans
- Healthy fats, including olive oil, fish oil, nuts, seeds, avocados
- Dietary supplements, such as ashwagandha, Asian red ginseng, fenugreek seed, Tribulus terrestris, Coleus forskohlii root, and DHEA
Patients should always check in with their doctor before taking dietary supplements.
It is also helpful to limit or avoid:
- Added sugars, desserts, and pastries
- Refined carbohydrates (white bread, white rice)
- Sugar-sweetened beverages
- Trans fats, fried foods, highly processed foods, and fast foods
- Alcohol
Other Lifestyle Changes
Lifestyle adjustments that support testosterone balance and minimize the risk of high blood pressure include:
- Properly manage diabetes, hormone disorders, kidney disease, and alcoholism
- Exercise regularly and maintain an ideal body weight
- Use caution with medicines that affect testosterone
- Cook at home rather than dining out
- Limit alcohol and avoid drugs
- Get enough sleep
- Minimize stress using meditation, yoga, tai chi, acupuncture, or other methods
- Consider natural supplements
When to See a Doctor
Symptoms of heart issues or low testosterone that require medical attention include:
- Shortness of breath
- Chest tightness or pain
- Nosebleeds
- Headaches
- Extreme fatigue
- Problems concentrating or mood changes
- Erectile dysfunction (ED) or infertility
- Coldness, numbness, color changes, cramping, or weakness in the lower limbs
- Other new, unusual, or alarming symptoms
Patients with risk factors should undergo routine screenings for low testosterone and high blood pressure to detect potential problems early, reducing the risk of complications.
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Key Takeaways
- Clinical research suggests a link between testosterone and blood pressure.
- Too little or too much testosterone increases the risk of elevated blood pressure, heart disease, heart attacks, strokes, or other heart problems.
- It is vital to check hormone levels routinely in patients with symptoms of low testosterone or its risk factors, including older age, obesity, and underlying medical conditions.
- Healthy lifestyle changes and undergoing TRT as needed can enhance hormone health, improve blood pressure control, and minimize the risk of heart problems.
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