Both High and Low Levels of Testosterone Correlate With Cardiovascular Issues in Men

Posted by Professor Anna Gray, Updated on May 5th, 2021
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As men age, hormone levels tend to decline or become imbalanced. The majority of hormones tend to decrease, but occasionally levels are seen to be too high. For example, this includes testosterone, growth hormone, thyroid stimulating hormone (TSH), etc. All of these hormones (and more!) play essential roles in our bodies – roles that need to be continued if one wants to live a long and happy life. A hormone of major interest to most men is testosterone.


As men age, testosterone tends to decline by about 10% a decade after he reaches 30 years of age. Unfortunately, we are seeing low levels happening even earlier in men due to poor lifestyle choices and environmental factors, most likely. A recent study has found that if a man’s testosterone levels are out of balance, being too low or even too high, he is at increased risk for cardiovascular issues.

Low Testosterone a Risk Marker for Hypertension

The results of a recent study, published in the Journal of the American Heart Association, demonstrated that high blood pressure (hypertension) is associated with decreased free testosterone, total testosterone and sex hormone-binding globulin (SHBG) in middle-aged and older men.

Free testosterone is the testosterone in the blood that is not attached to other molecules or proteins. It just the testosterone molecule itself circulating through the bloodstream. It is bioavailable and free to use by the body. Total testosterone includes both the unbound (free) testosterone and the testosterone that is bound to proteins, such as SHBG or albumin. The bound testosterone cannot enter most cells of the body.

SHBG is a protein that is made by the liver. It chemically binds to sex hormones in both men and women and carries the hormones through the bloodstream. Its role is to control the amount of testosterone that the body uses.

For years, there has been controversy regarding whether or not high testosterone causes cardiovascular (CV) issues, especially increased heart attack risk. The results of multiple studies were inconclusive and contradictory. Researchers in China wanted to try again and attempt to discover the relationship between testosterone levels and cardiovascular events.

The study was conducted on 6,296 men between the years 2013 and 2016. Their methods included patient questionnaires and collecting data on clinical symptoms. They specifically sampled blood pressure, total testosterone, SHBG, luteinizing hormone (LH) and free testosterone. The average age of the subjects was 55 years of age and 32.7% of them had hypertension already.

Testosterone Levels Associated With Blood Pressure, Stroke and CV Diseases

The most important findings of the study found that total testosterone, free testosterone and SHBG levels were inversely correlated with the presence of hypertension. This means that when these hormone levels are low, there is an increased prevalence of hypertension. If a man is older than 65 years of age and has a body mass index (BMI) greater than 24, these factors negatively impact the correlation between testosterone and high blood pressure.

In addition, in the subjects with grade 2 hypertension, total testosterone was positively associated with the presence of stroke and LH was positively correlated with CV and cerebrovascular diseases.

The authors wrote this about their findings: “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. Primary hypogonadism may be a risk marker for major cardiovascular diseases in men with severe hypertension.”

This is why it is essential to have your hormone levels checked regularly. Aging, lifestyle factors, weight gain and environmental issues all can cause hormone imbalance in men. Testosterone is the essential hormone for all men. Most men are afraid of having low testosterone, but according to this study, having high testosterone can have scary effects as well. Cardiovascular issues are no joke because a stroke or heart attack can kill you in seconds. Get your hormone levels checked as soon as possible! It’s super easy and our clinic can get you in touch with an experienced endocrinologist to get you started today.

Reference

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