Abstract
The aim of this study was to evaluate the relationship between serum testosterone levels and arterial blood pressure (BP) in the elderly. We studied 356 non-diabetic, non-smoking, non-obese men aged 60 to 80 years and untreated for hypertension. All subjects were evaluated in the morning after an overnight fast. Evaluation included measurements of the following: BP (by mercury sphygmomanometer, Korotkoff I and V), body weight, height and free testosterone (T) plasma levels (by radioimmunoassay). According to the BP values, the subjects were classified as normotensives (NT; n=112; SBP/DBP<140/90 mmHg), systolic and diastolic hypertensives (HT; n=127; SBP/DBP>140/90 mmHg), and isolated systolic hypertensives (ISH; n=117; SBP>140 mmHg and DBP<90 mmHg). T values decreased with increasing age in all 3 groups and was significantly lower in HT (-15%) and ISH men (-21%) than in NT men (p<0.05). In each group, the T levels showed a highly significant negative correlation with BMI (p<0.001). A significant negative correlation was also found between T levels and SBP in NT (r=-0.35, p<0.001), ISH (r=-0.67, p<0.001), and HT (r=-0.19, p<0.05) men, whereas a negative correlation with DBP was observed only in the NT men (r=-0.19, p<0.05). Adjusting for the BMI confirmed a significant difference in plasma T levels between ISH and NT men, but not between HT and NT men. Multiple regression analysis employing BP as a dependent variable confirmed a strong relationship between T levels and SBP in all 3 groups, whereas a significant relationship between T levels and DBP was found only in NT men. In conclusion, although further studies are needed to clarify the relationship between plasma T levels and BP, our findings suggest that in elderly men with ISH, the reduced plasma levels of testosterone might contribute to the increased arterial stiffness typical of these subjects.
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Kumai T, Tanaka M, Watanabe M : Possible involvement of androgen in increased norepinephrine synthesis in blood vessls of spontaneously hypertensive rats. Jpn J Pharmacol 1994; 66: 439–444.
Oparil S, Levine RL, Chen YF : Sex hormones and vasculature, in Sowers JR ( ed): Contemporary Endocrinology: Endocrinology of the Vasculature. Totowa, Human Press, 1997, pp 225–237.
Sullivan ML, Martinez CM, Gennis P, Gallagher EJ : The cardiac toxicity of anabolic steroids. Prog Cardiovasc Dis 1998; 41: 1–15.
Zmuda JM, Bausserman LL, Maceroni D, Thompson PD : The effect of supraphysiologic doses of testosterone on fasting total homocysteine level in normal men. Atherosclerosis 1997; 130: 199–202.
Herman SM, Robinson JT, McCredie RJ, Adams MR, Boyer MJ, Celermajer DS : Androgen deprivation is associated with enhanced endothelium-dependent dilatation in adult men. Arterioscler Thromb Vasc Biol 1997; 17: 2004–2009.
Alexandersen P, Haarbo J, Byrjalsen I, Lawaetz H, Christiansen C : Natural androgens inhibit male atherosclerosis: a study in castrated, cholesterol fed rabbits. Circ Res 1999; 84: 813–819.
English KM, Mandour O, Steeds RP, Diver JM, Jones TH, Channer KS : Men with coronary artery disease have lower levels of androgens than men with normal coronary angiograms. Eur Heart J 2000; 21: 890–894.
Rosano GM, Leonardo F, Pagnotta P, et al: Acute anti-ischemic effect of testosterone in men with coronary artery disease. Circulation 1999; 99: 1666–1670.
Webb CM, Adamson DL, de Zeigler D, Collins P : Effects of testosterone on coronary vasomotor regulation in men with coronary heart disease. Circulation 1999; 100: 1690–1696.
Heller R, Wheeler MJ, Micallef J : Relationship of HDL cholesterol with total and free testosterone and SHBG. Acta Endocrinol (Copenh) 1983; 194: 253–256.
Zumoff B, Strain GW, Miller LK, et al: Plasma free and non-sex-hormone binding-globulin-bound testosterone are decresed in obese men in proportion to their degree of obesity. J Endocrinol Metab 1990; 71: 929–931.
Haffner SM, Karhapaa P, Mykkanen L, Laakso M : Insulin resistance, body fat distribution and sex hormones in men. Diabetes 1994; 43: 212–219.
Endre T, Mattiason I, Berglund G, Hulthen UL : Low testosterone and insulin resistance in hypertension prone men. J Hum Hypertens 1996; 10: 755–761.
Glueck CJ, Glueck HI, Stroop D, Spiers J, Hamer T, Tracy T : Endogenous testosterone, fibrinolysis and coronary heart disease risk in hyperlipidaemic men. J Lab Clin Med 1993; 122: 412–420.
Reckelhoff JF : Gender differences in the regulation of blood pressure. Hypertension 2001; 37: 1199–1208.
Dubey RK, Oparil S, Imthum B, Jackson EK : Sex hormones and hypertension. Cardiovasc Res 2002; 53: 688–708.
Cambotti LJ, Cole FE, Gerall A, Frohlic ED, MacPhee AA : Neonatal gonadal hormones and blood pressure in the spontaneously hypertensive rat. Am J Physiol 1984; 247: E258–E264.
Khaw KT, Barret-Connor E : Blood pressure and endogenous testosterone in men: an inverse relationship. J Hypertens 1988; 6: 329–332.
Hughes GS, Mathur RS, Margolius HS : Sex steroid hormones are altered in essential hypertension. J Hypertens 1989; 7: 181–187.
Phillips GB, Jing TY, Resnick LM, Barbagallo M, Laragh JH, Sealey JE : Sex hormones and hemostatic risk factors for coronary heart disease in men with hypertension. J Hypertens 1993; 11: 699–702.
Fogari R, Zoppi A, Preti P, et al: Sexual activity and plasma testosterone levels in hypertensive males. Am J Hypertens 2002; 15: 217–221.
Day WS, Kuller LH, LaPorte RE, Gutai JP, Falvo-Jerard L, Caggiula A : The epidemiology of plasma testosterone levels in middle-aged men. Am J Epidemiol 1981; 114: 804–816.
Labropoulos B, Winkel P, Oekonomados P, Laskans J, Katsimades D : Serum sex hormones in patients with coronary disease and their relationship to known factors causing atherosclerosis. Cardiology 1982; 69: 98–103.
Gray A, Feldman HA, McKinlay JB, Longcope C : Age, disease and changing sex hormones levels in middle-aged men: results of the Massachussets male aging study. J Clin Endocrinol Metab 1991; 73: 1016–1025.
Kauffman JM, Vermeulen A : Declining gonadal function in elderly men. Baillieres Clin Endocrinol Metab 1997; 11: 289–309.
Vermeulen A, Verdonck L, Kaufman JM : A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 2001; 86: 2903.
McCarm DS, Kirkish LS : Evaluation of free testosterone in serum. J Clin Immunoassay 1985; 8: 234–236.
Pandei KM, Oliver PM, Maeda N, Smithies O : Hypertension associated with decreased testosterone levels in natriuretic peptide-receptor-A gene knock-out and gene-duplicated mutant mouse models. Endocrinology 1999; 140: 5112–5119.
Giagulli V, Kauffman JM, Vermeulen A : Pathogenesis of the decreased androgen levels in obese men. J Clin Endocrinol Metab 1994; 79: 997–1000.
Vermeulen A : Decreased androgen levels and obesity in men. Ann Med 1998; 28: 13–15.
Vermeulen A, Kaufman JM, Giagulli VA : Influence of some biological indexes on sex-hormone binding globulin and androgen levels in aging or obese males. J Clin Endocrinol Metab 1996; 81: 1821–1826.
Schneider G, Kirschner MA, Berkowitz R, Ertel NH : Increased estrogen production in obese men. J Clin Endocrinol Metab 1979; 48: 633–638.
Jockenhovel F, Blum WF, Vogel E, et al: Testosterone substitution normalizes elevated serum leptin levels in hypogonadal men. J Clin Endocrinol Metab 1997; 82: 2510–2513.
Dockery F, Bulpitt CJ, Agarwal S, Rajkumar C : Testosterone suppression in men with prostate cancer is associated with increased arterial stiffness. Aging Male 2002; 5: 216–222.
Ahimastos AA, Formosa M, Dart AM, Kingwell BA : Gender differences in large artery stiffness pre and post puberty. J Clin Endocrinol Metab 2003; 88: 5375–5380.
Dockery F, Bulpitt CJ, Donaldson M, Fernandez S, Rajkumar C : The relationship between androgens and arterial stiffness in older men. J Am Geriatr Soc 2003; 51: 1627–1632.
Dockery F, Rajkumar C, Agarwal S, Waxman J, Bulpitt CJ : Androgen deprivation in males is associated with decreased central arterial compliance and reduced central systolic blood pressure. J Hum Hypertens 2000; 14: 395–397.
Malkin CJ, Pugh PJ, Jones RD, Jones TH, Channer KS : Testosterone as a protective factor against atherosclerosis: immunomodulation and influence upon plaque development and stability. J Endocrinol 2003; 178: 373–380.
Kang SM, Jang Y, Kim JY, et al: Effect of oral administration of testosterone on brachial arterial vasoreactivity in men with coronary artery disease. Am J Cardiol 2002; 89: 862–864.
Yambe M, Tomiyama H, Hirayama Y, et al: Arterial stiffening as a possible risk factor for both atherosclerosis and diastolic heart failure. Hypertens Res 2004; 27: 625–631.
Nitta K, Akiba T, Uchida K, et al: Left ventricular hypertrophy is associated with arterial stiffness and vascular calcification in hemodialysis patients. Hypertens Res 2004; 27: 47–52.
Tomiyama H, Arai T, Koji Y, et al: The age-related increase in arterial stiffness is augmented in phases according to the severity of hypertension. Hypertens Res 2004; 27: 465–470.
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Fogari, R., Preti, P., Zoppi, A. et al. Serum Testosterone Levels and Arterial Blood Pressure in the Elderly. Hypertens Res 28, 625–630 (2005). https://doi.org/10.1291/hypres.28.625
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DOI: https://doi.org/10.1291/hypres.28.625
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