The influence of testosterone on blood pressure and risk factors for cardiovascular disease in a black South African population.

OBJECTIVES Traditionally high testosterone levels have been thought to have a detrimental effect on lipid profiles. Recently, reports have shown that testosterone has a beneficial effect on lipid profiles. On the other hand, androgens may increase blood pressure via the renin-angiotensin system. The aim of this study was to determine whether the level of testosterone is increased in hypertensive subjects or if other cardiovascular risk factors are altered with increased levels of testosterone in the Black population of South Africa. METHODS For this study, 536 male and 666 female Black subjects were included. The subjects were divided into hypertensive and normotensive groups and high and low testosterone groups. Resting blood pressure was recorded with a finger arterial pressure device. Blood sampling and biochemical analyses were done by using standardized methods. RESULTS The levels of testosterone in the hypertensive males and females were significantly higher compared to the normotensives. In the male high testosterone group, the level of triglyceride was significantly lower, while the high-density lipoprotein cholesterol level was significantly higher. In the female high testosterone group, systolic blood pressure, cortisol level, and renin activity were significantly higher. CONCLUSION In the males, we found beneficial effects of testosterone, which may explain the reported lower incidence of atheroma. However, the testosterone level is also higher with hypertension. The elevated levels of systolic blood pressure and renin activity that were found in the female group with high testosterone levels may be an indication of the role of the renin-angiotensin system in this regard.