The Serum Testosterone Level in Male Patients Is Inversely Associated With Hypertension Incidence

Hypertension is a primary risk factor for cardiovascular diseases and all-cause mortality. Testosterone, the most potent androgen in males, regulates reproduction, metabolism, and erythropoiesis. Hypertension incidence increases with age, whereas testosterone levels decline. Thus, we conducted a study to explore the association between the two events and the predictive role of serum testosterone for hypertension. Among 3480 male patients aged ≥40 years who visited the Cardiovascular Medicine Center of our hospital, 3401 were eligible for the study. Linear relationships, generalized additive models, multivariate regression, and the data's receiver operating characteristic (ROC) curves were constructed and analyzed. These male patients were consecutively admitted to our Cardiovascular Medicine Center during a 4-year period. We found that hypertensive patients aged between ≥40 and <80 years had significantly lower serum testosterone levels than the normotensive ones. A multivariate regression model showed an inverse association between serum testosterone levels and hypertension in these patients. As expected, there was a significant correlation between age and testosterone levels. ROC curve analysis revealed that serum testosterone had a modest predictive role for hypertension in male patients aged between 40 and 60 years. For those aged between 60 and 79 years, a combination of testosterone, age, smoking status, and body mass index (BMI) improved a predictive value for hypertension. This observational study demonstrates that in aged male patients, testosterone levels were inversely proportional to hypertension. In some age groups, they had an improved predictive value for hypertension when combined with other clinical factors.