Features of blood pressure variability and arterial stiffness in hypertensive men with androgen deficiency

Authors

  • V. A. Vizir Zaporizhzhia State Medical University,
  • A. S. Sadomov Zaporizhzhia State Medical University,
  • O. V. Nasonenko Zaporizhzhia State Medical University,

DOI:

https://doi.org/10.14739/2310-1210.2016.4.79893

Keywords:

Hypertension, Testosterone, Arterial Stiffness

Abstract

Male sex has long been argued as a strong risk factor for arterial hypertension. Noteworthy is that available data support the negative impact of low testosterone on male cardiovascular health.

Objective. This study was designed to assess characteristics of circadian blood pressure and arterial stiffness in hypertensive men with and without testosterone deficiency.

Materials and methods. A total of 60 male hypertensive patients aged above 45 years were screened on androgen deficiency symptoms via Male andropause symptoms self-assessment questionnaire (MASSQ). 42 subjects with suspected low testosterone level were recruited into the study for subsequent total testosterone (TT) measurement. 24 h BP monitoring was carried out for all participants. Aortic stiffness was assessed using BPLab Vasotens System (cuff-based oscillometry method).

Results. 43 % of patients had biochemically confirmed low testosterone level. The total score of MASSQ in this group was significantly higher compared to patients with normal testosterone. The decreasing of TT concentration with age was detected. The low TT group was characterized by significantly higher values of 24 h systolic blood pressure (SBP) and pulse pressure (PP) values. The lower testosterone appears to be associated with prevalence of “non-dipper” pattern. The results of the multiple regression analysis revealed the relationship between plasma testosterone levels and SBP values in both study groups, while the relationship between testosterone and DBP values was not significant. A significant relationship was also found in each group between TT and PWV.

Conclusion. The study revealed the high prevalence of androgen deficiency among hypertensive middle-aged men. These patients are characterized by higher BP values compared to those with normal TT levels in the same age range. Low TT concentration may be considered also as the contributor of increased arterial stiffness in hypertensive males.

References

Dolan, E., Thijs, L., Li, Y., Atkins, N., McCormack, P., McClory, S. et al. (2006). Ambulatory Arterial Stiffness Index as a Predictor of Cardiovascular Mortality in the Dublin Outcome Study. Hypertension, 47(3), 365–370. doi: http://dx.doi.org/10.1161/01.hyp.0000200699.74641.c5.

Hwang, K. & Miner, M. (2015). Controversies in testosterone replacement therapy: testosterone and cardiovascular disease. Asian Journal Of Andrology, 17(2), 187. doi: 10.4103/1008-682X.146968.

McBride, J., Carson, C., & Coward, R. (2015). Diagnosis and management of testosterone deficiency. Asian Journal Of Andrology, 17(2), 177–86. doi: 10.4103/1008-682X.143317.

Laughlin, G., Barrett-Connor, E., & Bergstrom, J. (2008). Low Serum Testosterone and Mortality in Older Men. The Journal Of Clinical Endocrinology & Metabolism, 93(1), 68–75. doi: http://dx.doi.org/10.1210/jc.2007-1792.

Liu, P., Death, A., & Handelsman, D. (2003). Androgens and Cardiovascular Disease. Endocrine Reviews, 24(3), 313–340.

Mitchell, G., Hwang, S., Vasan, R., Larson, M., Pencina, M., Hamburg, N. et al. (2010). Arterial Stiffness and Cardiovascular Events: The Framingham Heart Study. Circulation, 121(4), 505–511. doi: 10.1161/CIRCULATIONAHA.109.886655.

Muram, D., Zhang, X., Cui, Z., & Matsumoto, A. (2015). Use of Hormone Testing for the Diagnosis and Evaluation of Male Hypogonadism and Monitoring of Testosterone Therapy: Application of Hormone Testing Guideline Recommendations in Clinical Practice. The Journal Of Sexual Medicine, 12(9), 1886–1894. doi: 10.1111/jsm.12968.

Stenholm, S., Metter, E., Roth, G., Ingram, D., Mattison, J., Taub, D., & Ferrucci, L. (2011). Relationship between plasma ghrelin, insulin, leptin, interleukin 6, adiponectin, testosterone and longevity in the Baltimore Longitudinal Study of Aging. Aging Clinical And Experimental Research, 23(2), 153–158.

Travison, T., Araujo, A., Kupelian, V., O’Donnell, A., & McKinlay, J. (2007). The Relative Contributions of Aging, Health, and Lifestyle Factors to Serum Testosterone Decline in Men. The Journal Of Clinical Endocrinology & Metabolism, 92(2), 549–555. doi: 10.1210/jc.2006-1859.

Vikan, T., Schirmer, H., Njolstad, I., & Svartberg, J. (2009). Endogenous sex hormones and the prospective association with cardiovascular disease and mortality in men: the Tromso Study. European Journal Of Endocrinology, 161(3), 435–442. doi: 10.1530/EJE-09-0284.

Vlachopoulos, C., Aznaouridis, K., O'Rourke, M., Safar, M., Baou, K., & Stefanadis, C. (2010). Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. European Heart Journal, 31(15), 1865–1871. doi:10.1093/eurheartj/ehq024.

Wang, C., Nieschlag, E., Swerdloff, R., Behre, H., Hellstrom, W., Gooren, L. et al. (2009). ISA, ISSAM, EAU, EAA and ASA recommendations: investigation, treatment and monitoring of late-onset hypogonadism in males. The Aging Male, 12(1), 5–12. doi: 10.1080/13685530802389628.

Wang, F., Pan, W., Wang, H., Wang, S., Pan, S., & Ge, J. (2012). Relationship between thyroid function and ICU mortality: a prospective observation study. Critical Care, 16(1), R11. doi: 10.1186/cc11151.

Wu, F., Tajar, A., Beynon, J., Pye, S., Silman, A., Finn, J., et al. (2010). Identification of Late-Onset Hypogonadism in Middle-Aged and Elderly Men. New England Journal Of Medicine, 363(2), 123–135. doi: 10.1056/NEJMoa0911101.

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How to Cite

1.
Vizir VA, Sadomov AS, Nasonenko OV. Features of blood pressure variability and arterial stiffness in hypertensive men with androgen deficiency. Zaporozhye Medical Journal [Internet]. 2016Oct.13 [cited 2024Nov.22];18(4). Available from: http://zmj.zsmu.edu.ua/article/view/79893

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Original research