Among the many other functions of testosterone, it helps the tissues of the body to take in more blood sugar in response to insulin (hormone that helps lower blood sugar levels). In this way, blood pressure can be maintained at normal levels. Aside from this mechanism, an overwhelming body of clinical research has shown that testosterone has potent vasodilatory effect, which causes blood vessels to widen and ultimately lowers blood pressure.  This effect is very similar to how anti-hypertensive drugs work.
Normal testosterone levels are known to regulate blood pressure, and a decline in this hormone could potentially cause a sudden spike in blood pressure. In fact, there are numerous studies linking low testosterone levels to blood pressure elevation. For instance, Akinloye et al. reported that there is a strong association between low blood testosterone levels and high blood pressure.  The researchers included patients with metabolic syndrome and type 2 diabetes. Upon checking the subjects’ testosterone levels, researchers found that their testosterone levels are abnormally low.
In one study assessing testosterone levels in both sexes, Reckelhoff et al. found that hypertensive subjects have low levels of testosterone.  The researchers therefore concluded that measurement of testosterone levels must be included in the medical management of hypertensive patients as well as those with medical conditions in which hypertension is a major risk factor.
Similarly, data from the population-based Study of Health in Pomerania, Germany involving 1,484 men aged 20-79 years, revealed that total testosterone were significantly lower in men with baseline and incident hypertension.  According to the researchers, low testosterone levels can therefore be included in the predictive markers of hypertension.
There is also increasing evidence that testosterone replacement therapy can help bring down high blood pressure. In a study by Janjgava et al., eighty-five subjects (41-65 years old) were divided into two groups: 1) a testosterone-treated group; 2) a placebo group.  After 6 months of treatment, subjects who were treated with testosterone undecanoate 250 mg/ml intramuscularly once every 3 months had significant reductions in their blood pressure readings compared to placebo-treated group.
In a study by Marin et al., twenty-three middle-aged abdominally obese men were treated for eight months with testosterone or with placebo.  After the treatment period, researchers concluded that testosterone treatment of middle-aged abdominally obese men gives beneficial effects on blood pressure and well-being, as well as cardiovascular and diabetes risk profile.
In the TIMES2 study, Jones et al. evaluated the efficacy, safety, and tolerability of a novel transdermal 2% testosterone gel over 12 months in 220 hypogonadal men with type 2 diabetes and/or MetS.  In just 6 months, researchers observed that testosterone replacement therapy was associated with beneficial effects on blood pressure.
Other high quality studies assessing the therapeutic benefits of testosterone replacement therapy in older men and postmenopausal women with high blood pressure have shown that the treatment may help lower blood pressure levels by improving blood circulation within the arteries. [488-494]
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