To the content
2 . 2022

Arterial hypertension associated with physiological hyperandrogenism in men

Abstract

It has been established that the problem of arterial hypertension is noted more often among transgender men than in the general population. In addition, an increase of blood pressure is often observed in men using androgenic anabolic steroids. In this regard, the assessment of arterial hypertension in men with physiological hyperandrogenism is relevant.

Aim – ​to assess the presence of correlation between arterial hypertension and physiological hyperandrogenism in men.

Material and methods. A continuous cross-sectional study of 80 men with hyperandrogenism. During the study, the levels of luteinizing hormone, total testosterone, sex hormone-binding globulin were determined with further calculation of free testosterone according to Vermeulen equation and dihydrotestosterone (DHT). In men with elevated testosterone levels estradiol was determined. Blood pressure was monitored by measuring it with a tonometer 3 times a day for 2 weeks. Differences between groups were considered statistically significant at p<0.05.

Results. Morning blood pressure was statistically significantly higher in men with elevated total and free testosterone compared to men with elevated DHT. An increase in blood pressure was characteristic for 35% of patients with elevated levels of total and free testosterone. Statistically significant differences were found between patients with and without arterial hypertension in the level of estradiol, which, while remaining within the normal range, was lower in the group of patients with arterial hypertension.

Conclusion. Physiological hyperandrogenism, accompanied by an increased testosterone levels, may be associated with arterial hypertension. Estrogen production may be a factor influencing its development.

Keywords:hyperandrogenism; testosterone; dihydrotestosterone; men; arterial hypertension

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Data collection, analysis and interpretation of the results, text writing – ​Filatova V.A.; the concept and design of the study, editing a manuscript in order to increase scientific value of the article – ​Rozhivanov R.V. All authors approved the final version of the article before publication, agreed to be responsible for all aspects of the work, implying the proper study and resolution of issues related to the accuracy or integrity of any part of it.

For citation: Filatova V.A., Rozhivanov R.V. Arterial hypertension associated with physiological hyperandrogenism in men. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2022; 11 (2): 41–6. DOI: https://doi.org/10.33029/2304-9529-2022-11-2-41-46 (in Russian)

REFERENCES

1. Dedov I.I., Mel’nichenko G.A., Fadeev V.V. Endocrinology: textbook. 3rd ed., revised and supplemented. Moscow, 2015: 416 p. (in Russian)

2. Alzahrani T., Nguyen T., et al. Cardiovascular disease risk factors and myocardial infarction in the transgender population. Circ Cardiovasc Qual Outcomes. 2019; 12 (4): e005597.

3. Jian-Di L., Yan-Qing Wu. Anabolic-androgenic steroids and cardiovascular risk. Chin Med J (Engl). 2019; 132 (18): 2229–36.

4. Williams Br., Mancia G., et al. 2018 ESC/ESH guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J. 2018; 39 (33): 3021–104.

5. Vermeulen A., Verdonck L., Kaufman J.M. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999; 84 (10): 3666–72. DOI: https://doi.org/10.1210/jcem.84.10.6079

6. STATISTICA help [Internet], 2019. STATISTICA automated neuronal networks overviews – network types. The multilayer perceptron neural networks. URL: http://documentation.statsoft.com/STATISTICAHelp.aspx?path=SANN/Overview/SANNNeuralNetworksAnOverview (date of access April 11, 2019)

7. Zhu J., Wittemans L.B.L., Lindgren C., Hirschhorn J.N., et al. A genetically defined male counterpart of polycystic ovary syndrome: evidence for ovarian-independent pathogenesis. J Endocr Soc, 2021; 5 (Suppl 1, April-May): A773–4.

8. Gillis E., Sullivan J. Sex differences in hypertension: recent advances. Hypertension. 2016; 68 (6): 1322–7.

9. Chasland L., Green D., et al. Effects of testosterone treatment, with and without exercise training, on ambulatory blood pressure in middle-aged and older men. Clin Endocrinol (Oxf). 2021; 95 (1): 176–86.

10.Isidoro L., Ferrer M., et al. Vasoactive androgens: vasorelaxing effects and their potential regulation of blood pressure. Endocr Res. 2018; 43 (3): 166–75.

11.Swerdloff R., Dudley R., et al. Dihydrotestosterone: biochemistry, physiology, and clinical implications of elevated blood levels. Endocr Rev. 2017; 38 (3): 220–54.

12.Iorga A., Cunningham C., Moazeni S., et al. The protective role of estrogen and estrogen receptors in cardiovascular disease and the controversial use of estrogen therapy. Biol Sex Differ. 2017; 8 (1): 33.

13.Teoh H., Quan A., Leung S.W., et al. Differential effects of 17beta-estradiol and testosterone on the contractile responses of porcine coronary arteries. Br J Pharmacol. 2000; 129 (7): 1301–8.

14.Caceres B.A., Carl G.Jr. Cardiovascular health concerns in sexual and gender minority populations. Nat Rev Cardiol. 2021; 18 (4): 227–8.

15.Streed C.G.Jr., Harfouch O., Marvel F., et al. Cardiovascular disease among transgender adults receiving hormone therapy: a narrative review. Ann Intern Med. 2017; 167 (4): 256–67.

16.Reckelhoff J.F., Zhang H., Granger J.P. Testosterone exacerbates hypertension and reduces pressure-natriuresis in male spontaneously hypertensive rats. Hypertension. 1998; 31 (1 pt 2): 435–9.

17.Kario K., Saito I., Kushiro T., Teramukai S., et al. Home blood pressure and cardiovascular outcomes in patients during antihypertensive therapy: primary results of HONEST, a large-scale prospective, real-world observational study. Hypertension. 2014; 64: 989–96.

18.Kario K., Saito I., Kushiro T., Teramukai S., et al. Morning home blood pressure is a strong predictor of coronary artery disease: the HONEST study. J Am Coll Cardiol. 2016; 67: 1519–27.

CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
Вскрытие
Medicine today

Уважаемые коллеги! Представляем оргкомитет 17-го Национального конгресса терапевтов (с международным участием) , который состоится 12-14 октября в МВЦ "Крокус Экспо" (павильон 3, Зал 20, г. Москва). · Президент Российского научного медицинского общества терапевтов,...

IV Съезд онкологов Московской области 7 октября 2022 года Активное развитие онкологической службы позволяет эффективно решать проблемы, возникающие на всех уровнях оказания помощи пациентам с онкозаболеваниями. Одним из успешных примеров такого взаимодействия является IV...

II Всероссийская конференция с международным участием "Воспаление глаза" 12 ноября 2022 года, Москва Воспалительные заболевания глаза - широко распространенная и многогранная проблема, с которой может столкнуться в своей практике любой специалист. Найти оптимальные алгоритмы...


Journals of «GEOTAR-Media»