Kidney Blood Press Res. 2008 Mar 4;31(2):71-79

Testosterone and Blood Pressure Regulation.

Kienitz T, Quinkler M.
Clinical Endocrinology, Department of Internal Medicine, Gastroenterology,
Hepatology and Endocrinology, Charité Campus Mitte, Charité
Universitätsmedizin Berlin, Berlin, Germany.

Background: There is substantial evidence that androgens may play a role in
determining sex-specific blood pressure. Men are at higher risk for
developing coronary heart disease or hypertension compared to premenopausal
women. However, effects of androgens on the renal and cardiovascular system
are complex. This review provides a critical overview of testosterone
actions. Methods: We searched Pubmed library for experimental, animal and
clinical studies, using the keywords 'blood pressure', 'hypertension',
'testosterone' and 'androgens'. Results: While acute administration of
testosterone seems to decrease vascular tone, the long-term net effect of
androgens appears to be vasoconstriction via upregulation of thromboxane
A(2) expression, norepinephrine synthesis, angiotensin II expression, and
endothelin-1 action. Furthermore, androgens cause cardiac hypertrophy,
promote atherosclerosis, vascular remodelling and stimulate renal
prohypertensive processes involving the renin-angiotensin-aldosterone
system. Androgens seem to promote oxidative stress in the kidney and may
also play a role in the differentiation of brain areas involved in blood
pressure regulation. Conclusion: The effects of sex steroids on different
parts of the renal-vascular system are complex and often contradictory. In
sum, net effects of androgen action seem to be vasoconstriction,
atherosclerosis and stimulation of the renin-angiotensin-aldosterone
system. Therefore, androgens may determine blood pressure and the
prevalence of cardiovascular disease. Copyright (c) 2008 S. Karger AG,
Basel.