Hypertension and sex hormone levels in young and middle-aged men

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Abstract

Background. Hypertension is a major cardiovascular condition and exhibits significant sexual dimorphism. The prevalence of hypertension in the general population could be associated with the state of sex hormone system to a large degree. Currently the data obtained on the relationship between sex hormones and blood pressure levels are insufficient.

Aims — to study the relationship between hypertension and sex hormone levels in young and middle-aged men in a retrospective cohort study setting.

Methods. A retrospective observational clinical trial was conducted. 698 medical records of male patients aged 18 to 59 years were analyzed. 508 patients with an average age of 41.1 ± 9.4 years, obesity prevalence of 48.2%, and hypertension prevalence of 52% were selected. Blood pressure levels, anthropometric data, levels of sex hormones, lipid panel and insulin resistance indicators were analyzed.

Results. In our study group, obesity and its abdominal form were more common among patients with hypertension. A decrease in the testosterone level (< 12.1 nmol/l) was significantly more common among patients with hypertension (64.91 versus 41.98%; p ≤ 0.001). Differences in the prevalence of hyperestrogenism (estradiol level above 41.2 pg/ml) did not reach statistically significant values (29.43 versus 22.22%; p = 0.064). When dividing the study sample by estradiol tertiles, the groups significantly differed from each other in the prevalence of hypertension (p = 0.028). According to the results of multivariate logistic analysis, sex hormones made a significant contribution to the model of the presence of hypertension. High levels of estradiol were associated with a higher probability of hypertension, while lower levels reduced the probability of hypertension. The relationship between testosterone and hypertension was inverse: the higher the level of this hormone, the lower the probability of hypertension in young and middle-aged men.

Conclusions. Our study shows the presence of an independent relationship between the level of testosterone and estradiol and the presence of hypertension in young and middle-aged men.

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About the authors

Iana A. Orlova

Lomonosov Moscow State University

Email: YAOrlova@mc.msu.ru
ORCID iD: 0000-0002-8160-5612
SPIN-code: 3153-8373

MD, PhD, Professor

Russian Federation, Moscow

Egor D. Sorokin

Lomonosov Moscow State University

Author for correspondence.
Email: srknegor@gmail.com
ORCID iD: 0009-0002-5730-4286
SPIN-code: 3601-1377

MD

Russian Federation, 27 bldg 10 Lomonosovsky Prospekt, 119991, Moscow

Zukhra Sh. Pavlova

Lomonosov Moscow State University

Email: zukhra73@gmail.com
ORCID iD: 0000-0001-7954-0437
SPIN-code: 9329-7628

MD, PhD

Russian Federation, Moscow

Alina G. Plisyuk

Lomonosov Moscow State University

Email: apl.cardio@yandex.ru
ORCID iD: 0000-0003-2015-4712
SPIN-code: 3541-2077

MD, PhD, Assistant Professor

Russian Federation, Moscow

Kirill P. Raevskii

Lomonosov Moscow State University

Email: raevskiikp@my.msu.ru
ORCID iD: 0000-0002-9939-3443
SPIN-code: 9133-3802
Russian Federation, Moscow

Armais A. Kamalov

Lomonosov Moscow State University

Email: armais.kamalov@rambler.ru
ORCID iD: 0000-0003-4251-7545
SPIN-code: 6609-5468

MD, PhD, Professor, Academician of the RAS

Russian Federation, Moscow

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Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. The contribution of the studied metabolic parameters and sex hormones to the presence of arterial hypertension. Multifactorial logistic analysis data Note. SHBG is a sex hormone binding globulin; DHT is dihydrotestosterone; E2 is total estradiol; BMI is body mass index; LH is luteinizing hormone; HDL is high—density lipoprotein cholesterol; LDL is low—density lipoprotein cholesterol; OT is waist circumference; OHC is total cholesterol; CVE 2 is free estradiol; svT is free testosterone; T — total testosterone; T/E2 — ratio of testosterone to estradiol; TSH — thyroid stimulating hormone; FSH — follicle stimulating hormone.

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3. Fig. 2. SHAP-parameters of the hypertension prediction model based on the studied metabolic parameters and sex hormones Note. DHT — dihydrotestosterone; E2 — total estradiol; BMI — body mass index; LH — luteinizing hormone; HDL — high-density lipoprotein cholesterol; LDL — low-density lipoprotein cholesterol; OT — waist circumference; OHC — total cholesterol; cvE2 — free estradiol; svT — free testosterone; T — total testosterone; T/E2 is the ratio of testosterone to estradiol.

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