Abstract 13759: Testosterone in Hypertensive Patients: A Secret Player?
Objective: Impaired left ventricular diastolic (LVD) relaxation, reduced exercise capacity and increased aortic stiffness identify hypertensive patients at increased CV risk. Low testosterone concentration has been associated with increased risk for CV events, however, the influence of androgen deficiency on LVD function, exercise workload and aortic stiffness in patients with essential hypertension (HTN) is unknown.
Methods: 82 non diabetic hypertensive men (56±8 y/o, BMI<30kg/m2) and 75 age-matched subjects with normal blood pressure (BP) underwent exercise treadmill testing. Peak exercise capacity was measured in metabolic equivalents, (METS). Diastolic Doppler parameters were used to assess LVD function. Aortic stiffness was evaluated with carotid femoral pulse wave velocity (PWVc-f). Total testosterone (TT) levels were measured in all participants. Hypogonadism (HypG) was defined when TT levels were below 3.4 ng/ml.
Results: Compared to normotensive subjects, patients with HTN had decreased TT (3.9 vs 4.6 ng/ml) and a higher prevalence of HypG (34 vs 16%), (all P<0.01). According to regression analysis, TT was positively associated with METS (b = 0.29, p<0.01) and negatively associated with PWVc-f (b = -0.38, p<0.001), independent of age, BP and metabolic profile. Furthermore, TT was positively associated with E/A ratio (b =0.19, p<0.05) and negatively associated with E/Em ratio (b = -0.26, p<0.01). All participants were subdivided according to presence/absence of HypG. Patients with both HTN and HypG exhibited lower maximum workload and greater impairement of LVD function and aortic elastic properties compared to all the other groups (figure).
Conclusion: Androgen deficiency confers an incremental unfavourable impact on maximal workload, LV early diastolic relaxation and aortic stiffness in men with HTN. Our data allow identification of hypertensive patients without overt CV disease who might warrant more intensive follow-up.
- © 2011 by American Heart Association, Inc.