Positive association between testosterone, blood pressure, and hypertension in women: Longitudinal findings from the Study of Health in Pomerania

Benedict Ziemens, Henri Wallaschofski, Henry Völzke, Rainer Rettig, Marcus Dörr, Matthias Nauck, Brian G. Keevil, Georg Brabant, Robin Haring

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24 Citations (Scopus)


Background: The association between sex hormones and blood pressure (BP) in women has been investigated mostly in cross-sectional studies yielding inconsistent results. Methods: Data from 1428 women from the population-based Study of Health in Pomerania were used. Associations of total testosterone, androstenedione, sex hormone-binding globulin (SHBG), and free testosterone concentrations with BP and hypertension were analyzed in multivariable cross-sectional and longitudinal regression models in the full sample and stratified by menopausal status. Results: A positive association between total testosterone and BP was revealed in the full sample [SBP: β per standard deviation (SD) increase: 3.22; pulse pressure (PP): β per SD increase: 2.30] and among postmenopausal women (DBP: β per SD increase: 3.33; SBP: β per SD increase: 7.11; PP: β per SD increase: 3.77). Longitudinal analyses also showed a positive association between baseline total testosterone and follow-up BP. Furthermore, low total testosterone concentrations were associated with a decreased risk of prevalent hypertension in all women [relative risk (RR) quartile 1 (Q1) vs. Q4, 0.79; 95% confidence interval, CI 0.67-0.94]. Low SHBG was associated with prevalent hypertension in postmenopausal women (RR 1.27; 95% CI 1.06-1.53) and with incident hypertension in the full sample (RR 1.73; 95% CI 1.10-2.75). Conclusion: The present population-based study is the first to show a consistent positive association between total testosterone and BP in both, cross-sectional and longitudinal analyses, suggesting high total testosterone as a risk marker of increased BP, as well as prevalent hypertension in women.

Original languageEnglish
Pages (from-to)1106-1113
Number of pages8
JournalJournal of Hypertension
Issue number6
Publication statusPublished - Jun 2013
Externally publishedYes


  • blood pressure
  • hypertension
  • sex hormones
  • testosterone
  • women

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