Περίληψη:
Background: There is evidence for inverse association between endogenous
testosterone and blood pressure. Furthermore, low plasma testosterone is
associated with increased risk of major cardiovascular events in
middle-aged hypertensive men. Central (aortic) blood pressures determine
left ventricular hypertrophy and predict cardiovascular mortality. The
aim of the present study was to assess the relationship of total
testosterone (TT) with central haemodynamics and left ventricular mass
in hypertensive men.
Methods: We investigated 134 non-diabetic, middle-aged, hypertensive men
and 60 age-matched normotensive males. All participants were subject to
measurement of aortic systolic (aoSBP) and pulse pressure (aoPP) by
pulse wave analysis using the SphygmoCor device. Wave reflections were
assessed by the measurement of heart rate corrected augmentation index
(AIx(75)). Echocardiography was performed in all individuals and left
ventricular mass (LVM) was calculated using the Devereux's formula.
Plasma TT was measured by enzyme immunoassay.
Results: In hypertensive men, univariate analysis showed an inverse,
significant correlation between TT and aoSBP (r = -20, p = 0.02), aoPP
(r = -0.21, p = 0.01), AIx75 (r = -0.22, p = 0.01) and LVM (r = -0.19, p
= 0.008). Multivariate regression analysis demonstrated an independent
inverse association of TT with aoPP (b = -0.21, p = 0.02), AIx(75) (b =
-0.19, p = 0.03) and LVM (b = -0.28, p = 0.005) after adjustment for
age, BMI, smoking, total cholesterol, triglycerides, fasting glucose,
mean arterial pressure, antihypertensive treatment and statin use.
Independent associations were retained even after inclusion of
normotensive subjects in the analysis.
Conclusions: In hypertensive men, TT is independently and inversely
associated with central pulse pressure, wave reflections and left
ventricular mass. Considering the adverse prognostic role of central
blood pressures and LV hypertrophy on cardiovascular outcomes in
hypertensive patients, the present findings might explain part of the
increased cardiovascular risk associated with low testosterone. Whether
measurement of central haemodynamics may improve risk stratification in
hypertensive men with low testosterone warrants further investigation.
(C) 2016 Elsevier Ireland Ltd. All rights reserved.
Συγγραφείς:
Vlachopoulos, Charalambos
Pietri, Panagiota
Ioakeimidis,
Nikolaos
Aggelis, Athanasios
Terentes-Printzios, Dimitrios and
Abdelrasoul, Mahmoud
Gourgouli, Ioanna
Stefanadis, Christodoulos
and Tousoulis, Dimitrios
