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Effects of testosterone treatment, with and without exercise training, on ambulatory blood pressure in middle‐aged and older men
Author(s) -
Chasland Lauren C.,
Green Daniel J.,
Schlaich Markus P.,
Maiorana Andrew J.,
Cooke Brian R.,
Cox Kay L.,
Naylor Louise H.,
Yeap Bu B.
Publication year - 2021
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14442
Subject(s) - medicine , testosterone (patch) , endocrinology , blood pressure , placebo , ambulatory blood pressure , waist , body mass index , alternative medicine , pathology
Context With age, testosterone (T) and physical activity levels often decline in parallel. The effect of combining T treatment and exercise training on ambulatory blood pressure (ABP) is unclear. Objective To assess T and exercise effects, alone and in combination, on ABP in men aged 50–70 years, waist circumference ≥ 95 cm and low‐normal serum T (6–14 nmol/L), without organic hypogonadism. Design A 2 × 2 factorial randomised, placebo‐controlled study. Intervention Randomization to daily transdermal AndroForte5 ® (Testosterone 5.0%w/v, 100 mg in 2 ml) cream (T), or matching placebo (P) (double‐blind), and to supervised exercise (Ex) or no additional exercise (NEx), for 12 weeks. Results Average 24‐h systolic blood pressure (SBP) increased with T treatment (testosterone*time, p = .035). Average 24‐h SBP increased in T+Ex (T+Ex:+3.0 vs. P+NEx: −3.0 mmHg, p = .026) driven by day‐time changes (T+Ex:+3.5 vs. P+NEx: −3.0 mmHg, p = .026). There was an effect of T for 24‐h average diastolic blood pressure (DBP, testosterone*time, p = .044) driven by the decrease in P+Ex (P+Ex: −3.9 vs. T+NEx: −0.5 mmHg, p = .015). Night‐time DBP was lower with exercise (P+Ex: −4.0 vs. P+NEx: +0.7 mmHg, p = .032). The effect of exercise to lower night‐time DBP was not apparent in the presence of T (T+Ex: −0.4 vs. P+NEx: +0.7 mmHg, p > .05). Ex increased average 24‐h pulse pressure (PP, exercise*time, p = .022), largely during daytime hours (exercise*time, p = .013). Conclusions There was a main effect of T to increase 24‐h SBP, primarily seen when T was combined with Ex. Exercise alone decreased 24‐h and night‐time DBP; an effect attenuated by T. BP should be carefully assessed and monitored, when prescribing T treatment to middle‐aged and older men, especially when combined with exercise training.