Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, D-17489 Greifswald, Germany.
J Hypertens. 2013 Jun;31(6):1106-13. doi: 10.1097/HJH.0b013e3283603eb1.
The association between sex hormones and blood pressure (BP) in women has been investigated mostly in cross-sectional studies yielding inconsistent results.
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.
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).
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.
在女性中，性激素与血压（BP）之间的关系主要在横断面研究中进行了研究，但结果不一致。
本研究使用了基于人群的波罗的海地区健康研究中 1428 名女性的数据。在全样本和按绝经状态分层的多变量横断面和纵向回归模型中，分析了总睾酮、雄烯二酮、性激素结合球蛋白（SHBG）和游离睾酮浓度与 BP 和高血压的关系。
在全样本中，总睾酮与 BP 呈正相关[收缩压（SBP）：每标准差增加β值为 3.22；脉压（PP）：每标准差增加β值为 2.30]，在绝经后女性中也呈正相关[舒张压（DBP）：每标准差增加β值为 3.33；SBP：每标准差增加β值为 7.11；PP：每标准差增加β值为 3.77]。纵向分析还显示，基线总睾酮与随访 BP 呈正相关。此外，在所有女性中，低总睾酮浓度与高血压的患病率降低相关[相对风险（RR）四分位 1（Q1）与 Q4 相比，0.79；95%置信区间，0.67-0.94]。低 SHBG 与绝经后女性的高血压患病率相关（RR 1.27；95%置信区间，1.06-1.53），与全样本的高血压发病相关（RR 1.73；95%置信区间，1.10-2.75）。
本基于人群的研究首次在横断面和纵向分析中一致显示总睾酮与 BP 之间存在正相关，提示高总睾酮是 BP 升高和女性高血压患病率的危险因素。
