Division of Women's Health.
Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital.
J Hypertens. 2018 Nov;36(11):2237-2244. doi: 10.1097/HJH.0000000000001812.
Higher levels of total testosterone and lower levels of sex hormone-binding globulin (SHBG) have been associated with increased blood pressure (BP) in women with an inverse association between total testosterone and BP among men. Fewer studies have examined associations with 24-h ambulatory blood pressure (ABP), blunted nocturnal BP decline or the role of dehydroepiandrosterone sulfate (DHEAS), a precursor to androgens.
Baseline blood samples were assayed for 229 normotensive men (≥50 years) and women (≥55 years) participating in the VITamin D and OmegA-3 TriaL. Standardized seated BP (SBP and DBP) and 24-h ABP were measured by trained technicians. Self-reported cardiovascular risk factors and sociodemographic variables were reported on baseline questionnaires. Sex stratified linear regression models adjusted for age, race/ethnicity, BMI, smoking and alcohol estimated the association between each sex hormone and measures of BP and 24-h ABP. Logistic regression used to estimate associations with blunted nocturnal decline (>10% reduction in SBP or DBP during sleeping hours).
Total testosterone and SHBG demonstrated significant inverse correlations with SBP whereas DHEAS was not significantly associated with BP. Among men, in multivariable analyses, each 10% increase in DHEAS was associated with a 0.41 mmHg higher seated DBP (β = 4.29, 95% CI 0.84-7.73) and each 10% increase in total testosterone and SHBG was associated with a 0.54 mmHg (β = -5.65, 95% CI -10.45 to -0.84) and 0.60 mmHg (β = -6.30, 95% CI -11.38 to -1.21) decrease in seated DBP, respectively. No significant associations were observed among women.
Among men only, we observed statistically significant inverse cross-sectional associations between total testosterone and SHBG with seated DBP, and a significant positive association with DHEAS levels.
较高的总睾酮和较低的性激素结合球蛋白（SHBG）水平与女性的血压升高有关，而男性的总睾酮与血压之间则呈负相关。较少的研究检查了与 24 小时动态血压（ABP）、夜间血压下降减弱或脱氢表雄酮硫酸盐（DHEAS）的关系，DHEAS 是雄激素的前体。
对 229 名参加维生素 D 和欧米加-3 试验的正常血压男性（≥50 岁）和女性（≥55 岁）的基线血液样本进行了检测。由经过培训的技术人员测量了标准化坐姿血压（SBP 和 DBP）和 24 小时 ABP。心血管危险因素和社会人口统计学变量通过基线问卷报告。按性别分层的线性回归模型，调整了年龄、种族/民族、BMI、吸烟和饮酒，估计了每种性激素与血压和 24 小时 ABP 测量值之间的关系。使用逻辑回归来估计与夜间下降减弱（睡眠时间内 SBP 或 DBP 下降超过 10%）的关联。
总睾酮和 SHBG 与 SBP 呈显著负相关，而 DHEAS 与血压无显著相关性。在多变量分析中，DHEAS 每增加 10%，坐位舒张压就会升高 0.41mmHg（β=4.29，95%CI 0.84-7.73），总睾酮和 SHBG 每增加 10%，坐位舒张压就会降低 0.54mmHg（β=-5.65，95%CI-10.45 至-0.84）和 0.60mmHg（β=-6.30，95%CI-11.38 至-1.21）。在女性中没有观察到显著的相关性。
仅在男性中，我们观察到总睾酮和 SHBG 与坐位舒张压之间存在统计学上显著的负交叉关联，与 DHEAS 水平呈显著正相关。
