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The Importance of Monitoring Blood Pressure While on Testosterone Therapy

Discover effective strategies to lower blood pressure during testosterone therapy. Learn how to maintain healthy blood pressure levels while optimizing hormone balance.

August 4, 2023
Medically-reviewed and fact checked by Ryan Lester, PA-C

Why is monitoring blood pressure so important? How does it impact our day-to-day lives and even our longevity as we age?

These are all important questions. Let’s start with the numbers.

Cardiovascular disease leading to a heart attack or stroke is the number one killer of people in the world. Yes, you read that correctly. It was responsible for 18 million deaths as of 2019.  The next closest? Cancer, at 10 million. What are the two biggest risk factors for heart disease? You guessed it… high blood pressure and smoking. The American Heart Association estimates more than half of all adults in the United States have high blood pressure.

What does all this have to do with testosterone replacement therapy? Most studies looking at TRT show that it does not increase blood pressure, with some even showing an improvement in numbers; however, a small subset of men can notice a gradual increase in blood pressure while on TRT, which is counterproductive to healthy aging.

In addition to increasing the risk of a heart attack or stroke, high blood pressure, also known as hypertension, can significantly increase your risk of cognitive decline as well as irreversible nerve, eye, and kidney damage. Optimal blood pressure is 120/80 mmHG or less, whereas “elevated” is 120-129, “stage 1” is 130-139 and “stage 2” is 140/90 or higher. 

When receiving testosterone treatment, it's crucial that blood pressure be continually monitored, especially if blood pressure is already mildly elevated or if you have pre-existing cardiovascular disease. The goal for everyone should be an average blood pressure of 120/80 mmHg or less. 

Lifestyle changes such as diet and exercise, as well as medications and supplements intended to lower blood pressure, are covered in our guide. Whether this is your first attempt at testosterone therapy or you have already taken action, our manual provides everything needed to maintain optimal blood pressure.

What Is Testosterone Therapy?

Testosterone replacement therapy has become an increasingly popular solution for men suffering from low testosterone levels. When testosterone production decreases, supplementing with testosterone medication can have several positive effects, including increased energy, sexual function, sexual desire, strength, muscle mass, fat loss, and better mood for many individuals.

Before considering testosterone replacement therapy to address low testosterone levels, several considerations must first be addressed. Not every case warrants treatment, while long-term risks and potential side effects must also be carefully weighed against the potential benefits.

Concerns over testosterone levels require consulting with a hormone specialist who will assist each patient individually to assess if hormone medication is a suitable solution.

Before initiating testosterone replacement therapy, blood tests and a discussion of potential testosterone deficiency symptoms must confirm that low testosterone is the source of symptoms before prescribing treatment.

The Relationship between TRT and Blood Pressure

Theories surrounding testosterone replacement therapy's relationship to increased blood pressure often center around its secondary impact of increasing red blood cell production.

Known as secondary polycythemia, this side effect is a bit of a double-edged sword. On one side, increased red blood cell production is highly beneficial because it results in more oxygen being delivered to the body, which improves cardiovascular endurance and energy production. This is one of the reasons why TRT is considered a performance-enhancing drug in certain high-level sports. Alternatively, the potential downside is that this increase in red blood cell production can be accompanied by an increase in blood pressure. In individuals who already have inflammation and rigidity in the lining of their arteries, this can theoretically put further undue stress on the cardiovascular system as a whole and increase the risk of a cardiovascular event. The most recent high-quality clinical studies do not demonstrate an increase in the risk of heart attack, stroke, or death from testosterone replacement therapy.

Therefore, if you are considering testosterone replacement therapy, you should have a good understanding of your current average blood pressure numbers before starting the medication. 

How to Monitor Blood Pressure While Undergoing Testosterone Therapy


Monitoring blood pressure during testosterone therapy is vital to identify irregularities or potential issues that might emerge, so regular check-ins with both your physician and yourself via at-home monitoring are important.

At home, purchasing and using an affordable automatic blood pressure cuff to track changes during testosterone therapy should be straightforward and effortless. The most accurate way to measure your blood pressure at home is to be in a rested, seated position for at least 5 minutes prior to the blood pressure check. Make sure the arm that you are testing your blood pressure in is at heart level, with your legs uncrossed. To get an accurate baseline of your average pressure, you should check it in the morning and evening for at least two weeks. Taking the average of all the readings should give you an accurate baseline measurement.

Managing Your Blood Pressure

There are several strategies you can implement to lower your blood pressure. From lifestyle changes to supplements or medications, here is a list of effective tools: 

  • Lifestyle Changes: Men can take steps such as giving up smoking, cutting back their alcohol consumption, exercising regularly, and optimizing their nutrition to maintain a healthy weight. Improving sleep by giving yourself at least an 8 hour sleep opportunity each night has been shown to effectively lower blood pressure. Implementing stress management techniques such as meditation can also improve your levels.
  • Medications: Prescription medication can be a safe and effective way to lower blood pressure if lifestyle change proves to be ineffective. The class of medications called Angeiotension Receptor Blockers or ARBs (olmesartan, losartan, valsartan) and Angiotensin Converting Enzyme Inhibitors (lisinopril, enalapril) are two of the best and most tolerated medications used today. Discuss these options with your primary care physician.
  • Supplements: Although less impactful, some evidence suggests that certain supplements could help lower blood pressure. Potassium, magnesium, dietary fiber, folic acid in the form of methylfolate, coenzyme Q10, omega-3 fatty acids (fish oil), garlic, and green or black tea have all been investigated as potential treatments. It should be noted that supplements are not an adequate substitute for lifestyle modification or prescription medication in treating high blood pressure.

In Conclusion 

Blood pressure management during testosterone therapy is crucial to promote overall health and well-being.

Implementing this guide's recommendations on lowering blood pressure will reduce your risk of chronic disease and promote healthy aging. 

As we age, most men typically lose 1-2% of their testosterone each year, which affects multiple systems throughout the body. Wellcore’s program was created explicitly with everyday men in mind — not just health enthusiasts. From assessments to follow-ups, this comprehensive solution makes optimizing hormones easy while improving overall health.

When choosing Wellcore, you can be confident in receiving superior hormonal optimization and overall wellness support.

May your journey toward better health be joyful and fruitful. Here's to a healthier tomorrow!


Join millions of men and women who are improving their health by ordering the Wellcore At-Home Assessment Kit today.

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