Testosterone & Cardiovascular Health

Is testosterone good for our cardiovascular health? And why should I care about my cardiovascular health? Every 40 seconds an American has a heart attack! About 1 in 3 deaths in the US is caused from cardiovascular disease, it is the leading cause of death in both men and women. Over half of the deaths from heart disease are men with an average age of 65yo. This includes deaths from coronary heart disease, heart attacks, high blood pressure, heart failure, arterial diseases and strokes. (facts from CDC & American Heart Association).

Risk Factors for Cardiovascular Disease

  • Increased age
  • Decrease testosterone levels
  • Diabetes
  • Inactivity
  • High blood pressure
  • Smoking & drinking
  • Poor diet
  • Obesity
  • Certain genetic or SNP mutations

Testosterone & Common Sense

Let’s look at the basics of testosterone and it’s effects in the body, from this you can see how having healthy levels contribute to a healthier cardiovascular system and a better quality of life.

Role of Testosterone in the body

  • Body Hair– Promotes growth of hair growth on face, chest, pubic area, and umbilical line.
  • Bone & Muscle– Stimulation and maintenance of muscle and bone strength.
  • Healthy joints– stimulation of growth and repair of ligaments and cartilage.
  • Sex Organs- stimulates the development of the testes, scrotum and causes sperm production.
  • Healthy erections– helps maintain healthy erectile function. Boost sex drive.
  • Energy & Fat Burning– Increases metabolism to promote energy production, fat burning and maintenance of a healthy weight.
  • Improves Mood– boost mood, confidence and drive
  • Improves Sleep quality.
  • Cardiovascular Health– Maintains good cholesterol called HDLs, while preventing arteriosclerosis, and maintaing a healthy blood pressure. All important markers for cardiovascular health

We know as testosterone declines prostate cancers, other cancers, and cardiovascular disease all increase. As men hit andropause they get fatter, muscle mass declines, activity and mood declines. Men who have healthy testosterone levels have more muscle which helps burn sugar and fat, their mood is better and they are more motivation to get out exercise and be healthy. They have better recovery time and less joint pain which keep you mobile longer. With health erections, and a healthy libido they are likely more sexually active, which means more cardio! This alone would improve your cardiovascular health and overall well being. But lets look at the research and see what it says!

What does the Research Say

Overall the research indicates that men with low testosterone levels have higher mortality rate and higher rates of cardiovascular disease. Men who normalized their testosterone with testosterone replacement therapy had lower rates of stroke, heart attacks and overall mortality.

The Research indicates that testosterone has the following effects on our cardiovascular system :

  • Improves exercise induced ST depression and myocardial ischemia
  • Dilates the coronary arteries -increase blood flow to the heart muscle
  • Improves body composition, insulin resistance and reduces risks for metabolic syndrome
  • Improves inflammation, CRP and inflammatory cytokins
  • Improves congestive heart failure
  • Lowers risks for heart attacks and overall mortality
  • May slow the progression of artherosclerosis
  • Reduces risks of type 2 diabetes
  • Mixed results on lipid profiles, however lower testosterone is related to dyslipidemia (poor lipid levels), and testosterone replacement has been shown in improve lipid ratios.

In summary having healthy levels of testosterone helps to improve your cardiovascular health in a variety of ways, improving metabolism, reducing blood sugar, improving fat burning, reducing inflammation, increasing circulation to the heart, and lowering other risks factor for cardiovascular disease. Conversely, having low levels is associated with increased mortality, strokes and heart attacks. So why not choose to have your testosterone levels tested, improve your quality of life and your longevity! If you want o learn more about low testosterone and what you can do to boost it read more here!

Dr.Escobedo has extensive experience working with men to balance, replace and restore healthy hormones including testosterone as well as improve cardiovascular health. She utilizes a wide range of testosterone replacement therapies, supplements, diet, exercise and herbs to help restore the bodies natural hormone levels and restore cardiovascular health. To find out if she can help book your free 15 minute phone consult today.


Sharma, R et al. Normalization of testosterone level is associated with reduced incidence of myocardial infarction and mortality in men. Eur Heart J. 2015 Aug 6

Shores MM, Moceri VM, Gruenewald DA, et al. Low testosterone is
associated with decreased function and increased mortality risk: a
preliminary study of men ina geriatric rehabilitation unit. J Am
Geriatr Soc 2004;52:2077e81.

Khaw KT, Dowsett M, Folkerd E, et al. Endogenous testosterone
and mortality due to all causes, cardiovascular disease, and cancer
in men: European prospective investigation into cancer in Norfolk
(EPIC-Norfolk) Prospective Population Study. Circulation

Shores MM, Matsumoto AM, Sloan KL, et al. Low serum
testosterone and mortality in male veterans. Arch Intern Med

Laughlin GA, Barrett-Connor E, Bergstrom J. Low serum
testosterone and mortality in older men. J Clin Endocrinol Metab

Basaria S et al. Effects of Testosterone Administration for 3 Years on Subclinical Atherosclerosis Progression in Older Men with Low or Low-normal Testosterone Levels. JAMA.2015; 314(6):570-581.

Cheetham TC et al. Association of Testosterone Replacement With Cardiovascular Outcomes Among Men With Androgen Deficiency. JAMA Intern Med. 2017 Apr 1;177(4):491-499

Berg G. et al. Impact on lipoprotein profile after long-term testosterone replacement in hypogonadal men. Horm Metab Res. 2002 Feb;34(2):87-92.

Hormones & Your Cardiovascular Health

adobe spark post 3

Find Out if You Are at Risk of Cardiovascular Disease

Heart disease is the leading cause of death in north america, so yeah, it’s important part of your health! You have probably been to your Primary Healthcare Provider and had your lipids tested. If you have elevated cholesterol they probably told you you need to start a statin like Lipitor. But did you know that 50% of people who have a heart attack have normal cholesterol levels? Or that taking a statin reduces your risks of having a cardiovascular event by 1% over 10 years? Did you know that statins deplete CoQ10, an essential nutrient your heart muscles need to operate? Did you know that taking CoQ10 with Selenium has been shown to cut yours risks down by 50% (read more here). It’s time to rethink the statin strategy, and get the whole picture. So what does it mean to really asses your risks for cardiovascular disease? It’s alot more involved then just looking at your cholesterol and lower it. There are four main areas to focus on in testing when assessing your cardiovascular health:

  1. Inflammation & Plaque stability: hs-CRP, Homocystein, Fibrinogen, MPA, LpPLA
  2. Genetics: Lp(a), MTHFR, Clotting factors
  3. Lipid profile: HDL, ApoA, LDL, sdLDLs, Cholesterol, Apo B, TG
  4. Metabolics: HbA1C, insulin, C-peptide, fasting glucose

*More information on these tests here.

External factors that play a big role at influencing the above internal factors are of course: (see info-graph here.)

  1. Smoking
  2. Weight- more over weight a person is the higher the risk.
  3. Activity level: minimum 30 minutes daily.
  4. Stress
  5. Diet: can drastically change your lipid profile alone.
  6. Alcohol intake: 3 drinks or less per week.
  7. Blood pressure: ideal is 120/60

Besides eating healthy, not smoking, maintaining a healthy weight and exercising regularly there is lots you can do maximize your cardiovascular health. Maintaining healthy hormones is a big part of that. For women estrogen play an important role, and for men testosterone does. (See my blog here for more on Testosterone role in cardiovascular health).

Estrogen is Cardio-protective in Women

Before menopause women have a lower risk of cardiovascular disease then men the same age, after menopause we have an increased risk. Estrogen replacement therapy has been shown in numerous studies to reduce cardiovascular mortality by 40-50% in post-menopausal women. Seem how women are much more likely to die of cardiovascular disease then breast cancer (read about estrogen and cancer risks here) that is something to consider. Here is how estrogen can prevent cardiovascular disease:

  • Improved lipid profile (lower LDL, Lp(a) & TG, increases HDLs by 10-15%)
  • Lower accumulation of lipids in the arteries
    Stimulates endothelial NO production = vasodilation (less pressure in system)
  • Increase mitochondrial efficiency and reduces oxidative stress
    Reduces vascular oxidative stress (less inflammation = better health of vessels)
  • Limits the progression of fibrofatty and atherosclerotic plaques formation
  • Improves endothelial growth and repair, and reduces thickening of the intima
  • Lowers blood pressure (ACE inhibiting, down regulates constriction and increase vasodilaiton)
  • Transdermally it acts as an anti-inflammatory

Oral Estrogen & Clotting

The form of estrogens make a big difference in their safety, oral synthetic estrogens like birth control pills and Premarin increase clotting. In the Womens Health Initiative study they found an increased risk of cardiovascular disease, mostly relating to clot formation- strokes, embolism, and other forms of clots, in this study they used Conjugated Equine Estrogens (CEE). These are a from of oral estrogens and oral (Bio-identical or not) have a long list of side effects that are very hard on your health and cardiovascular system including:

  • Increase blood pressure
  • Increased 4-OH estrone production (the “bad” estrogen)
  • Hard on the liver
  • Increases clotting factors
  • Increases inflammatory marker CRP
  • Increases cravings for carbs (which usually results in eating more carbs and sugar, which creates more inflammation).

When a hormone is taken orally it is metabolized through the first pass in the liver, during this process they are broken down into metabolites that can increase clotting and inflammation resulting in many of the above concerns. This is why doctors always ask you before taking the birth control pill if you have a family history of blood clots or if you are a smoker. We know oral estrogens have this risk, so it’s no surprise in the WHI study they saw an increase in cardiovascular events like clots, strokes and embolism. When estrogen is taken topically in a cream or vaginally this first pass metabolism doesn’t happen and many of the above risks are negated. I don’t recommend women take any kind of estrogen orally! This includes the oral birth control pill. Endogenously produced, topical and vaginal estrogens are very safe and are cardio-protective. Here for more information on the cardio-protective effects of estrogen.

Naturally Reduce your Risks for Cardiovascular Disease

  • Enjoy a Mediterranean style diet- avoiding saturated fats, trans fast, refined sugars, processed foods, fried foods. Inlcude more salmon, olive oil, olives, coconut, plant based fats, colorful fruits and veggies, nuts and seeds, turmeric, garlic and ginger.
  • CoQ10, Selenium and Vitamin E
  • Maintain healthy levels of vitamin D (50-90 in blood)
  • Methylation factors to keep homocysteindown: B12, methyl-folate, B6, TMG
  • Magnesium
  • Mitochondrial support: L-Carnitine, CoQ10, D-Ribose, Niacinamide (niacin, NAD).


When estrogens are produced naturally in the body, or taken as a bio-identical topical cream, or vaginal suppository they have a very beneficial and protect effect on the cardiovascular system, and your heart. It’s important to be informed about the form of estrogen your taking, the mode of delivery, and have your estrogen metabolites measured. Estrogen metabolites will let you know how you’re breaking down your estrogens, as some estrogen metabolites are not good for you (for more info on estrogen metabolism click here)

If you are wanting to have your hormones tested or want to have your cardiovascular health assessed, Dr. Escobedo can help. We work with Boston Heart and Cleveland Heart labs- two of the leading cardiovascular labs in the country, with some of the most sensitive markers for assessing cardiovascular health. Book your free 15 minute phone consult today.