Our findings at AlphaMD seem to correlate with the general consensus on the matter that TRT lowers BP in nearly all men who were previously hypogonadal and had related problems such as obesity, a sedentary lifestyle, prediabetes, and other metabolic disorders.

This makes sense, considering testosterone itself has no bearing on blood pressure itself, but the medical conditions that come along with low T (excess adipose tissue, low muscle mass, poor sleep, etc) are all known risk factors for high BP.

In men who seem to have the opposite effect, it is typical to find that they have a high estradiol level due to high aromatization. Estrogen is known to cause bloating (ask any woman around her period) and that extra fluid results in high blood pressure. It also increases a compound known as superoxide, which causes oxidative stress and which ultimately causes elevated BP.There is some evidence that testosterone and estradiol both have some effect on the renin-angiotensin system (RAS), though the data is very inconclusive. For now, all we know is low testosterone causes fat gain, muscle loss, pre-diabetes, and poor sleep among other things, and all of these increase blood pressure more than TRT does.