1 in 3 US adults aged 40-59 years has high blood pressure (hypertension); among those over 60 years of age the prevalence is over two-thirds, 67%.[1] High blood pressure is a well known risk factor for cardiovascular disease; the leading cause of death worldwide.[1, 2] As two-thirds of sudden cardiac deaths occur in clinically healthy individuals [2], novel indicators of early recognition of adverse cardiometabolic risk in disease-free adults are clearly needed. It has been demonstrated that healthy disease-free adults with high-normal blood pressure (aka pre-hypertension, defined as 120-139/80-89 mmHg) have an adverse cardiometabolic risk profile.[2]

The prevalence of high-normal blood pressure in disease-free US adults is 36.3%; it is especially common in people with overweight/obesity, enlarged waist lines, and elevated glucose, insulin, hemoglobin A1c (glycated glucose), C-reactive protein (an inflammatory marker), and triglycerides (blood fats).[2]

High-normal blood pressure is an independent risk factor for cardiovascular disease (CVD)...[3-5]

It is well-documented that testosterone levels decline with age in men.

After the age of 40 years, total testosterone decreases on average -4 ng/dL ( -0.124 nmol/L) per year [1] or 1.6% per year [2], and bioavailable testosterone by -2 to 3% per year. [2]

In older men (over 60 years of age), the average rate of decrement in total testosterone levels has been found to be 110 ng/dL every decade.[3]

However, the relative contributions of changes in health and lifestyle to that decline have not been adequately evaluated. A notable study was set out to investigate this...

OBJECTIVE:

The objective of this study was to establish the relative importance of aging, health, and lifestyle in contributing to the testosterone decline in aging men.[4]