Vascular Pathways of Testosterone: Clinical Implications

J Cardiovasc Transl Res. 2020 Feb;13(1):55-72. doi: 10.1007/s12265-019-09939-5. Epub 2019 Dec 9.


Cardiovascular diseases (CVD) are one of the leading causes of death worldwide. Testosterone (T) is an important sex hormone that triggers several genomic and non-genomic pathways, leading to improvements of several cardiovascular risk factors and quality of life in men. At the vascular level, the key effect of T is the vasorelaxation. This review discusses the molecular pathways and clinical implications of T in the vascular system. Firstly, the mechanisms involved in the T vasodilator effect will be presented. Then, it will be discussed the association of T with the main risks for CVD, namely metabolic syndrome, type 2 diabetes mellitus, obesity, atherosclerosis, dyslipidaemia and hypertension. Several studies have shown a correlation between low T levels and an increased prevalence of several CVD. These observations suggest that T has beneficial effects on the cardiovascular system and that testosterone replacement therapy may become a therapeutic reality for some of these disorders. Graphical abstract .

Keywords: Androgens; Atherosclerosis; Blood pressure; Cardiovascular diseases; Diabetes mellitus; Dyslipidaemia; Metabolic syndrome; Obesity; Risk factors; Vasorelaxation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Blood Vessels / drug effects
  • Blood Vessels / metabolism*
  • Blood Vessels / physiopathology
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / metabolism*
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular System / drug effects
  • Cardiovascular System / metabolism*
  • Cardiovascular System / physiopathology
  • Female
  • Health Status Disparities
  • Hemodynamics* / drug effects
  • Hormone Replacement Therapy
  • Humans
  • Male
  • Prognosis
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Signal Transduction
  • Testosterone / deficiency
  • Testosterone / metabolism*
  • Testosterone / therapeutic use


  • Testosterone