How Testosterone Deficiency Contributes to Cardiovascular Risk in Men

Testosterone plays a central role in a man’s energy, strength, mood, and overall health. As awareness grows around the impact of hormone health on the body, more men are exploring bio-identical hormone replacement therapy (BHRT) with their local healthcare providers. 

Pellecome is a nationwide BHRT and supplement provider founded by Dr. Enrique G. Jacome, a board-certified OB-GYN and hormone specialist with decades of experience in pellet-based therapy. Pellecome supplies high-quality bio-identical hormone pellets and support to clinicians across the country who offer BHRT in their own practices. 

Increased awareness of BHRT also brings attention to the broader health effects of low testosterone, including its impact on the heart. While many men associate low testosterone with fatigue or low libido, fewer realize the connection between testosterone deficiency, cardiovascular risk, and long-term heart health. 

Understanding Testosterone and Heart Health

Testosterone influences several systems that affect the cardiovascular system. When levels decline, changes can occur that increase strain on the heart and blood vessels.

Research suggests low testosterone may contribute to:

• Increased Body Fat: Especially visceral fat linked to heart disease¹
• Insulin Resistance: A driver of type 2 diabetes and metabolic syndrome²
• Unfavorable Cholesterol Levels: Higher LDL and lower HDL³
• Chronic Inflammation: A known contributor to arterial plaque buildup⁴

Over time, these shifts may raise the likelihood of high blood pressure, atherosclerosis, and other cardiovascular conditions.

Why Low Testosterone Raises Cardiovascular Risk

Low testosterone often overlaps with metabolic syndrome, a cluster of risk factors that includes abdominal weight gain, elevated blood sugar, and abnormal lipids.⁵ Each of these factors independently increases cardiovascular risk. Together, they compound the problem.

Men with hormone imbalance may also notice reduced exercise tolerance and muscle mass. When energy drops and recovery slows, physical activity often declines, which further impacts heart health. This cycle can make it difficult to maintain a healthy weight and strong cardiovascular function.

It’s important to note that hormone balance is only one piece of the puzzle. Diet, movement, sleep, stress, and genetics are all important. However, ignoring testosterone deficiency may leave an underlying contributor unaddressed.

Can BHRT Help Support Cardiovascular Health?

When medically appropriate and properly monitored by a qualified healthcare professional, BHRT for men may help restore testosterone to physiologic levels. Pellet-based therapy, including the timed-release implants formulated through Dr. Jacome’s long-standing work in hormone replacement, is designed to deliver steady hormone levels over time rather than sharp spikes and drops.

Men concerned about fatigue, weight gain, or declining performance can speak with a local Pellecome healthcare provider who offers hormone testing and BHRT. Pellecome supplies bio-identical hormone pellets and clinical resources to providers across the country, helping expand access to consistent, high-quality hormone therapy nationwide.

1. Ma H, Sun J, Wu X, Mao J, Han Q. Percent body fat was negatively correlated with Testosterone levels in male. PLoS One [Internet]. 2024;19(1):e0294567. Available from: http://dx.doi.org/10.1371/journal.pone.0294567
2. Ottarsdottir K, Nilsson AG, Hellgren M, Lindblad U, Daka B. The association between serum testosterone and insulin resistance: a longitudinal study. Endocr Connect [Internet]. 2018;7(12):1491–500. Available from: http://dx.doi.org/10.1530/EC-18-0480
3. Thirumalai A, Rubinow KB, Page ST. An update on testosterone, HDL and cardiovascular risk in men. Clin Lipidol [Internet]. 2015;10(3):251–8. Available from: http://dx.doi.org/10.2217/clp.15.10
4. Budoff MJ, Ellenberg SS, Lewis CE, Mohler ER 3rd, Wenger NK, Bhasin S, et al. Testosterone treatment and coronary artery plaque volume in older men with low testosterone. JAMA [Internet]. 2017;317(7):708–16. Available from: http://dx.doi.org/10.1001/jama.2016.21043
5. Muraleedharan V, Jones TH. Testosterone and the metabolic syndrome. Ther Adv Endocrinol Metab [Internet]. 2010;1(5):207–23. Available from: http://dx.doi.org/10.1177/2042018810390258