How To Lower Your Blood Pressure While On Testosterone

If you're on TRT (Testosterone Replacement Therapy) you will usually experience an elevated resting blood pressure. Over time this can cause damage to your hear, leading to significant health issues. Fortunately, this can be mitigated easily first with diet and exercise and then with ancillary drugs if necessary. 

Follow along as we break down the ins and outs of keeping your blood pressure at a normal level while on TRT.

Blood pressure monitor

Monitor Your Blood Pressure

The first step in lowering blood pressure is to monitor it. This is crucial because it provides a baseline understanding of your current blood pressure levels and helps in assessing how serious the condition might be. 

Regular monitoring can detect any patterns or changes over time, allowing for early intervention and management. It's important to use an accurate blood pressure monitor and to take readings at the same times each day, ideally under similar conditions, to ensure consistency.

When monitoring your blood pressure at home, follow these basic instructions to ensure accuracy and consistency:

Prepare for the Measurement:

  • Avoid caffeine, exercise, and smoking for at least 30 minutes before taking a measurement.
  • Use the restroom if needed, as a full bladder can affect your reading.
  • Rest quietly for 5 minutes before measuring, sitting in a comfortable position with your legs and ankles uncrossed and your back supported.

Position Yourself Correctly:

  • Sit in a chair with your feet flat on the floor.
  • Rest your arm on a flat surface, such as a table, with your upper arm at heart level.
  • Make sure the cuff is fitted correctly on your bare arm, following the instructions that came with your blood pressure monitor. The cuff should be snug but not too tight.

Taking the Measurement:

  • Remain still and quiet as the cuff inflates and deflates. Talking or moving can affect your reading.
  • Follow the instructions on your specific blood pressure monitor to start the reading.
  • It's often recommended to take two or three readings, each a minute apart, and then use the average to get the most accurate measurement.

Record Your Readings:

  • Write down your blood pressure numbers, the date, time, and which arm was used for the reading.
  • Note any special circumstances like stress or recent activity.

Do Your Cardio 

Cardiovascular exercise (cardio) is particularly important for individuals taking testosterone replacement therapy (TRT) when it comes to managing blood pressure for several reasons:

Improves Heart Health:

Cardio exercise strengthens the heart muscle, improving its ability to pump blood efficiently. This can help lower the resting heart rate and reduce the force required to pump blood, effectively lowering blood pressure.

Reduces Blood Pressure:

Regular cardio activity can help dilate blood vessels and improve blood flow, reducing the overall pressure in the cardiovascular system. This is crucial for individuals on TRT, as testosterone can sometimes increase red blood cell count and blood volume, potentially raising blood pressure.

Aids Weight Management:

Engaging in regular cardio helps burn calories and fat, aiding in weight loss or maintenance. Since overweight and obesity are risk factors for hypertension, maintaining a healthy weight is important for keeping blood pressure in check, especially for those on TRT.

Improves Endothelial Function:

Cardio exercise can increase the production of nitric oxide in the body, which helps in the dilation of blood vessels, improving blood flow and reducing pressure on arterial walls.

Balances Hormonal Impact:

While TRT is aimed at correcting low testosterone levels, it's crucial to monitor and manage its effects on the body, including its impact on blood pressure. Cardio exercise can help mitigate some of the cardiovascular risks associated with hormone therapy by improving overall cardiovascular health.

Stress Reduction:

Regular physical activity, including cardio, is known for its ability to reduce stress levels, which in turn can lower blood pressure. Stress can cause temporary spikes in blood pressure and long-term stress can contribute to hypertension.

Healthy Foods

Eat Smart

For individuals managing high blood pressure while on testosterone replacement therapy (TRT), adopting a heart-healthy diet is essential. 

The DASH diet is widely recommended; it focuses on increasing intake of fruits, vegetables, whole grains, and lean proteins, while reducing sodium, red meat, and added sugars to mitigate hypertension. Lowering sodium intake is crucial, as it helps to reduce water retention and blood volume, thus lowering blood pressure. 

Incorporating potassium-rich foods can counteract the effects of sodium and aid in relaxing blood vessel walls. It's also important to include healthy fats, particularly omega-3 fatty acids found in fish and flaxseeds, which benefit heart health and may help control blood pressure

Limiting alcohol consumption is advised, as excessive drinking can elevate blood pressure and interfere with medications.

Blood pressure medication

As A Last Resort, Blood Pressure Medications 

If you are dealing with high blood pressure while on TRT it is important to address the easy lifestyle changes listed above before immediately hopping on blood pressure medication. 

If the underlying issues that are causing high blood pressure are not addressed in an appropriate manner, other issues may begin to emerge. 

For those of you who do need blood pressure medication, your doctor may prescribe one of these:

ACE Inhibitors (Angiotensin-Converting Enzyme Inhibitors):

These drugs, such as lisinopril and enalapril, help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.

Angiotensin II Receptor Blockers (ARBs):

Similar to ACE inhibitors, ARBs like losartan and valsartan block the action of angiotensin II, a chemical that narrows blood vessels, allowing blood vessels to stay wider.

Calcium Channel Blockers:

Drugs like amlodipine and diltiazem reduce blood pressure by preventing calcium from entering the cells of the heart and arteries, which relaxes the blood vessels.


Medications such as metoprolol and atenolol reduce blood pressure by slowing the heartbeat and decreasing the heart's workload.


These drugs reduce nerve impulses to blood vessels, allowing blood to pass more easily, examples include doxazosin and prazosin.

Alpha-Beta Blockers:

Combining the effects of alpha and beta blockers, these drugs can decrease nerve impulses and slow the heartbeat to reduce blood pressure.

Central Agonists:

These medications, such as clonidine, prevent the brain from sending signals to the nervous system to increase heart rate and narrow blood vessels.


Directly relax the muscles in the blood vessel walls, causing them to dilate. Examples include hydralazine and minoxidil.

Each person is different and their body requires different things. Talk to your doctor about which blood pressure medications are right for you. 


High blood pressure is a common concern for individuals on testosterone replacement therapy (TRT), but it's important to remember that managing this condition is entirely feasible with the right approach. By adopting a heart-healthy diet, such as the DASH diet, and engaging in regular cardiovascular exercise, many individuals can significantly improve their blood pressure. These lifestyle changes not only contribute to better blood pressure management but also enhance overall health and well-being. It's encouraging to know that many have successfully controlled their blood pressure through these natural means.

However, if lifestyle adjustments are not enough to bring your blood pressure to a safe range, a variety of blood pressure medications are available. These should be considered a supportive measure, often introduced as a last resort or as an adjunct to lifestyle modifications. If you find yourself needing medication, rest assured that there are many effective options, and with the guidance of your healthcare provider, you can find the right one for your specific situation. 

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