Our study aimed to examine the effect of testosterone replacement therapy (TRT) on blood pressure in opioid-treated men with relative hypogonadism, and whether the effect of TRT on blood pressure was modified by body composition, red blood cell levels, or carotid intima media thickness. Men (over 18 years old) receiving opioid treatment and total testosterone less than 12 nmol were randomly assigned to receive either TRT or placebo. Baseline and 6-month measurements included anthropometric measurements, office blood pressure (OBPM), 24-h ambulatory blood pressure, blood samples, and carotid ultrasound. The mean systolic OBPM increased by 6.2 mmHg (0.2-12.1) in the TRT group and decreased by 7.0 mmHg (1.0-15.1) in the placebo group, with a mean difference of 13.2 mmHg (3.4-23.1), P = 0.01. In the TRT group, a 10 mmHg increase in systolic OBPM was associated with an increase in hematocrit of 0.3% points (0.1-0.5) (P = 0.01), whereas no association was observed in the placebo group (P = 0.266). Daytime SBP showed a nonsignificant increase of 5.2 mmHg (-1.7, 12.1) (P = 0.134) in the TRT group compared to that in the placebo group. However, the impact of TRT on the increase in daytime ambulatory blood pressure was significantly accentuated by baseline values of BMI, hematocrit, and hemoglobin. In conclusion, TRT was associated with higher OBPM compared to placebo, and the increase in blood pressure was linked to higher hematocrit during TRT. Our data suggest that men with opioid-induced androgen deficiency, particularly those with obesity or red blood cell levels in the upper normal range, are more susceptible to increased daytime SBP during TRT.

中文翻译：

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在阿片类药物引起的雄激素缺乏中，血细胞比容水平会放大睾酮治疗的血压反应：一项双盲、随机、安慰剂对照试验。


我们的研究旨在检查睾酮替代疗法（TRT）对接受阿片类药物治疗的相对性腺功能减退男性血压的影响，以及 TRT 对血压的影响是否会因身体成分、红细胞水平或颈动脉内膜中层而改变厚度。接受阿片类药物治疗且总睾酮低于 12nmol 的男性（18 岁以上）被随机分配接受 TRT 或安慰剂。基线和 6 个月测量包括人体测量、诊室血压 (OBPM)、24 小时动态血压、血液样本和颈动脉超声。 TRT组的平均收缩压OBPM增加了6.2mmHg（0.2-12.1），安慰剂组则减少了7.0mmHg（1.0-15.1），平均差异为13.2mmHg（3.4-23.1），P = 0.01。在 TRT 组中，收缩期 OBPM 增加 10mmHg 与血细胞比容增加 0.3% 点 (0.1-0.5) 相关 (P = 0.01)，而在安慰剂组中未观察到相关性 (P = 0.266)。与安慰剂组相比，TRT 组日间收缩压显示无显着性增加 5.2 mmHg (-1.7, 12.1) (P = 0.134)。然而，BMI、血细胞比容和血红蛋白的基线值显着加剧了 TRT 对日间动态血压升高的影响。总之，与安慰剂相比，TRT 与较高的 OBPM 相关，并且血压升高与 TRT 期间较高的血细胞比容相关。我们的数据表明，患有阿片类药物引起的雄激素缺乏的男性，特别是那些肥胖或红细胞水平处于正常范围上限的男性，在 TRT 期间更容易受到白天收缩压升高的影响。