Testosterone is a key hormone in men (and women) that supports muscle strength, sexual health, and overall well-being. As men age, testosterone levels may naturally decline, which may contribute to increased body fat, reduced muscle mass, and a higher risk of certain health conditions. Normal testosterone levels are considered to be between 300 to 1,000 nanograms per deciliter (ng/dL). While research has debated whether testosterone levels affect heart health, some studies suggest that low testosterone levels may be linked to higher risks of cardiovascular disease (CVD) and metabolic diseases like diabetes.
To better understand this connection, a group of researchers analyzed data from U.S. men using “Life’s Essential 8” (LE8), a set of heart health measures including diet, physical activity, sleep, nicotine exposure, cholesterol, body mass index (BMI), blood glucose, and blood pressure. Specifically, this study explored how natural (endogenous) testosterone levels relate to LE8 scores and overall cardiovascular health. For this study, the researchers defined normal testosterone levels as ≥300 ng/dL and low testosterone levels as <300 ng/dL. The findings offer new insights into how testosterone is correlated with heart health beyond its well-known roles in reproduction and muscle function.
The authors of this study used existing data from the National Health and Nutrition Examination Survey (NHANES). They analyzed data from 3,308 men aged 20 and older, collected between 2013-2016, who were not on any testosterone-containing medication. Participants had their blood testosterone levels measured in the morning after fasting, and cardiovascular health was assessed using the men’s LE8 scores.
The participants were divided into four groups based on their testosterone levels. To increase the accuracy of results, the study accounted for factors such as age, BMI, race, smoking, alcohol use, and medical history. Statistical methods, including regression analysis and subgroup comparisons, were used to identify patterns in the data.
Ultimately, the researchers found that men with higher natural testosterone levels were more likely to have better overall health, as shown by higher LE8 scores. Men with the lower natural testosterone had an average LE8 score of 62.65, while those with the highest had a score of 71.72.
Higher natural testosterone levels were also associated with better body weight, blood pressure, blood sugar, and physical activity levels. Men with normal natural testosterone levels were shown to have a lower risk of CVD. Overall, the men with normal testosterone levels (above 300 ng/dL) had significantly better health scores compared to those below this level.
The results of this study show a consistent positive link between natural testosterone production and heart health, even after considering factors like age, weight, and medical conditions. Still, it is not clear whether increasing testosterone levels using medication can directly improve cardiovascular health, especially in men whose testosterone levels are normal.
Although previous research has explored testosterone’s role in heart disease, results have been mixed. Some studies suggest low testosterone is linked to obesity, diabetes, and a higher risk of heart problems, while others found no strong connection. This study took a broader approach by using LE8 to assess overall heart health rather than focusing only on disease risk.
This study provides valuable insights that testosterone level can serve as an indicator of heart health, but it does not prove that testosterone directly improves heart health. More research is needed to confirm these findings and explore how testosterone influences heart health. Future studies should also examine potential genetic links and whether maintaining optimal testosterone levels can be a strategy for improving cardiovascular health.
References:
Wu, X., Zhang, Y., & Zhang, X. (2025). Association between serum testosterone level and cardiovascular health in US male adults: Results from the 2013-2016 NHANES. The Journal of Sexual Medicine, 22(2), 265–273. https://doi.org/10.1093/jsxmed/qdae196
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