TRT, blood pressure
and heart health.

Yes. Testosterone replacement therapy can increase blood pressure, including when it is prescribed for medical reasons. FDA-required studies using blood-pressure monitoring during daily life confirmed increases across the testosterone product class. A prescription does not make that effect disappear.[1]

This matters because higher blood pressure can add to heart attack and stroke risk. You cannot judge your blood pressure from how energetic you feel or whether your testosterone symptoms improve. Discuss blood-pressure checks with your physician before treatment and during follow-up.[4]

Already having hypertension is a reason for a careful review, not an answer this article can turn into an automatic yes or no. Your physician needs to consider your readings, whether your pressure is controlled, other health conditions and the particular treatment being considered.

TRAVERSE enrolled 5,246 men aged 45–80 who had symptoms, two low fasting testosterone results, and existing cardiovascular disease or high cardiovascular risk. It compared monitored testosterone gel with placebo gel—not bodybuilding use or every testosterone formulation.[2][6]

The main outcome combined cardiovascular death, nonfatal heart attack and nonfatal stroke. It occurred in 7.0% of the testosterone group and 7.3% of the placebo group over an average follow-up of about 33 months. Testosterone met the study’s prespecified noninferiority standard: it did not show an excess of that combined outcome beyond the trial’s defined margin. This was not proof that testosterone prevents heart attacks.[2][6]

There were also more cases of atrial fibrillation (an irregular heart rhythm), acute kidney injury and pulmonary embolism (a blood clot in the lungs) in the testosterone group. Those findings should not be erased by the reassuring main result.[2][6]

The results do not establish safety for every person, every patient group, every dose or lifelong use. The study population, gel formulation, monitored treatment and follow-up period limit what can be inferred. Its findings cannot be applied to supraphysiologic use—exposure above normal physiological levels—or treated as a guarantee for an individual patient.[6]

Call 911 for possible heart attack or stroke symptoms such as new chest pain, severe shortness of breath, sudden weakness or numbness on one side, or difficulty speaking. These symptoms need emergency assessment, whether or not you think TRT is involved.[4]

New painful swelling, warmth or redness in a leg, new swelling in the feet or ankles, or a new concerning irregular heartbeat warrants prompt medical contact. If symptoms are sudden or severe, or occur with chest pain, fainting or breathing difficulty, seek emergency care.[4]

For rising readings without emergency symptoms, contact your treating physician for a review rather than trying an online dose fix. Ask for a written plan for your own readings and symptoms. Return to the TRT Learning Hub or explore pricing and payment before your consultation.

Educational information, not a personal treatment plan.

1. FDA — Class-wide testosterone labeling changes, February 28, 2025
2. Lincoff et al. — Cardiovascular Safety of Testosterone-Replacement Therapy (TRAVERSE), 2023; PubMed abstract
3. Endocrine Society — Testosterone Therapy for Hypogonadism guideline resources, 2018
4. MedlinePlus — Testosterone Injection, revised May 15, 2025
6. Lincoff et al. — Cardiovascular Safety of Testosterone-Replacement Therapy, New England Journal of Medicine, 2023; full study