T Nation

Blood Pressure


I debated where to put this post (over 35 thread, off topic, etc) so I decided here would be as good as any since I think this topic includes a few different subject areas.

My systolic blood pressure reading is by no means alarmingly high but it's high enough, frequently enough that it got me thinking, researching, etc.

I have a home blood pressure reading kit that tends to track well with the doc's office, CVS pharmacy machine, etc. I tend to read anywhere from 135 to 148 on the systolic whereas the diastolic tends to read in the good range of mid 70s.

I've learned over time that trying to keep my estradiol level in a tight range where I feel good (which I think is somewhere in the 25 to 35 pg/ml range for me) is somewhat of a moving target based on multiple factors that I'm still learning to ferret out. All that being said, I do notice (which is not surprising) that when my estradiol levels rise, so does my systolic blood pressure reading.

But even when I estradiol levels are in a "good" range, my systolic still reads somewhat high for medical community standards (> than 140). I also happen to have built some pretty muscular arms (approximately 18.5 inches). I've done quite a bit of research that states a larger cuff size is important when measuring blood pressure for someone who has larger arms (which the medical community defines somewhere over 16" in circumference).

Even with the larger cuff size, my systolic still reads in the high 130s to high 140s most of the time however.

I do have a sneaking suspicion that the make up of your arm (size and the percentage of muscle to fat) has some direct correlation to producing higher "false" systolic readings based on my own intutive sense and some posts I've seen around these parts and around the web.

Unfortunately there has not been a lot of studies as far as I can tell about the accuracy of blood pressure readings for someone with very dense, muscular arms. I do remember hearing or reading that in one case a medical professional could not even obtain a blood pressure reading for a patient that was severely obese. This makes sense to me that the "makeup" of your arm would have some direct influence over the type of reading you would get. How then do you ever get an accurate reading if you happen to either have a) very fat arms or b) very large muscular arms?

I do notice that when I get into single digit bodyfat that the systolic reading tends to be a bit more spotty where it can read as low as 117 for the systolic all the way up to the mid 130s.

As I guy who is interested in building a fine physique into old age AND maintaining health as long as possible, should I be even the least bit concerned about systolic readings in the 135 to 148 range when I'm not in ripped summer condition?

What say you T-Nation experts?


As a follow up to my post, maybe it does have to do more with my estradiol levels regarding higher blood pressure. Maybe I'm sensitive to E2 and when it goes up over a certain level, this results in higher blood pressure readings. I don't know, there are a lot of factors I'm trying to suss out.

I only get E2 levels checked every 6 months and I've been struggling with libido lately. Maybe I have to up my Arimidex to 0.75 mg/week.


I work as a paramedic and I can tell you with larger arms a larger cuff is needed. The population of obese patients is growing everyday and I sometimes have to use a "thigh cuff" for their arm. I know excess fat isn't an issue for you, but a large arm is a large arm lol. A cuff that is too large will normally yield a systolic reading that is lower than the actual number. Too tight and the systolic will be sky high...sizing is very important with BP cuffs.

Readings can vary greatly if you take repeated pressures off of the same arm in a short amount of time. Take a pressure with the correct cuff and repeat the process on the other arm if you want another reading. I'm not a doc, but I do know a sustained systolic pressure of 140 and higher for a month or more is considered hypertension and something that should be addressed by the experts.

Speaking of E2 being high and it's relation to BP...I know exactly what you are talking about. My E2 was high (47) when I first started injected TRT. My systolic shot up to 144 (I normally sit around 110-114) I started myself on liquid arimidex and the pressure came back down. I feel you may be onto something believing that E2 is the cause of the unexplained hypertension. There are others here that I am sure can provide better insight. (My theory is the water retension with elevated E2 levels screwing with the pressures)


aldosterone, salt levels, electrolyte balance, (and I think maybe magnesium levels and calcium levels) play a role in blood pressure.

I went from 120/75 up to 140/90... and only dropped back down to 130/80 once I started taking 1-2 teaspoons of sea salt daily (once I had a test result back that confirmed low Aldosterone).

aldosterone is responsible for salt/potassium retention. If you lose too much salt, your body retains water, increases your blood pressure and increases heart rate.

a search for sea salt test or pupil test can give you some more information possibly.


Interesting. I actually started taking a supplement with sea salt in it so I'm doubting that's the culprit.


There can be lots of reasons and you may need to look at other things than estrogen. If you want to live long and healthy, you need to drop the E2 tunnel vision. Your sensitivity to E2 levels may be a case where the E2 levels are playing with an underlying cause. So E2 may not the root cause.

In general-

Cholesterol plays a part. If too high, you know that, if too low, hormone synthesis suffers and all cause mortality increases.

E2 needs to be balances to avoid endothelial dysfunction. In women, E2 is balanced by progesterone. In men, T plays that role.

BP can increase from damage from endothelial dysfunction that decreases the suppleness of the arteries. But note that muscle tone of the muscles in the arteries is also very important. These muscles must relax to allow the arteries to expand with the pulses of blood, then the muscles need to contract afterwards. These muscles can have issues with expanding. Low T can make that happen and then TRT can lower BP in uncomplicated cases.

You need proper nutrients, EFAs, healthy fats, minerals, glucose control.

Low body fat: Extreme diets and relative over training, can mess up your hormones big time. We have seen some guys who are train wrecks from such things.

Post your labs and ranges. There is too little here to be able to do what we normally do. Read the lab work sticky.


I have had the same intuitive thoughts regarding the BP cuff. I always register lower w/ the bigger cuff, although the bigger cuff still hurts like hell( it crushes my tricep). The pain alone, I have to assume, shoots my BP higher. The larger my arms, the more pain there is. Gotta be a better way to measure bp..