Medically Reviewed by Anil Om, MD

Dr. Anil Om, a Cardiologist with McLeod Health, explains how hormones can play a big role in the health of your heart.

When we think about heart health, we often focus on lifestyle factors like diet, exercise, and managing stress. But there’s another crucial player in the equation: hormones. Hormones can affect your blood pressure, cholesterol metabolism and more.

Estrogen

Estrogen has long been known for its protective effects on the cardiovascular system, particularly in premenopausal women. Before menopause, estrogen helps maintain healthy levels of cholesterol, dilates blood vessels, and reduces the risk of developing blood clots. All of these actions are beneficial for heart health.

However, as women approach menopause—usually around age 50—estrogen levels begin to decline significantly. This drop in estrogen is linked to an increase in the risk of heart disease. Postmenopausal women are more likely to develop high blood pressure, high cholesterol, and other risk factors for cardiovascular disease.

Testosterone

Testosterone also plays a role in cardiovascular health. Testosterone helps regulate red blood cell production, and it is thought to have a positive effect on lipid metabolism and insulin sensitivity. Some research even suggests that men with higher testosterone levels may have a lower risk of cardiovascular events.

However, low testosterone levels, particularly in older men, are associated with an increased risk of heart disease. Low testosterone can lead to a higher accumulation of body fat, lower muscle mass, and insulin resistance, all of which can increase the risk of conditions like high blood pressure, diabetes, and obesity—known risk factors for cardiovascular disease.

On the other hand, too much testosterone, especially when taken through supplementation or anabolic steroids, can increase the risk of developing blood clots and possibly elevate the risk of heart attack or stroke. Therefore, maintaining balanced testosterone levels is essential for optimal heart health.

Thyroid Hormones

The thyroid gland produces hormones that regulate metabolism, growth, and energy production. These hormones also have a profound impact on heart function, influencing heart rate, blood pressure, and cholesterol metabolism.

Hypothyroidism (an underactive thyroid) can lead to a number of cardiovascular issues. People with hypothyroidism often experience elevated cholesterol levels, an increased risk of atherosclerosis (plaque buildup in the arteries), and slower heart rate, which can increase the risk of heart disease.

Hyperthyroidism (an overactive thyroid), on the other hand, is associated with an elevated heart rate, increased blood pressure, and a higher risk of arrhythmias (irregular heartbeats). Both thyroid disorders can strain the heart and increase the likelihood of cardiovascular complications if left untreated.

Insulin

Insulin is a hormone produced by the pancreas that helps regulate blood sugar levels. In individuals with insulin resistance—a condition commonly seen in people with type 2 diabetes—insulin is not used effectively by the body, leading to higher blood sugar levels.

This condition is closely tied to an increased risk of cardiovascular disease. High blood sugar levels can damage blood vessels, contribute to the development of plaque in the arteries (atherosclerosis), and increase the risk of heart attacks and strokes. Additionally, insulin resistance is often accompanied by other metabolic issues like high blood pressure, high cholesterol, and obesity, all of which further increase heart disease risk.

Cortisol

Cortisol, often referred to as the “stress hormone,” is released by the adrenal glands in response to stress. While cortisol is important for short-term survival, chronic elevation of cortisol—due to ongoing stress—can have negative effects on cardiovascular health.

Elevated cortisol levels are linked to increased blood pressure, a higher risk of developing abdominal fat, and the release of inflammatory markers. All of these factors can increase the risk of heart disease. Chronic stress also often leads to behaviors that are harmful to heart health, such as poor dietary choices, lack of exercise, and disrupted sleep patterns.

Hormonal Birth Control

Hormonal birth control methods, including the pill, patches, and IUDs, work by manipulating the body’s natural hormone levels to prevent pregnancy. These methods typically use synthetic forms of estrogen and/or a synthetic form of progesterone to regulate ovulation.

While these methods are effective for birth control, they can have an impact on heart health, particularly in women who smoke or have preexisting cardiovascular risk factors. Hormonal birth control can slightly increase the risk of blood clots, high blood pressure, and stroke. Women with a history of cardiovascular disease or high blood pressure may be advised to explore alternative forms of contraception.

Find a cardiologist near you at McLeodHealth.org