Is Telmisartan Better Than Lisinopril On Testosterone?

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Timeline

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A man on testosterone asks about switching from lisinopril to telmisartan, and Dr. O’Connor discusses ARBs, blood pressure, erythrocytosis, LDL cholesterol, insulin resistance, and hematocrit.

Video Summary

A man on testosterone asks whether telmisartan offers advantages over lisinopril for blood pressure control. Dr. O’Connor explains that angiotensin receptor blockers may offer some advantages over ACE inhibitors, although he does not describe the difference as dramatic.

Telmisartan is discussed as particularly relevant for a man on testosterone because Dr. O’Connor notes potential benefits involving androgen-induced erythrocytosis in addition to blood-pressure control. He also discusses favorable metabolic effects involving LDL cholesterol and insulin resistance.

The member also raises hematocrit levels around 54 to 55 and blood donation. Dr. O’Connor’s response emphasizes choosing a blood-pressure medication that may provide additional metabolic and blood-related benefits for men using testosterone.

Drug Callouts

Lisinopril

Lisinopril is the member’s current blood-pressure medication and is discussed as an ACE inhibitor. Dr. O’Connor considers it effective but believes an angiotensin receptor blocker may offer some additional advantages for a man using testosterone.

Telmisartan

The transcript appears to refer to telmisartan as the ARB Dr. O’Connor prefers over lisinopril. He discusses potential benefits involving blood pressure, testosterone-related erythrocytosis, LDL cholesterol, and insulin resistance.

Condition Callouts

Hypertension

Blood-pressure treatment is the central reason for comparing lisinopril with an angiotensin receptor blocker. For men on testosterone, Dr. O’Connor considers blood pressure an important long-term health issue while also looking for medications that may provide additional metabolic benefits.

Androgen-Induced Erythrocytosis

The member raises hematocrit around 54 to 55 while using testosterone, and Dr. O’Connor discusses excessive red blood cell production as an additional concern. He notes that the ARB being discussed may provide some benefit for testosterone-related erythrocytosis.

Key Takeaways

Dr. O’Connor believes angiotensin receptor blockers may offer modest advantages over ACE inhibitors for some men using testosterone.
Telmisartan is discussed for potential benefits beyond blood pressure, including effects on testosterone-related erythrocytosis and metabolic health.
Elevated hematocrit remains an important monitoring issue for men on testosterone even when blood-pressure treatment is the primary concern.
Medication selection can consider blood pressure, LDL cholesterol, insulin resistance, and red blood cell effects rather than blood pressure alone.