As the owner of a Steel Health and Hormones Centre, a HRT clinic that treats men with testosterone replacement therapy (TRT), I’ve had the opportunity to see firsthand how transformative this treatment can be. My experience teaches me that the vast majority of men who start TRT experience meaningful improvements in their quality of life—better energy, improved body composition, enhanced mood, stronger libido, and overall better well-being.
At the same time, responsible hormone optimization requires us to continuously evaluate the latest clinical evidence and carefully manage potential risks.
Before we get into the content of this blog post – I am the owner of Steel Health and Hormones Centre which is a TRT clinic located in Delmont, Pennsylvania. I do believe I have a good understanding of this topic but it’s important to understand that I am not a medical doctor and none of this is medical advice. This post and the accompanying video is for education and entertainment purposes only. If you’re in the Delmont area and you’re interested in working with a medical professional, fill out the contact form below and we’ll be in touch within 24 hours.
Furthermore, a deep dive into the research referenced in this video can be found in the accompanying video. Now let’s get into this…
What the TRAVERSE Trial Taught Us
The recently published TRAVERSE trial significantly advanced our understanding of testosterone therapy and cardiovascular risk.
One of the most important takeaways was this:
Testosterone replacement therapy did not show a statistically significant increase in major adverse cardiovascular events compared to the control group.
This finding helped address long-standing concerns about TRT and heart health. For many clinicians and patients, it reinforced that testosterone therapy is safer than many previously believed, particularly when managed appropriately.
However, the study also highlighted something equally important: individual risk factors still matter.
While overall cardiovascular risk was not significantly increased, researchers did observe some trends worth paying attention to, including:
- Increased incidence of atrial fibrillation (AFib)
- Slight increases in blood pressure
- Signals related to kidney stress or injury
These findings don’t mean TRT is dangerous—but they do underscore the importance of proactive risk management.
Why I Like Telmisartan for Men on TRT
One medication my providers consider in appropriate patients (myself included) is Telmisartan, which belongs to a class of drugs called angiotensin II receptor blockers (ARBs).
ARBs work by blocking the effects of angiotensin II, a hormone that causes blood vessels to constrict and raises blood pressure. Specifically, telmisartan blocks the AT1 receptor, preventing many of the hypertensive and vascular effects of angiotensin II.
For men on TRT—especially those with borderline blood pressure or cardiometabolic risk factors—this can be extremely helpful.
But telmisartan has several additional benefits that make it particularly interesting in the context of hormone optimization.
Metabolic Benefits: PPAR-Gamma Activation
Telmisartan has a unique property among ARBs: it partially activates PPAR-gamma, a receptor involved in metabolic regulation.
Activation of this pathway may help:
- Improve insulin sensitivity
- Improve blood glucose regulation
- Support overall metabolic health
For men focused on optimizing hormones, body composition, and longevity, these effects are highly relevant.
Potential Cardiovascular Protection
Beyond blood pressure control, research suggests telmisartan may have additional cardiovascular benefits.
Some studies indicate it may help:
- Reduce visceral fat accumulation
- Prevent cardiac remodeling
- Slow the development of atherosclerosis
These effects are particularly appealing for individuals who want to take a long-term, preventative approach to cardiovascular health.
My Personal Approach
As someone who is also on testosterone therapy, I think about these issues not only as a the owner of a TRT clinic in Westmoreland county, but also as a patient.
My goal isn’t just to feel better today—it’s to stay healthy decades into the future.
Given the trends observed in the TRAVERSE trial—such as increases in AFib and blood pressure—I prefer to take a proactive approach.
Even though my blood pressure is already quite good, I personally take a small dose of telmisartan at night. It lowers my blood pressure slightly, but more importantly, I believe it nudges several important physiologic systems in a healthier direction.
My thinking is simple:
Small positive shifts in the right direction, maintained over many years, can have a meaningful impact on long-term health.
A Final Word
Testosterone replacement therapy can be life-changing when used appropriately. But like any medical treatment, it should be approached with thoughtful risk management and individualized care.
Medications like telmisartan may play a role in supporting cardiometabolic health, especially for men who want to take a preventative approach while optimizing their hormones.
As always, decisions about medications should be made in consultation with a qualified healthcare provider who understands your individual health history, labs, and long-term goals. If you’re interested in working with a qualified medical professional, fill out a contact form down below and we’ll be in touch within 24 hours.When it comes to health optimization, the real objective isn’t just feeling better today—it’s building a foundation for lifelong vitality.
