I went with Dr. Nichols after Dr. Shippen retired, he talked me into letting my E2 be higher, and guess what as my E2 went up my Blood Pressure went down.
While controlling E2 my BP was 135/85 Pulse = 76
Now NOT controlling E2 my BP is 112/74 Pulse = 71
But how high is your E2?
If my E2 is higher than ~50 I gain water weight and my blood pressure will go up.
But I have spent over 10 years with total T of 350 and E2 <5, so I believe I have become more sensitive to whatever Estradiol I have available.
And serum E2 is not always cellular E2. I could see it possible that an AI affects not just serum E2, but E2 in brain, prostate and bone tissue.
I tried an AI but it was such a small dose, 0.0625 2 times in a week, for one week only, I can't think it did all that much. I only get highish E2 for a few weeks after an injection of testosterone undecanoate, and the highest I have ever measured it was 56, at
Nashtide's 45 he was barely over normal range.
I could ignore the BP and water weight, it will go down after a month even if I do nothing.
More oddly, my higher (normal range) E2 has given me allergic reactions to various meds, the same meds my mother is allergic to, so no doubt it's a genetic predisposition and the higher E2 just made it symptomatic.