Hypertension in Men
High blood pressure in men follows the same 2025 AHA/ACC guideline thresholds as everyone else -- Stage 1 at 130-139/80-89, Stage 2 at 140/90 or higher -- but men develop it earlier in life than women on average, and it interacts directly with erectile function, since healthy blood flow depends on the same vessels.
Symptoms
Usually none -- which is exactly why erectile dysfunction sometimes serves as an early warning sign in men, since the small vessels of the penis are affected by vascular disease before larger arteries show symptoms.
Causes and risk
The same risk factors apply as in the general population -- age, family history, sodium intake, obesity, diabetes, alcohol, and poor sleep -- with sleep apnea deserving particular attention in men given its higher prevalence.
How it is evaluated
Confirmed home and office readings, a review of medications and lifestyle, and baseline labs (kidney function, glucose, lipids, urine protein) plus an ECG make up a full evaluation.
Treatment
First-line treatment is the same across sexes: thiazide diuretics, ACE inhibitors or ARBs, and calcium channel blockers, alongside a DASH-style diet, lower sodium, weight loss, and exercise. Worth noting for men specifically: some blood pressure medications (particularly certain diuretics and beta-blockers) can affect erectile function, so mention any changes in sexual function when starting or adjusting treatment.
When to seek care
A reading of 180/120 or higher with chest pain, severe shortness of breath, new weakness, or vision changes is a hypertensive emergency requiring immediate care.