How Can Men Manage Their Blood Pressure?

Robert Pilchik, M.D., a board-certified cardiologist with Manhattan Cardiology in New York City, focused on three key facts regarding men and their blood pressure:

1. Before the age of 45, men are typically more prone than women to have high blood pressure (HBP).
2. Men are more likely than women to suffer from a heart attack or stroke at a younger age; high blood pressure is a key risk factor for many illnesses.
3. Research indicates men may be less conscious of their blood pressure state and less inclined to seek medical assistance for it.

"Men should therefore have their blood pressure checked frequently, especially if they smoke, are obese, have a sedentary lifestyle or have a family history of high blood pressure," he advised.

Despite the lack of clarity regarding the underlying mechanisms, substantial evidence suggests that androgens, including testosterone, contribute significantly to gender-based disparities in blood pressure regulation.

Testosterone is a hormone primarily associated with male physiology and development. While its exact role in blood pressure regulation is not fully understood, studies suggest testosterone can influence blood pressure levels in a few different ways:

• There may be links between low testosterone levels and various cardiac risk factors. Low testosterone is associated with an increased risk of prevalent hypertension for men who smoke or have a family history of hypertension.
• Reduced plasma levels of testosterone may contribute to increased arterial stiffness, which can, in turn, raise blood pressure levels.
• Testosterone may affect the production of other hormones, such as aldosterone and renin, which are involved in regulating blood pressure. Higher testosterone levels can lead to increased production of these hormones, which might contribute to hypertension.
• Research indicates higher testosterone levels can lead to increased salt retention in the body, which can raise blood pressure levels.

The exact mechanisms through which testosterone affects blood pressure are not fully understood. Even so, evidence suggests the hormone plays a significant role in blood pressure regulation in men.

Awareness of possible connections between testosterone and blood pressure can help you better monitor your blood pressure on a regular basis if you have concerns with high or low testosterone levels.

Often, high blood pressure does not cause any symptoms, explained Hana Patel, M.B.B.S, a general practitioner and mental health coach in London. However, she advised high blood pressure can sometimes lead to symptoms such as:

• Blurred vision
• Dizziness
• Feeling tired or weak
• Headaches
• Irregular heartbeat or chest pain
• Nausea
• Nosebleeds
• Shortness of breath

In a similar way, if men have low blood pressure, they may present few to no symptoms. Pilchick added that if there are signs of low blood pressure, they may include the following:

• Blurred vision
• Cold, clammy, pale skin
• Depression or confusion
• Dizziness or lightheadedness
• Fainting or feeling faint
• Fatigue or weakness
• Nausea
• Rapid or shallow breathing

Normal blood pressure is considered to be a systolic pressure (top number) of less than 120 mmHg (millimeters of mercury) and a diastolic pressure (bottom number) of less than 80 mmHg. If your blood pressure is less than that and you have no risk factors for high blood pressure, get your blood pressure checked at least once every three to five years.

However, if any of the following factors apply to you, get your blood pressure checked annually:

• Your blood pressure is higher than normal.
• You have certain health conditions, such as diabetes, heart disease or kidney problems.
• You are overweight.
• You have a family history of high blood pressure.
• You are Black.

"Because blood pressure measurements might change throughout the day, it's crucial to remember that a single reading may not be sufficient to determine if someone has high or low blood pressure," Pilchik said.

It's crucial to follow a healthcare professional's advice for managing and monitoring blood pressure and to schedule routine checkups with them.

High blood pressure in men is linked to a number of medical conditions, Pilchik noted. Some of them are signs of potential blood pressure problems and others are contributors to HBP. Among the most typical are:

• Erectile dysfunction (ED). High blood pressure can damage the blood vessels and reduce blood flow to the penis, making it difficult to achieve or maintain an erection. ED is often an early sign of larger cardiovascular issues.
• Kidney disease. High blood pressure can damage the blood vessels in the kidneys, leading to impaired kidney function and, potentially, kidney failure. The incidence of end-stage kidney disease is 50 percent higher in adult men than in women.
• Obesity. In the United States, a higher percentage of men are overweight (34.1 percent) compared to women (27.5 percent). Excess body weight can lead to an increase in blood volume and resistance to blood flow, putting extra pressure on the blood vessels and leading to HBP. Additionally, obesity can contribute to the development of other risk factors for high blood pressure, such as insulin resistance and inflammation.
• Sleep apnea. During sleep apnea, the airway is blocked or narrowed, leading to interruptions in breathing and a decrease in the oxygen levels in the blood. This causes the body to release stress hormones, which can increase heart rate and constrict blood vessels, increasing blood pressure or making existing high blood pressure worse. Men are two to three times more likely to have sleep apnea than women.
• Stress. Men and women can suffer from stress-induced high blood pressure, but men may have a more robust physiological response to stress compared to women. Additionally, men may be more likely to engage in behaviors that increase their risk of high blood pressure, such as consuming alcohol and smoking.

It's important to remember high blood pressure can be genetic, and men with a family history of hypertension may be at increased risk. Also, blood pressure tends to increase with age, as men older than 45 are more likely to develop HBP than younger men.

Men's sexual health can be intrinsically linked to blood pressure as high blood pressure can harm blood vessels and restrict blood flow to the penis, which can make getting an erection challenging to attain or maintain, Pilchik explained.

"Men with hypertension are almost twice as likely to have issues with blood flow to their penis, which can result in ED and sexual health issues, compared to men whose blood pressure is in the normal range," Patel said.

Furthermore, Pilchik said some blood pressure drugs, including beta blockers and diuretics, can also cause ED, decreased libido or delayed ejaculation.

In addition, elevated blood pressure might impair sperm quality and diminish male fertility. According to Patel, research shows men with hypertension are more likely to produce poor-quality sperm.

"There may also have lower sperm count, damage to the testes, and problems with hormone production and sperm production," she added.

Sexual dysfunction, on the other hand, might have an impact on blood pressure, Pilchik added. According to several studies, men with ED are more likely than men without ED to suffer hypertension or other cardiovascular problems.

"Men with erectile dysfunction should get a full cardiovascular evaluation, because ED may be an early warning indication of cardiovascular disease," he recommended.

Pilchik's top strategies for men to manage their blood pressure include the following:

1. Cut the salt. Sodium can elevate blood pressure, so men should aim to limit their sodium intake to fewer than 2,300 milligrams per day.
2. Eat a better diet. Pursue a diet that's rich in fruits, vegetables, whole grains, lean proteins and low-fat dairy products. Men should limit their intake of processed foods and saturated and trans fats.
3. Get regular physical activity. Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week.
4. Maintain a healthy weight. Being overweight or obese can increase blood pressure. Men should aim to maintain healthy body weight through a combination of healthy eating and regular exercise.
5. Reduce alcohol intake. Drinking too much alcohol can raise blood pressure. Men should limit their alcohol intake to no more than two drinks per day.
6. Reduce stress. Men should find healthy ways to manage stress, such as through exercise, meditation or therapy.
7. Quit smoking. Smoking can increase blood pressure and damage blood vessels.

"Men can maintain healthy blood pressure and lower their chance of developing hypertension and other related health conditions by following these suggestions," Pilchik concluded.