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Hypertension Serious in Young Men

High blood pressure is more common in younger men, and should be taken just as serious as in their older counterparts.

Younger vs. Older Men With High Blood Pressure continued...

Lackland, who is professor of epidemiology and medicine at the Medical University of South Carolina in Charleston, says that as with older men, treatment for younger men follows JNC 7 guidelines for lifestyle changes and medications.

The JNC 7 recommends the following lifestyle modifications for people with prehypertension as well as hypertension:

Weight reduction. Maintain a normal weight with a target body mass index (BMI) of 18.5 to 24.9.

This can result in an approximate reduction in systolic blood pressure of 5-20 points per 10 kilograms of weight loss, according to the JNC 7.

DASH (Dietary Approaches to Stop Hypertension) eating plan. Adopt a diet rich in fruits, vegetables, and low-fat dairy products. Reduce saturated and total fat. This can be expected to drop systolic blood pressure by 8-14 points.

Lower salt intake. Reduce dietary sodium to less than 2,400 milligrams or about 1 teaspoon a day. According to the JNC 7, a 1,600-milligram sodium DASH eating plan has effects similar to a single drug therapy. The approximate reduction in systolic blood pressure would be 2-8 points.

Aerobic physical activity. Engage in regular physical activity, such as brisk walking, at least 30 minutes per day most days of the week. This can decrease systolic blood pressure by 4-9 points.

Moderation of alcohol consumption. Men should limit alcohol to no more than two drinks per day. A standard drink is defined by the type of alcohol. For example, a standard drink, such as a 12-ounce bottle of beer, a 5-ounce glass of wine, or 1.5-ounce shot of 80-proof distilled spirits, has between 11 and 14 grams of alcohol. Limiting the amount of alcohol to this quantity is expected to result in a reduction in systolic blood pressure by 2-4 points.

When medications are indicated for younger men, one question is what will be the long-term effect? "We've had medications around since the 1970s, but with newer ARBs (angiotensin receptor blockers), we don't know," says Lackland. "But the benefit of keeping blood pressure to goal is so great. Without treatment, a man at [age] 30 could be facing end-stage renal disease, stroke, or heart attack."

Another Complication Worth Considering

If the threat of premature death from complications of untreated high blood pressure doesn't get your attention, perhaps this will: A recent study showed that men with high blood pressure were 2.5 times as likely as men with normal pressure to develop erectile dysfunction (ED). Men with prehypertension also had a higher incidence of ED than did men with normal pressure.

Michael Doumas, MD, of the University of Athens in Greece, presented the study at the American Society of Hypertension 20th Annual Scientific Meeting and Exposition. In order to assess the link between hypertension and erectile dysfunction, researchers excluded men who had a history of diabetes, heart disease, renal failure, or liver and vascular disease, which are associated with ED.

While the study of men aged 31 to 65 didn't compare younger vs. older men, the fact that more than one-third of the participants with high blood pressure had erectile dysfunction should be seen as another very good reason to seek treatment and follow doctor's orders.

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