Similar numbers of American men and women overall have high blood pressure, but in younger age groups, men are much more likely to have hypertension issues. The chart shows two key age groups and the percent of people with high blood pressure.


Men age 20-34 Women age 20-34 
Men age 34-44Women age 35-44
Source: Centers for Disease Control and Prevention


A Discussion of Hypertension with Dr. William J. Scarpa

Dr. William J. Scarpa Jr. is a clinical cardiologist working for Wake Forest Baptist Health’s North Wilkesboro office. He has more than 20 years of experience, with his areas of interest including all aspects of non-interventional, consultative cardiology, nuclear cardiology, stress testing and diagnostic modalities.

Here he discusses hypertension, heart and and health issues, particularly as they relate to men.

 Learn more about the Heart Center and Vascular Center at Wake Forest Baptist Health. 

Q. In today’s world, with all that’s out there about healthy lifestyles and advances in technology, how frequently do you come across men who haven’t had their blood pressure checked or are unaware they are at risk for hypertension?

A. Men tend to go to the doctor less frequently and at a later time than women. Women have already established with primary care physicians at a much younger age because of child bearing.

Men have a tendency to show up later, and they usually show up when there’s a problem. Or better yet when their wife suspects there’s a problem. They literally get dragged into the office screaming, digging their heels in.

Q. Why are men so reluctant to get a check-up?

A. One of the things they really don’t pay attention to is hypertension and their cardiac risk factors. There is a denial and a fright factor. Men are usually the breadwinners of the family. They’re working, bringing in money. They’re scared to find a problem. Scared to open a Pandora’s box, so to speak. The engine’s running, don’t open the hood attitude.

Q. How have lifestyle changes affected health?

A. There are definite changes in our lifestyle and in our environment that have impacted upon hypertension, especially in men. The first thing, stress issues now are greater than they were 20 years ago.

It’s arguable, but with the Internet and the philosophy of everything needs to be done immediately, instead of mailing a check – you have to put on a stamp, walk to the mailbox, walk to the post office – now we just do everything electronically sitting at a desk.

You take care of these things faster so you think you would have more time to exercise and go to the gym and so on, but I think by nature human beings have a tendency to fall into a lazier lifestyle. Also, the fast-food issues – everything is prepared quickly, there’s a lot more processed foods, a lot more sodium in foods. All of these factors are impacting hypertension rates. 

Q. What are the key cardiac risk factors?

A. Obesity, diabetes, smoking and hypertension. All those four things are easily treatable. We can manage and take care of all your cardiac risk factors with the exception of family history. We can’t change that.

Q. Does everyone have to be on medication to control high blood pressure? 

A. A lot of times not. If someone doesn’t have other risk factors (family history, diabetes), you have a tendency to use non-medication means. What that comes down to is diet and exercise.

Q. What are the most important steps men can take to control high blood pressure?

A. I bring it back to the patient and say ‘You’re a young guy, you’re in your 40s. We can make a direct impact to your health if we start treating your blood pressure and get you on an exercise program and loose weight. The sooner you do things, the better off you’ll be in the long run.’

Q. What about the stories of people who’ve been taking medicine for high blood pressure and still get strokes or heart attacks?

A. A lot of patients come in with a history of hypertension and they’re on treatment, but they’re not adequately controlled. Patients have to take more of a primary role in treating blood pressure. I recommend for almost every patient that I have that has hypertension to invest in a home blood pressure monitoring device.

Q. At what age should men think about monitoring their blood pressure? 

A. There’s no guideline in terms of recommending when you should start to monitor it. But I would say it’s never too soon to at least be aware of your blood pressure readings, especially if there’s a strong family history of hypertension.

Q. What are the worst things men do to their bodies that put stress on their heart? 

A. The worst thing is smoking. Forget about food, lifestyle, job stress; the worst thing anybody could do to their body is smoke. It will affect every organ in the body. It destroys your intravascular lining, and that’s why it is a problem with heart attack and stroke. It will affect the lungs causing COPD, as well as increase the risk of different types of cancer.

What I’ve found since moving to North Carolina is the incidence of heart disease and hypertension is much more prevalent. In the South, not only is the incidence much more prevalent in numbers, but at a younger age … the common thread, and this is across the board, every one of these young people came in with a heart attack or stroke, the common thread was smoking. Period. End of story. That was it. Every one of them.

Q. What other issues should men be worried about when it comes to heart health and hypertension?

A. If you’re a young middle-aged male, and you think that you might have a problem, or you have had a thought that, ‘Well, you know my parents had heart disease. Should I get checked?’ or ‘I was out this weekend biking and hiking and I had a little chest pain and it might be a problem.’ If there’s any sort of thought that there might be an issue, get it checked. Don’t wait. Don’t ignore it. 

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Last Updated: 01-06-2014
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