High Blood Pressure Is a Highly Prevalent but Unrecognised Condition in Primary Infertile Men: Results of a Cross-sectional Study

BACKGROUND: Although most of the components related to metabolic syndrome were shown to have a detrimental effect on male fertility, the effects of high blood pressure (HBP) have been partially analysed. OBJECTIVE: To investigate the prevalence and impact of hypertension on clinical and semen parameters in a cohort of white European men presenting for couple's infertility at a single tertiary referral academic centre. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional study was performed including analysis of data from 2185 primary infertile men. Comorbidities were scored with Charlson Comorbidity Index (CCI; categorised 0 vs ≥1). HBP was defined as blood pressure ≥140/90mmHg. Semen analyses followed the 2010 World Health Organization reference criteria. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Descriptive statistics and logistic regression analyses tested the association among semen parameters, clinical characteristics, and HBP. RESULTS AND LIMITATIONS: Overall, HBP was found in 6.8% of infertile patients and in 3.6% of age-comparable men without known fertility problems. Of 148 patients, 85 (58%) were either unaware of their HBP or not adequately medically-controlled. +HBP men were older (median age [interquartile range], 37 [33-40] vs 39 [36-44] yr; p<0.001), had higher CCI scores (X(2)=25.6; p<0.001), higher BMI (25.1 [23.3-27.3] vs 26.8 [24.9-29.4]; p<0.001), and a waist circumference >102cm in a greater proportion of individuals (41% vs 23%; X(2)=4.68 p<0.05) than -HBP men. Hypertensive and normotensive men did not differ in terms of hormonal milieu and semen parameters. Patients did not differ in terms of HPB rates according to oligozoospermia, asthenozoospermia, and teratozoospermia status. The lack of a real control group represents the main limitation of the study. CONCLUSIONS: Hypertension and unrecognised or not adequately controlled HBP are highly prevalent among white European primary infertile men. Hypertension per se did not have an impact on hormonal and semen parameters. PATIENT SUMMARY: Because of its effects in terms of overall prospective men's health, high blood pressure must be comprehensively considered over the basic work-up of every infertile man in the outpatient clinic setting.