Most people think that high blood pressure is a disease exclusive to the elderly, but in fact it is not. With the changes in people’s lifestyles, there is a clear trend towards the rejuvenation of hypertensive patients, and many men between the ages of 30 and 50 are also suffering from high blood pressure. Due to the gradual postponement of the marriage age of young people and the full liberalization of the new national fertility policy, having children at middle and high ages has become a problem that more and more families need to face. Hypertension is gradually becoming an important factor affecting male fertility. The effects on male fertility are mainly in the following aspects. 1, hypertension affects erectile dysfunction Erectile dysfunction patients are more sensitive to changes in blood vessels than hypertensive patients, when patients do not have symptoms of hypertension, erectile dysfunction may have occurred. Many experts refer to erectile dysfunction as the “outpost” of cardiovascular disease. Erectile dysfunction is an early clinical manifestation of hypertension. The direct effect of hypertension on male erectile function is manifested in the alteration of penile vascular compliance and vascular endothelium, which makes the penis unable to gain sufficient strength during erection. Meanwhile the side effects of some antihypertensive drugs can also induce erectile dysfunction. Currently, the drugs commonly used in clinical hypertensive patients can be divided into diuretics, β-blockers, calcium channel antagonists, angiotensin-converting enzyme inhibitors, angiotensin I1 receptor antagonists, and a-adrenergic receptor antagonists. A recognized adverse effect of thiazide diuretics is erectile dysfunction, occurring in 3%-32% of cases. The mechanism by which spironolactone affects erectile function is by decreasing the binding of dihydrotestosterone to the androgen receptor, causing a decrease in libido and erectile function. Non-selective beta-blockers affect erectile function in relation to the direct action of beta2 receptors on penile vascular smooth muscle cells, leading to vasoconstriction and reduced perfusion to the cavernous body of the penis. With the third generation of β1-adrenergic receptor antagonists widely used in the clinic, their adverse effects have been reduced and they also have a certain effect of improving erectile function. The mechanism is that highly selective β1-adrenergic receptor antagonists specifically antagonize myocardial β1-receptors and have less effect on β2-receptors present in the cavernous body of the penis. Moreover, highly selective β1-adrenergic receptor antagonists have some ability to modulate the endothelial nitric oxide signaling system, which can increase the release of nitrogen oxides from the endothelial system, thus improving erectile function in patients. In the short term, angiotensin-converting enzyme inhibitors may improve penile cavernous perfusion by releasing nitrogen oxides and vasodilating blood vessels. However, from the long-term effect, angiotensin converting enzyme inhibitors can promote the proliferation of penile vascular collagen tissue by blocking angiotensin II, so that the lumen of the blood vessel is narrowed, resulting in erectile dysfunction. 2, hypertension can affect semen quality Hypertension can reduce sperm quality. In addition to the effect of high blood pressure itself on sperm quality, some antihypertensive drugs will also affect the number and vitality of sperm. Spironolactone, Pranolol and other drugs can lead to a decrease in sperm vitality and concentration. a-blockers (such as tamsulosin, etc.) may lead to retrograde ejaculation (semen flows retrograde into the bladder and cannot be ejaculated from the urethra) and ejaculation disorders in patients. 3, hypertension will reduce male sexual desire Male gonadal hormone levels are also an important factor affecting male reproductive function. The abnormalities of sex hormones in hypertensive patients are mostly caused by side effects of antihypertensive drugs. For example, spironolactone has an antiandrogenic effect, reducing testosterone production by inhibiting C17 hydroxylation and prompting the conversion of serum testosterone to estradiol in the body to accelerate the rate of long-term use of spironolactone will increase the clearance of androgenic testosterone in the liver, so that the concentration of testosterone in the blood is reduced. Beta-blockers such as metoprolol, atenolol and propranolol can reduce testosterone levels. 4.Which groups of people are prone to high blood pressure? (1) Family history of hypertension. Hypertension has obvious family aggregation. If both parents do not have high blood pressure, the chance of their offspring getting high blood pressure is only 3.1%, but if both parents have it, the chance rises to 46%. (2) Elderly. There is a significant correlation between hypertension and age, especially systolic blood pressure. The older you get, the less elastic your blood vessels become and the ability to regulate your blood pressure decreases. (3) Excessive taste. People in the north have a higher chance of developing high blood pressure than people in the south, because people in the north have a heavy taste in food and a higher content of salt. Blood vessels are sensitive to salt, and over-salting leads to higher blood pressure. (4) overweight, obesity. Generally obese people, the body fat will be excessive, the possibility of hyperlipidemia will be elevated, and the corresponding blood pressure will be high. At the same time, most obese people are sleepy and lack of exercise, which will form a vicious circle. (5) Long-term smoking. Nicotine and carbon monoxide in the cigarette will continue to act on the blood vessels, making the blood vessels in spasm and damaging the elasticity of the blood vessels. (6) Alcoholism. Long-term alcohol consumption will cause cholesterol to rise, the substance accumulates in the blood vessels is not easy to remove, the blood vessels will be lesions. (7) Long-term mental stress, lack of sleep, anxiety and depression. These people are prone to high blood pressure, but after a certain amount of rest, the blood pressure will drop to normal. (8) Long-term oral contraceptive pills, non-steroidal anti-inflammatory drugs and other drugs are also prone to hypertension. (5) How to treat hypertensive patients? For hypertensive patients in the stage of preparation for pregnancy, the combination of angiology and reproduction should be carried out to implement individualized treatment for the specific conditions of the patients. Meanwhile, it is also important to improve lifestyle, adjust diet and strengthen exercise.