OBJECTIVE: The purpose of this study was to assess the relationship between road traffic noise exposure at home and the prevalence of hypertension. METHODS: We conducted cross-sectional analyses in a large random sample (N = 40,856) of inhabitants of Groningen City, and in a subsample (the Prevention of Renal and Vascular End-Stage Disease [PREVEND]) study cohort; N = 8592). RESULTS: Before adjustment for confounders, road traffic noise exposure was associated with self-reported use of antihypertensive medication in the city of Groningen sample (odds ratio [OR] = 1.31 per 10-dB increase in Lden). Adjusted odds ratios were significant for the subjects between 45 and 55 years old in the full model when adjusted for PM10 (OR = 1.19) and at higher exposure (Lden >55 dB) only (OR = 1.21; with adjustment for PM10, OR = 1.31). In the PREVEND cohort, the unadjusted odds ratio was 1.35 for hypertension (systolic and diastolic blood pressure >140 and >90 mm Hg, respectively, or use of antihypertensive medication). Again, the adjusted odds ratio was significant for subjects between 45 and 55 years old (OR = 1.27; with adjustment for PM10, OR = 1.39). CONCLUSIONS: Exposure to road traffic noise may be associated with hypertension in subjects who are between 45 and 55 years old. Associations seemed to be stronger at higher noise levels. ©2007The American College of Occupational and Environmental Medicine.