OBJECTIVE: This study aimed to examine the association between cumulative occupational noise exposure, using high-frequency hearing loss as an objective marker, and hypertension among Air Force ground staff. METHODS: Active-duty Air Force ground staff ( n  = 451) completed standardized questionnaires and underwent pure-tone audiometry, and their blood pressure (BP) and laboratory profiles were measured. High-frequency hearing loss was defined as the average 4-kHz hearing threshold in both ears and was categorized into low (< 7.5 decibels [dB], 2nd quartile), medium (7.5-12.5 dB), and high (≥ 12.5 dB, 3rd quartile) groups. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or a previous diagnosis. Multiple logistic and linear regression models were used to estimate associations. RESULTS: The prevalence of hypertension increased progressively across the hearing loss categories (40.9%, 63.5%, and 82.1%, respectively). Compared with the low group, the odds of hypertension were significantly higher in the medium (adjusted odds ratio [aOR] = 1.90, 95% confidence interval [CI]: 1.08-3.34) and high (aOR = 4.81, 95% CI: 2.51-9.02) groups. Each 5-dB increase in the 4-kHz hearing threshold was associated with double the likelihood of hypertension (aOR = 2.15, 95% CI: 1.57-2.94) and with increases in SBP and DBP (adjusted beta coefficients [aβ] = 0.63 and 0.46 mmHg, respectively). CONCLUSION: High-frequency hearing loss as a proxy for cumulative noise exposure was strongly associated with hypertension among the Air Force ground staff. These findings suggest that occupational noise may be associated with an increased risk of hypertension.