Over 130 million people are affected by transportation noise, an important risk factor for disease burden. Road traffic noise increases cardiovascular risk by approximately 3.2% per 10 dB increase and all-cause mortality risk by approximately 5.5%. The WHO road-noise guideline of 53 dB Lden may not be sufficiently protective, as mortality risk increases at lower noise levels. Night-time noise increases blood pressure and is associated with increased use of sleeping medication. Aircraft and road traffic noise can increase blood pressure, disturb its normal daily rhythm, and contribute to hypertension. Reducing residential noise exposure should become part of cardiovascular prevention.