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EspañolWhat causes hypertension? Diagnosis, prevention, and treatment
Overview: What is hypertension?
Hypertension is diagnosed when systolic blood pressure (when the heart pumps blood into the arteries) is more than 130 mm Hg, and diastolic blood pressure (when the heart relaxes) exceeds 80 mm Hg. 1 out of 2 adults in the United States has hypertension. Worldwide the incidence is 45%. Most cases of hypertension have no identifiable cause. Referred to as essential hypertension, there are lifestyle, physical, and genetic risk factors that may contribute to its development, but do not actually cause it.. On the other hand, some cases of hypertension do have an identifiable cause and are diagnosed as “secondary hypertension.” No matter what the cause, hypertension rarely has symptoms, but left untreated, can lead to serious health problems such as stroke, heart attack, heart failure, kidney damage, and kidney failure. That’s why it’s sometimes called “the silent killer.”
RELATED: Understanding blood pressure levels
Key takeaways:
Hypertension is a common health condition that can affect anyone regardless of age, sex, race, or ethnicity. Find updated hypertension statistics here.
Hypertension usually does not have an identifiable cause.
Risk factors for hypertension include genetics, some chronic diseases, pregnancy, and lifestyle habits such as smoking, poor diet, lack of exercise, salt intake, and obesity.
There are usually no symptoms of hypertension.
Hypertension usually requires a medical diagnosis from a healthcare provider.
Hypertension usually requires treatment. It typically improves with treatment within a few days or weeks, but it may take longer for other people.
Treatment of hypertension may include blood pressure medications and lifestyle changes. Read more about hypertension treatments here.
Hypertension is usually preventable by maintaining a healthy lifestyle, eating a healthy diet, maintaining a healthy weight, avoiding smoking, reducing alcohol consumption, exercising, and sleeping well.
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What causes hypertension?
Most people are diagnosed with essential hypertension: high blood pressure with no identifiable cause. There are contributing risk factors, but no single identifiable cause.
However, around 1 out of 10 people with high blood pressure have secondary hypertension: high blood pressure due to an identifiable cause. Secondary hypertension causes include health problems such as:
Kidney disease
Hormone disorders such as thyroid or adrenal gland problems
Blood vessel disorders
Obstructive sleep apnea
Preeclampsia.
However, the most common causes of secondary hypertension are prescription and over-the-counter drugs such as:
Decongestants with phenylephrine or pseudoephedrine
Amphetamines
Birth control pills and estrogens
Testosterone and other androgens
Nicotine
Caffeine
Alcohol
Some herbal supplements
Illicit or recreational drugs.
In many cases of secondary hypertension, blood pressure improves when the cause is removed or resolved.
Risk factors for hypertension
While 90% of hypertension cases have no identifiable cause, a number of risk factors create a higher risk of developing hypertension. Some are genetic, some are medical conditions, but many are lifestyle choices that can be changed.
Genetic risk factors for hypertension include:
A family history of hypertension
Physical conditions that increase the risk of developing hypertension include:
Chronic kidney disease
Diabetes
Coronary artery disease
Aging
Lifestyle habits and behaviors that increase the risk of developing hypertension include:
Poor diet
Excess weight
Physical inactivity
Smoking
Alcohol consumption
Salt intake
Where a person lives is also a risk factor. For instance, the prevalence of high blood pressure is considerably higher in states like Louisiana and Mississippi than it is in California.
Is hypertension serious? When to see a doctor
Hypertension is a potenitally serious disorder that significantly increases the risk of developing cardiovascular diseases such as heart failure, heart attack, and stroke, as well as organ problems throughout the body. Blood pressure can be controlled by blood pressure medications, so healthcare professionals consider high blood pressure the most common preventable cause of heart disease.
Hypertension usually has no symptoms, so the only way to diagnose hypertension is to measure blood pressure. This can be done by any healthcare professional, so the best way to identify high blood pressure is to have regular physical examinations by a healthcare professional. However, a healthcare provider is needed to determine the cause, the risk, and the appropriate medical treatment.
High blood pressure in general is not a medical emergency, but blood pressure greater than 180/130 mm Hg is. Called a hypertensive crisis, extremely high blood pressure requires immediate admission into the hospital, and sometimes even an ICU (intensive care unit) admission is required to prevent organ damage. When the blood pressure is this high, the patient will usually have symptoms such as headaches, nosebleeds, chest pain, blurred vision, and confusion. In some cases, a medical condition such as preeclampsia causing elevated blood pressure will have other noticeably severe symptoms.
RELATED: How to prevent—and treat—high blood pressure during pregnancy
How is hypertension diagnosed?
Hypertension is often first spotted when a healthcare provider performs a routine blood pressure check. Blood pressure can go up and down throughout the day, and so healthcare professionals need at least two or three separate blood pressure measurements made on separate days to confirm that there’s a problem. It’s important that these blood pressure measurements be taken by a professional. Proper technique with a blood pressure cuff is required for the reading to be accurate. Measurements from home or the pharmacy should be confirmed by your doctor.
Once high blood pressure is confirmed, a healthcare professional will get a medical history and perform a physical examination. This will help them figure out if there’s an identifiable cause or if there’s any organ damage. To accomplish this, the healthcare provider will need blood tests, urine tests, and an ECG. A retinal exam may also be needed.
Is hypertension hereditary?
Heredity is a risk factor for hypertension, but it’s not a cause. All that means is that people with a family history of hypertension have a higher probability of becoming hypertensive themselves. That’s it. People who live in Louisiana also have a higher probability of getting hypertension too, but Louisiana doesn’t actually cause hypertension. Other risk factors will also contribute, particularly lifestyle choices and behaviors. Those risk factors can be controlled. For instance, some people are born salt-sensitive. When they increase their intake of sodium, their blood pressure goes up. That’s a hereditary condition and affects about 1 in 2 people diagnosed with high blood pressure. However, people with salt sensitivity can control their salt intake and avoid hypertension entirely or at least get high blood pressure under control. Same genes, different outcomes.
Is hypertension curable?
In most people, high blood pressure can be brought into normal blood pressure ranges. The most effective treatment for essential hypertension is a combination of lifestyle changes, dietary changes, physical activity, and blood pressure medications. Secondary hypertension is generally treated by addressing the underlying cause. That may be easy in some cases. For instance, if someone is taking a drug that raises blood pressure, the drug can be stopped. It may be more difficult when treating physical conditions, especially if they’re chronic. In those cases, blood pressure medications are usually needed.
There are several types of blood pressure medications that are used individually or in combination. These include:
Diuretics (water pills)
How to prevent hypertension
Lifestyle is a leading factor in developing or preventing high blood pressure. The best prevention is to adopt a healthy lifestyle including:
Adopt a low-fat and low-cholesterol diet
Avoid junk food
Engage in physical activity or exercise
Lose excess weight and keep it off
Control salt intake
Stop smoking
Drink less alcohol
Avoid certain drugs that raise blood pressure such as NSAIDs, decongestants, stimulants, and caffeine
Manage stress
Practice good sleep hygiene
Most importantly, get regular physical checkups
Many, if not most, people diagnosed with high blood pressure discover the problem when a healthcare professional takes a blood pressure reading at a routine healthcare visit. Regular physical checkups will help to spot high blood pressure and put people on the path to the best treatment. Once diagnosed, regular checkups and blood tests are required to determine if treatment and lifestyle changes are working and to make sure medication side effects aren’t serious. The best outcomes occur in people who take their medications, keep their medical appointments, change their lifestyle, and regularly monitor their blood pressure with an at-home blood pressure monitor.
FAQs about hypertension causes
What is high blood pressure?
High blood pressure is diagnosed when the pressure in the arteries is greater than 130 mm Hg when the heart beats (called systolic pressure) and is greater than 80 mm Hg when the heart is at rest (diastolic pressure). However, blood pressure medications are typically not started until blood pressure persistently exceeds 140/90 mm Hg.
Causes of sudden high blood pressure
Blood pressure is dynamic, meaning it goes up and down throughout the day. It’s often high in the morning and lower near bedtime. There are certain things, however, that can cause sudden elevated blood pressure including:
Physical activity and exercise
Caffeine
Medications
Illicit drugs
Smoking
Stress or anxiety
RELATED: Can anxiety cause high blood pressure?
What foods can cause hypertension?
Diet is a significant risk factor for developing high blood pressure. However, most “bad” foods are just that: a risk factor, not a cause of high blood pressure. Some foods, however, may cause blood pressure to rise. These include foods high in sodium. Foods and drinks with stimulants, like caffeine (especially energy drinks), can also cause blood pressure to rise. Tyramine increases blood pressure, so foods with high tyramine levels such as aged cheeses, cured meats, processed meats, fermented foods, and alcoholic beverages, may not be good for blood pressure.
RELATED: The best diet for your blood pressure—14 foods to eat, and 8 to avoid
What’s next? Additional resources for people with hypertension
Test and diagnostics
High blood pressure symptoms and causes, Centers for Disease Control and Prevention (CDC)
2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, Journal of the American Academy of Cardiology
Treatments
Monitoring your blood pressure at home, American Heart Association (AHA)
Prevent high blood pressure, Centers for Disease Control and Prevention (CDC)
Scientific studies and clinical trials
Report of the National Heart, Lung, and Blood Institute Working Group on hypertension, Hypertension
Salt sensitivity of blood pressure: an enigmatic hypertension phenotype, American Heart Association