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Hypertension / High Blood Pressure Causes & Risk Factors

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What Causes High Blood Pressure?

writtenByWritten by: Shannon Chapman
Shannon Chapman

Shannon Chapman

Shannon enjoys breaking down technical subjects and giving others the tools to make informed decisions. Her interests include behavioral economics, sustainable living, meditation, and healthy cooking.

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reviewBy Reviewed by: Dr. Katalin Karolyi

Dr. Katalin Karolyi

Katalin Karolyi, M.D. earned her medical degree at the University of Debrecen. After completing her residency program in pathology at the Kenezy Hospital, she obtained a postdoctoral position at Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida.

April 13, 2021 Read Time - 9 minutes

High Blood Pressure Causes

High blood pressure can be caused by many factors, but mostly notably are diabetes, obesity, and excessive alcohol consumption. High blood pressure happens when the pressure your blood exerts against the artery walls is too high, leading to life-threatening conditions such as heart disease and stroke. 

Despite these severe health consequences, the vast majority of individuals with high blood pressure have no symptoms. This is why hypertension is sometimes called a “silent killer.”

According to the CDC, “Tens of millions of adults in the United States have high blood pressure, and many do not have it under control.” Learn more about the causes and risk factors below.

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What is Hypertension?

Hypertension, or high blood pressure, is the most common cardiovascular disease in the US. It is a condition in which the pressure your blood puts on your artery walls is higher than normal for a sustained period of time. 

Similar to the pressure needed to send air through a tube, your blood needs pressure to travel through your arteries. Just like too much pressure can damage a tire, high blood pressure can lead to a number of health conditions, including potentially life-threatening conditions like stroke. 

Illnesses or medications that narrow the arteries increase high blood pressure. This is why high blood pressure is much more common with older adults. As we age, our arteries narrow, and the same amount of pressure in a regular sized artery is equivalent to high blood pressure in a narrowed artery.

Risk Factors for Hypertension

There are two types of hypertension. Essential hypertension is where the underlying cause of the high blood pressure is unknown, which may account for as much as 95% of cases in the US. 

Secondary hypertension is when the direct cause of the high blood pressure can be determined. Common causes include kidney disease, tumors, birth control pills, and pregnancy in women. Both essential and secondary hypertension are the product of your medical history, genetics, and lifestyle.

Read: Get Hypertension Treatment Online

Why Do I Have High Blood Pressure?

The reasons for high blood pressure can vary from person to person, but it is clear that high blood pressure is more common in certain demographic groups:

  • Family history of hypertension: High blood pressure or a predisposition to high blood pressure can run in the family. If your parents or any close relatives have hypertension, it increases the likelihood you may have it as well.
  • African-Americans: African-Americans develop hypertension more often than any other racial group, and African-Americans tend to get high blood pressure at younger age and at more severe levels. In fact, the prevalence of hypertension among African-Americans in the US is some of the highest rates in the world. Most theories suggest that a higher rate of diabetes or a salt-sensitive gene may be the explanation.
  • Men under 45 and women over 65: Men aged 45 and younger are more likely to get high blood pressure, but women aged 65 and older are more likely to have the condition than men. Menopause, which starts later in life, changes the hormonal balance in women’s bodies contributing to increased risk of high blood pressure.
  • Older adults: High blood pressure is more likely as you age. In aging, our skin and blood vessels lose some elasticity, meaning that they can narrow or become more rigid and increase your blood pressure. It is still possible for children to get high blood pressure, but it is less likely.

Certain lifestyles also increase your likelihood of developing high blood pressure.

  • Overweight: Being more than 15% over the healthy weight for your body mass increases your likelihood of getting high blood pressure significantly. Obese people develop high blood pressure two to six times more often than healthy individuals.
  • Inactive: Being inactive contributes to obesity and high blood pressure. When we exercise, our heart muscles and circulatory system become stronger. A stronger heart can pump more blood with less effort, and when your heart works less, the force on your arteries decreases.
  • Unhealthy diet: Quality nutrition keeps all systems in your body working and is critical for your health. Excessive saturated fats and sugars can contribute to high blood pressure. Changing your diet is a key recommended treatment for most individuals that have high blood pressure. Sodium or salt intake in particular is directly linked to high blood pressure.
  • Heavy alcohol drinkers: Those who drink more than two drinks a day have higher rates of high blood pressure then those who do not. Heavy alcohol use is linked to a number of heart conditions. It is recommended to always drink in moderation to protect your health.
  • Smokers: Smoking negatively affects key body functions such as your ability to exercise, therefore contributing to obesity and high blood pressure. Smoking can also directly damage arteries, increasing your likelihood of heart disease.
  • Stress: Excessive amounts of stress can both contribute to high blood pressure and increase your participation in behaviors that may lead to high blood pressure.

Regular use of decongestants, pain relievers, birth control pills, or illegal drugs like cocaine also increase your chance of developing high blood pressure.

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Causes of High Blood Pressure in Women

There is a misconception that women are more rarely affected by hypertension. However, women have high blood pressure at the same rate as men, and are more likely than men to develop hypertension after the age of 65. In particular, three periods of life can affect a woman’s blood pressure:

  • Oral contraceptives: Taking birth control pills increases blood pressure for some women, especially for those who are already at risk of high blood pressure. Ask your doctor before taking birth control if your medical history could put you at risk of developing hypertension.
  • Pregnancy: High blood pressure during pregnancy, or gestational hypertension, may occur after the first 20 weeks and disappear after delivery. If it is not caught and treated, it can be damaging to the baby and mother, so a doctor should always be consulted with regular check-ups.
  • Menopause: While not entirely clear, the chances of women having high blood pressure after menopause increase considerably, even if they have had normal blood pressure their whole life.

Diagnosing & Treating Your High Blood Pressure

While high blood pressure can have serious consequences if left untreated, it is very easy to detect. A doctor or nurse, pharmacy, or even at home monitor can measure your blood pressure with a device called a sphygmomanometer. 

A sphygmomanometer consists of a dial, pump, valve, arm cuff, and stethoscope. The dial displays two numbers:

  • Systolic blood pressure: The maximum pressure during heartbeats
  • Diastolic blood pressure: The lowest pressure between two heartbeats. 

Written in millimeters of mercury (mmHg), normal guidelines are 120/80 or lower, with hypertension being blood pressure greater than 140/90.

Usually, three readings of hypertension are required for a diagnosis. Additionally, a doctor will ask about your medical history and potential risk factors before conducting a physical exam or requesting additional tests.

Two main treatments for high blood pressure are recommended: lifestyle changes and drug therapy. 

Lifestyle changes that will help bring down your high blood pressure include:

  • Losing weight
  • Eating healthy
  • Quitting smoking
  • Exercising regularly
  • Limiting alcohol intake
  • Reducing sodium intake

These lifestyle changes not only lower blood pressure, but can boost the effectiveness of hypertension medication.

If lifestyle changes are not enough or if the high blood pressure is severe enough, drug therapy can be life-saving. The major types of drug therapy for treating hypertension include:

  • Angiotensin II receptor blockers (ARBs)
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Alpha blockers
  • Beta blockers
  • Calcium channel blockers
  • Diuretics
  • Renin inhibitors
  • Combination medications

Diuretics are usually the first recommended therapy to treat hypertension, but they are not recommended for everyone based on their medical history. ACE inhibitors are more common for those with diabetes, and sometimes multiple drugs may be prescribed. Talk to a medical professional to learn more about your options.

Once starting the drug therapy, you should have monthly appointments with your doctor to see if you are moving toward your goal and check for potential side effects, such as kidney damage. After successfully lowering your blood pressure, you should still continue to have appointments with your doctor at least every three to six months.

When to Contact a Doctor for High Blood Pressure

If you believe you are at risk of hypertension or belong to one or more of the demographics at higher risk of developing high blood pressure, you should ask your doctor to take a measurement.

Call 911 immediately if you are experiencing the following hypertension symptoms, as they can be a sign of untreated high blood pressure resulting in a hypertensive emergency:

  • Blurred vision with severe headache and confusion
  • Numbness on one side of the body
  • Nausea and vomiting
  • Increasing shortness of breath, severe chest pain
  • Unresponsiveness
  • Seizure

If you suspect you may be at risk for high blood pressure, it is very important to get tested.

Even if you have no high blood pressure symptoms, as do the vast majority of those with hypertension, you should be getting check-ups regularly. You can make an appointment with your primary care physician or see an online doctor to learn more about testing for hypertension.

  • Book on our free mobile app or website.

    Our doctors operate in all 50 states and same day appointments are available every 15 minutes.

  • See a doctor, get treatment and a prescription at your local pharmacy.

  • Use your health insurance just like you normally would to see your doctor.


Can I Get a Blood Pressure Prescription Online?

Yes! In order to get any prescription medication, you’ll have to consult a doctor. Fortunately, online providers such as PlushCare make getting a virtual appointment simple, affordable, and convenient. 

High blood pressure is one of the many conditions that our telemedicine services are designed to help treat. Although we cannot take blood pressure measurements virtually, we can help interpret your results and provide a treatment plan that is right for you. 

Managing hypertension can take months or even years. Save the time and energy of having to go in for a recurring appointment with your physician and see a doctor online in minutes. PlushCare accepts many major insurance providers and is proud to offer service from some of the best primary care physicians in the country.

Just click here to get started and learn how we can help you manage your high blood pressure.

Read More About High Blood Pressure


PlushCare is dedicated to providing you with accurate and trustworthy health information.

American Heart Association. Essential hypertension. Accessed on April 06, 2021 at

Centers for Disease Control and Prevention. High Blood Pressure. Accessed on December 30, 2020 at

Mayo Clinic. High blood pressure (hypertension). Accessed on December 30, 2020 at

U.S. National Library of Medicine. MedlinePlus. High Blood Pressure. Accessed on December 30, 2020 at

Most PlushCare articles are reviewed by M.D.s, Ph.Ds, N.P.s, nutritionists and other healthcare professionals. Click here to learn more and meet some of the professionals behind our blog. The PlushCare blog, or any linked materials are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. For more information click here.

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