Hypertension / High Blood Pressure Causes & Risk Factors
Hypertension, commonly known as high blood pressure, affects millions of Americans, from children to older adults. 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 have no symptoms. This is why hypertension is sometimes called a “silent” killer. Learn more about the causes and risk factors here.
What is Hypertension?
Hypertension, or high blood pressure, is the most common cardiovascular disease in the US. It is a condition where the pressure your blood puts on your artery walls is higher than normal ranges 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 also why high blood pressure is so much more common with older adults. As we age, our arteries narrow meaning 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 be as many 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 and birth control pills and pregnancy in women. Both of these types depend on your medical history and increase in likelihood based on who you are and how you live.
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, so if your parents or any close relatives have hypertension, it increases your likelihood.
- African-Americans: African-Americans develop hypertension more often than any other racial group, and African-Americans get high blood pressure younger and more severe. If fact, the prevalence of hypertension among African-Americans in the US is some of the highest 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 that 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 and increase your blood pressure. It is still possible for children to get high blood pressure, but much less likely.
Certain ways you live also increase your likelihood of having high blood pressure or having sudden high blood pressure:
- Overweight: Being more than 15% of 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. In physical exercise, our heart muscles and circulatory system also stay in shape evening out our blood pressure, but inactivity can increase the likelihood of cardiovascular trouble.
- 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 as well as being inactive or overweight. Changing your diet is a key recommended treatment for most individuals that have high blood pressure. Sodium or salt intake in particularly 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, including your ability to exercise and therefore also contributes 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.
Additionally, regular use of decongestants or medications like ibuprofen or birth control as well as illegal drugs like cocaine all increase your chance of having high blood pressure.
Causes of High Blood Pressure in Women
There is a misconception that women rarely are affected by hypertension or high blood pressure, but women are just as likely as men and more likely than men 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. If you have any of these traits, you may want to talk to your doctor about the potential of birth control pills increasing your blood pressure.
- Pregnancy: High blood pressure during pregnancy, or gestational hypertension, can happen, usually after the first 20 weeks and disappears 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 during regular check-ups.
- Menopause: While not entirely clear, 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. This device consists of a dial, pump, valve, arm cuff, and stethoscope. The number is made up of two numbers: systolic blood pressure or the maximum pressure during heartbeats and diastolic blood pressure or the lowest pressure between two heartbeats. Written in millimeters of mercury, normal guidelines are 120/80 with hypertension being blood pressure greater than 140/90. Blood pressure can vary based on many factors, such as demographic factors or even stress. Usually three readings of hypertension are required for a diagnosis. In addition, a doctor will ask about your medical history and potential risk factors we well as 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:
- Losing weight
- Eating healthy
- Quitting smoking
- Exercising regularly
- Limiting alcohol intake
- Reducing sodium intake
These lifestyle changes can both lower blood pressure, and if you are taking high blood pressure drugs, then they can help improve their effectiveness. 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
- Calcium channel blockers
- Renin inhibitors
- Combination medications
Diuretics are usually the first recommended therapy, but 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 assigned. 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 check on how you are moving towards your goal and have your doctor check you 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
If you have any of the symptoms described, you should go see a doctor. In general, if you have any of the major risk factors, you should be tested for high blood pressure regularly.
Additionally, you should call 911 immediately if you have any of the following symptoms as they can be a sign of untreated high blood pressure resulting in a hypertensive emergency:
- Blurred vision or headache
- Numbness on one side of the body
- Increasing shortness of breath, chest pain, or confusion
Should any of these non-emergency symptoms arise or if you suspect you may be at risk for high blood pressure, it is very important to get tested. Even if you have no 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 in order to be tested.