In most cases, the cause of hypertension is unknown. This is called primary or essential hypertension. Usually, this type of hypertension increases slowly over many years. Although the causes can’t be identified, several risk factors can raise your risk of developing hypertension. Some of these risk factors are uncontrollable, which means they’re genetic, and you can’t change them. But there are other risk factors you can control to lower your blood pressure.
Uncontrollable risk factors
- Age – The older you are, the higher your risk is for hypertension.
- Family history – Hypertension runs in families, so your risk for hypertension increases if any family members have hypertension—especially if your mother or father has it.
- Ethnicity/Race – If you have Caribbean ancestry or are Black, you have an increased risk of hypertension.
Controllable risk factors
- Diet – Consuming a high-sodium/high-salt diet increases your hypertension risk. Following a low-sodium, heart-healthy diet full of vegetables and fruits helps lower your risk of hypertension.
- Exercise – A lack of exercise increases your risk of hypertension. Regular exercise makes your heart stronger and allows it to pump with less effort. As a result, the pressure on your blood vessels decreases. Increasing your physical activity helps lower your risk. Engaging in moderate exercise can lower your systolic blood pressure (the top number in a blood pressure reading) depending on the intensity of the exercise.
- Weight – The more you weigh, the more blood your body has to pump around. This puts more strain on the blood vessels throughout your body, which increases your risk of hypertension. If you’re overweight or obese, losing weight may help control your blood pressure.
- Smoking – The nicotine in smoking products increases your risk of hypertension. Quitting smoking is one of the best things you can do to lower your hypertension and heart disease risk.
- Alcohol intake – Drinking alcohol increases your risk for hypertension. If you drink, limit your alcohol consumption to two drinks per day for men (assigned at birth) and no more than one drink per day for women (assigned at birth). A drink is one 12-ounce beer, a 5-ounce wine, or 1.5 ounces of liquor (80 proof). Drinking less is better for your health than drinking more.2
Underlying health issues
In some cases, an underlying cause of hypertension can be identified. This type of hypertension is called secondary hypertension and usually occurs as a more sudden increase in blood pressure. In this type of hypertension, if you can correct the problem that is causing hypertension, your blood pressure will return to normal.
Underlying health issues that can cause hypertension include, but are not limited to, the following:
- Heart disease – Heart disease may be causing your kidney arteries to narrow with plaque (a process called renal artery stenosis). If this plaque can be removed through angioplasty and stenting, adequate blood flow can be restored through the kidneys' arteries, which could help decrease your blood pressure back to normal levels.
- Obstructive sleep apnea – This condition occurs when your throat muscles relax too much to allow for normal breathing while you sleep. This causes sudden drops in your blood oxygen levels, which increases your blood pressure. You can treat this condition by wearing a breathing machine—called Continuous Positive Airway Pressure (CPAP)—while you sleep at night, which may also help lower your blood pressure levels.
- Adrenal gland tumor – The adrenal glands sit on top of your kidneys and produce hormones, including adrenaline, in your body’s normal stress response. If a tumor is present in your adrenal glands, it can cause too many of these hormones to be produced, resulting in hypertension. If an adrenal gland tumor is found, doctors may recommend surgery to remove the tumor, which would help return your blood pressure to normal.
- Primary aldosteronism – This condition results when your adrenal glands produces too much of the hormone aldosterone. This causes your body to hold in too much sodium in your blood and to remove too much potassium, which increases blood pressure. This condition can usually be treated with medication or surgery, which helps to return blood pressure to normal.
Sometimes, hypertension is difficult to control, even when several medications are prescribed. If you're taking three or more blood pressure medications and your blood pressure is still not under control, it's called resistant hypertension.
About 30% of people with hypertension have resistant hypertension. If you have resistant hypertension, you’re at a higher risk for stroke and heart attack.
Did you know?
- The prevalence of high blood pressure in Black Americans is the highest globally.2
- Although Black adults are 20% more likely to have high blood pressure, they are less likely than non-Hispanic whites to have their blood pressure under control.3
- Black women are nearly 60% more likely to have high blood pressure as compared to non-Hispanic white women.3
- American Indian/Alaska Native adults were 10% more likely than white adults to have high blood pressure, as compared to non-Hispanic whites, in 2018.3
- American Indians/Alaska Native adults are likelier to have high blood pressure than white adults.3
*The term “men” in the context of “cardiovascular health” applies to individuals assigned male at birth (AMAB) who have a male biological reproductive system, which includes a penis, scrotum, testes, epididymis, vas deferens, prostate, and seminal vesicles.
*The term “women” in the context of “women’s cardiovascular health” applies to individuals assigned female at birth (AFAB) who have a female biological reproductive system, which includes a vagina, uterus, ovaries, Fallopian tubes, accessory glands, and external genital organs.