Causes and Risk Factors of High Blood Pressure

The following can increase your chances of developing high blood pressure.

Age The risk of high blood pressure increases as you age; the older you are, the more likely you are to develop high blood pressure. Blood vessels gradually lose their elasticity over time, which can contribute to high blood pressure.

The risk of prehypertension and high blood pressure has been increasing in recent years in young people too, including children and teens, possibly because of the rise in obesity in these populations.

Race High blood pressure is more common in Black American adults than in white, Asian, or Hispanic American adults.

Gender Men are more likely than women to be diagnosed with high blood pressure, until age 64.

However, after that age, women are more likely to have high blood pressure.

Family History Having a family history of high blood pressure increases your risk, as the condition tends to run in families.

Weight The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. When the volume of blood pumping through your blood vessels increases, the pressure on your artery walls also rises.

Physical Activity People who are not active tend to have a higher heart rate and higher blood pressure than those who are physically active.

Not exercising also increases the risk of being overweight.

Tobacco Use When you smoke or chew tobacco, your blood pressure rises temporarily, partly from the effects of nicotine. Moreover, chemicals in tobacco can damage the lining of your artery walls, which can cause your arteries to narrow, increasing your blood pressure.

Being exposed to secondhand smoke may also increase your blood pressure.

Diet What you choose to eat (and not to eat) can increase your risk of hypertension:

Too much sodium can cause your body to retain fluid, which increases blood pressure.
Since potassium helps balance the amount of sodium in your cells, not getting enough of it can raise blood pressure.

Alcohol Use Over time, heavy alcohol use can damage the heart and lead to heart failure, stroke, and irregular heart rhythm. If you choose to drink alcohol, do so in moderation. The American Heart Association advises no more than two drinks a day for men or one drink a day for women. One drink equals 12 ounces (oz) of beer, 4 oz of wine, 1.5 oz of 80-proof spirits, or 1 oz of 100-proof spirits.

Stress Being under intense stress can lead to a temporary increase in blood pressure.

Moreover, if you try to cope with stress by overeating, using tobacco, or drinking alcohol, all of these can contribute to high blood pressure.

Chronic Conditions Having kidney disease, sleep apnea, or diabetes can affect blood pressure.

Pregnancy Being pregnant can cause an increase in blood pressure. High blood pressure occurs in 1 in every 12 to 17 pregnancies in women ages 20 to 44.

Birth Control Women who take birth control pills have a greater risk of developing high blood pressure. It’s more likely to occur when women are overweight, have had high blood pressure during a previous pregnancy, have a family history of blood pressure, smoke, or have mild kidney disease.

Causes of Secondary Hypertension

When high blood pressure arises suddenly due to an identifiable condition, it’s called secondary hypertension.

The following conditions can lead to secondary hypertension, including:

Kidney problems
Adrenal gland tumors
Thyroid problems
Blood vessel defects
Obstructive sleep apnea
Alcohol abuse or chronic alcohol use
Illegal drugs, including cocaine and amphetamines

Drugs That Can Cause High Blood Pressure

Medications that you take to control other health conditions, such as arthritis, epilepsy, or allergies, can cause your blood pressure to rise.

They can also interfere with the ability of drugs used to keep blood pressure down.

The drugs below are some of the ones that may negatively affect blood pressure.

Pain Medications Common pain and anti-inflammatory medicines can lead to water retention, which can increase blood pressure and create problems with the kidneys.

Examples include:

nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin, Advil) and naproxen (Aleve, Naprosyn)
indomethacin (Indocin)
acetaminophen (Tylenol)
piroxicam (Feldene)

Antidepressants These drugs work by changing the body’s response to chemicals that affect mood. That can also lead to an increase in blood pressure.

Examples of antidepressants that may elevate blood pressure include:

Decongestants These medicines, which include common cough, cold, and allergy drugs, are known to raise blood pressure and to alter the effectiveness of blood pressure medication.

Examples include pseudoephedrine (Sudafed, Contac) and phenylephrine (Sudafed PE).

Hormones Birth control pills can also affect blood pressure. Women who take birth control pills usually experience a small rise in systolic and diastolic blood pressure (the top and bottom numbers that are determined when you get your blood pressure checked).

Hormone therapy used to relieve symptoms of menopause can also cause a small rise in systolic blood pressure.

If you know you have high blood pressure but are considering hormone therapy, talk with your doctor about the risks and benefits of undergoing hormone therapy, as well as the best ways to control your blood pressure.

Additionally, some recreational and illegal drugs, such as cocaine, ecstasy (MDMA), and amphetamines, are also known to increase blood pressure.

How Is High Blood Pressure Diagnosed?

Blood pressure checks are part of routine doctor visits. To check your blood pressure, your healthcare provider will place an inflatable cuff around your arm and use a pressure-measuring gauge.

Before giving a diagnosis of high blood pressure, your physician will likely take two or three readings during separate appointments. Your physician may also ask you to keep a record of blood pressure measurements you take at home. That’s because blood pressure varies throughout the day, and some people may be anxious before or during a doctor visit, causing elevated blood pressure.

If your blood pressure is consistently 130/80 millimeters of mercury (mmHg) or higher, you will most likely be diagnosed with high blood pressure.

In 2017, the AHA updated its definition of high blood pressure from the previous definition of 140/90 mmHg or higher. The guidelines recommend earlier intervention to prevent further increases in blood pressure that could lead to health problems.

If you have high blood pressure, your physician will take a full medical history and conduct a physical exam. Other routine tests may be given, including a blood test, urine test, cholesterol test, and an electrocardiogram or echocardiogram to check for signs of heart disease.

Duration of High Blood Pressure

The amount of time it takes to lower blood pressure varies depending on how high your blood pressure is and the aggressiveness of your treatment program. Medication can help lower blood pressure quickly, usually within a couple of days.

But because of potential side effects, a long-term aggressive medication regimen may not be sustainable.

Your doctor will prescribe lifestyle changes, such as a healthy diet and regular exercise, which have been proven to lower your blood pressure too.

Regular exercise can begin to make a significant impact on blood pressure levels within one to three months.

Treatment and Medication Options for High Blood Pressure

Most people who have high blood pressure will likely need lifelong treatment to help ward off or delay serious health problems brought on by the condition.

Options to treat high blood pressure may include eating a healthy diet with less salt, taking medication, and incorporating additional lifestyle changes. These include exercise, limiting alcohol intake, smoking cessation, and managing stress.

Medication Options

There are a variety of drugs available to treat hypertension. Some work by removing extra fluid and salt from your body to lower blood pressure; others slow down your heartbeat or relax and widen blood vessels.

For many people with high blood pressure, taking more than one medication in low doses is more effective than taking larger doses of a single drug.

Depending on your past medical history and the severity of your hypertension, your doctor may recommend one or more of the following drugs:

Diuretics Sometimes called water pills, diuretics are typically the first line of treatment for high blood pressure. This medication helps the kidneys rid sodium and water from the body, decreasing the amount of fluid flowing through the veins and arteries, which in turn lowers blood pressure.
Beta-Blockers These medications reduce the workload of the heart and widen blood vessels. As a result, the heart beats slower and less forcefully. Beta blockers are often combined with other blood pressure medications.
Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors) This class of drugs helps lower blood pressure by relaxing the blood vessels, allowing blood to flow through the body more easily.
Angiotensin II Receptor Blockers (ARBs) These medications block specific hormones from having any effect on the heart and blood vessels. This prevents blood pressure from rising.
Calcium Channel Blockers This type of medication interrupts the movement of calcium into the cells of blood vessels, thus relaxing the muscle cells in the blood vessels.
Renin Inhibitors These drugs slow the production of an enzyme called renin, which is made in the kidneys and can increase blood pressure. Renin inhibitors should not be taken with ACE inhibitors or ARBs.
Alpha-Blockers These medications lower blood pressure by blocking a hormone from tightening the muscles in the veins and arteries.
Alpha-Beta-Blockers This subclass of combined alpha- and beta-blockers slows the heart rate to reduce the amount of blood pumped through the blood vessels.
Central-Acting Agents These medications block signals from the brain that alert the nervous system to increase the heart rate and narrow the blood vessels.
Vasodilators These medications prevent the artery muscles from tightening and the arteries from narrowing.

Using Diet to Treat High Blood Pressure

People with high blood pressure should watch their sodium intake and stick to a healthy diet. Your doctor might recommend DASH (Dietary Approaches to Stop Hypertension), which is a diet that consists of foods that are low in sodium and cholesterol and rich in protein, fiber, and other nutrients.

How to Prevent High Blood Pressure

The best way to prevent high blood pressure is to lead a healthy lifestyle that includes:

Eat a healthy diet
Maintain a healthy weight
Exercise regularly
Don’t smoke
Limit alcohol use
Reduce stress

Black Americans and High Blood Pressure

High blood pressure is more common in non-Hispanic Black American men and women than any other ethnic group.

Fifty-six percent of non-Hispanic Black Americans have hypertension, compared with 48 percent of non-Hispanic white Americans, 46 percent of non-Hispanic Asian Americans, and 39 percent of Hispanic Americans. Black Americans also tend to develop hypertension earlier in life and experience more severe blood pressure elevation. Black American children are more likely than white children to have high blood pressure.

It is not known for sure why high blood pressure is more common in this group, but researchers theorize it may be partly due to higher rates of obesity and diabetes among Black Americans, as well as a gene that makes Black Americans more sensitive to salt. In people who have this gene, even half a teaspoon of salt can elevate blood pressure by 5 mmHg.

Related Conditions and Causes of High Blood Pressure

There are certain conditions that may make a person more likely to develop high blood pressure. These include pregnancy and post-traumatic stress disorder.

High Blood Pressure During Pregnancy

Women can develop high blood pressure during pregnancy. When this happens after 20 weeks of pregnancy, it is known as gestational hypertension. This is a form of secondary hypertension caused by pregnancy, and it generally goes away after delivery.

If not treated, high blood pressure during pregnancy can lead to a number of complications for both the mother and the baby. Hypertension can affect a mother’s kidneys and lead to preeclampsia, as well as increase her risk of future heart disease, kidney disease, and stroke.

Preeclampsia increases the risk of preterm delivery, low birth weight, placental abruption, cesarean delivery, and HELLP syndrome (a complication that involves hemolysis, elevated liver enzymes, and low platelet count).

PTSD and High Blood Pressure

A growing body of research has linked post-traumatic stress disorder (PTSD) to high blood pressure.

Researchers aren’t sure about the mechanism underlying the relationship between PTSD and high blood pressure, but it may have something to do with higher levels of inflammation in patients with PTSD, which may increase blood pressure.

Since PTSD has a much higher incidence in military veterans, one study suggests that screening for high blood pressure should be routine not only in active soldiers who are at risk but also in those who are no longer active and receive care from Veterans Affairs hospitals.

Resources We Trust

American Heart Association: Understanding Blood Pressure Readings

Million Hearts: ABCs of Heart Health

Mayo Clinic: High Blood Pressure Dangers: Hypertension’s Effects on Your Body

Cleveland Clinic: Blood Pressure

Centers for Disease Control and Prevention: How Does Sleep Affect Your Heart Health?

Communities of Support

Measure Up/Pressure Down

Read personal stories and connect with others who have shared their journey in controlling hypertension.

AHA’s Support Network

This online support group from the American Heart Association allows you to connect with others going through an array of heart issues, including hypertension. Ask questions, share your story, and get peer support from others going through similar experiences as they take control of their heart health.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

The Facts About High Blood Pressure. American Heart Association. May 25, 2023.
Know Your Risk Factors for High Blood Pressure. American Heart Association. May 31, 2023.
What Is High Blood Pressure. National Heart, Lung, and Blood Institute. March 24, 2022.
Facts About Hypertension. Centers for Disease Control and Prevention. July 6, 2023.
High Blood Pressure (Hypertension): Symptoms and Causes. Mayo Clinic. September 15, 2022.
Limiting Alcohol to Manage High Blood Pressure. American Heart Association. June 5, 2023.
High Blood Pressure During Pregnancy. Centers for Disease Control and Prevention. June 19, 2023.
High Blood Pressure and Heart Disease in Women. American Heart Association. January 30, 2024.
Medications and Supplements That Can Raise Your Blood Pressure. Mayo Clinic. April 13, 2023.
High Blood Pressure Redefined for First Time in 130 Is the New High. American Heart Association. November 13, 2017.
High Blood Pressure — Understanding the Silent Killer. U.S. Food and Drug Administration. August 1, 2023.
Roberts CK et al. Effect of Diet and Exercise Intervention on Blood Pressure, Insulin, Oxidative Stress, and Nitric Oxide Availability. Circulation. November 12, 2002.
Exercise: A Drug-Free Approach to Lowering High Blood Pressure. Mayo Clinic. November 10, 2022.
DASH Eating Plan. National Heart, Lung, and Blood Institute. December 29, 2021.
How to Prevent High Blood Pressure. MedlinePlus. November 20, 2020.
Health Threats From High Blood Pressure. American Heart Association. March 4, 2022.
High Blood Pressure in Children. American Heart Association. June 1, 2023.
High Blood Pressure Among Black People. American Heart Association. March 4, 2022.
Preeclampsia and High Blood Pressure. American Heart Association. February 23, 2021.
Preeclampsia: Symptoms and Causes. Mayo Clinic. April 15, 2022.
Howard JT et al. Associations of Initial Injury Severity and Posttraumatic Stress Disorder Diagnoses With Long-Term Hypertension Risk After Combat Injury. Hypertension. May 2018.