12 Causes of High Blood Pressure (and How to Prevent It)

Health Line

2 days ago

Key takeaways
Most cases of hypertension are primary (essential), meaning there's no specific cause but rather multiple factors, including genetics, age, lifestyle, and diet. Only about 5% to 10% of cases are secondary hypertension with a specific identifiable cause.
Key modifiable risk factors include having overweight or obesity (which accounts for 65% to 78% of primary hypertension cases), lack of physical activity, high sodium intake, heavy alcohol consumption, smoking, taking certain medications, and not getting enough high quality sleep.

Your blood pressure is a gauge of how much pressure your blood flow creates in your arteries. If it's too high, it can damage your cardiovascular system. Hypertension (chronic high blood pressure) can also increase your risk of certain complications, such as heart attack or stroke.
Nearly 50% of adults in the United States have hypertension, according to the Centers for Disease Control and Prevention (CDC). Many more have it and don't know it.
So how do you know if you have high blood pressure? Per the American Heart Association (AHA) 2017 guidelines, your blood pressure is in the normal range when it's less than 120/80 mm Hg. Doctors consider anything above that as elevated. Anything above 130/80 mm Hg falls into one of two stages of hypertension.
Hypertension can be primary or secondary. Most cases of hypertension are primary (essential). That means there's no specific cause for your hypertension, and it's likely due to several factors, including genetics, age, lifestyle, and diet.
About 5% to 10% of people with high blood pressure have secondary hypertension. It's attributable to a specific cause, such as hypothyroidism. You can often reverse secondary hypertension if you effectively treat the underlying condition.
1. Underlying health conditions
While most cases of hypertension are primary (many-faceted), several underlying health conditions can contribute to or cause secondary hypertension. Treating these conditions can often reverse hypertension.
They include:
elevated blood pressure
overweight or obesity
diabetes
chronic kidney disease
pregnancy
certain heart irregularities
»MORE: Get a refill for your high blood pressure medication in as little as 15 minutes with Optum Perks Online Care.
Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission.
2. Overweight or obesity
Although obesity is an underlying health condition, it warrants its own spot on this list. A 2020 literature review estimated that obesity accounted for 65% to 78% of cases of primary hypertension.
Being overweight or having obesity can cause you to develop high blood pressure. It can also worsen hypertension if you already have it. That's because having more fat tissue causes changes in your body.
Those changes include hormonal and physical shifts in your kidneys and how they function. Carrying too much weight could also alter how your body uses insulin. This could lead to insulin resistance and type 2 diabetes —another risk factor for hypertension.
If you're overweight or have obesity, losing 2% to 3% of your body weight could reduce your risk for heart disease and hypertension. But a healthcare professional may recommend aiming for 5% to 10%. They'll usually recommend a mix of diet, exercise, lifestyle changes, or other interventions.
3. Lack of physical activity
Getting too little physical exercise can negatively impact you in many ways. It could aggravate mental health conditions like anxiety and depression and lead to being overweight.
Exercising can help you maintain a moderate weight or lose weight if necessary. That can positively affect your blood pressure and give you more energy and a sense of well-being.
The AHA suggests the following, based on guidelines from the Department of Health and Human Services:
Aim for at least 150 minutes per week of moderate intensity aerobic activity or 75 minutes per week of vigorous aerobic exercise.
Perform moderate to high intensity muscle strengthening resistance training at least 2 days per week.
Spend less time sitting.
Work up to more activity — at least 300 minutes (5 hours) per week.
Gradually increase the amount and intensity of your exercise.
Learn more about the benefits of regular physical activity.
4. Salt intake
Eating less sodium can help you lower your blood pressure. Sodium is a component of table salt, aka sodium chloride. It's also a common addition to many packaged and processed foods to enhance taste.
A 2019 study found that moderately reducing your sodium intake could lower your blood pressure, whether you have hypertension.
Most people in the United States consume too much sodium. According to the Food and Drug Administration (FDA), the average daily intake for adults is 3,400 milligrams (mg) — 48% higher than the recommended limit.
The FDA suggests a limit of 2,300 mg per day, or about one teaspoon, for people ages 14 and up. The World Health Organization (WHO) suggests an even lower limit of 2,000 mg. The AHA recommends lower still — no more than 1,500 mg daily, especially if you have hypertension.
Learn more about a low sodium diet.
5. Alcohol
Heavy alcohol consumption can harm your overall health, including your cardiovascular health. It can contribute to or worsen hypertension. It can also increase your risk of diabetes and several cancers.
The AHA recommends limiting alcohol consumption to two drinks per day for males and one for females. A drink is:
12 ounces of beer
4 ounces of wine
1.5 ounces of 80-proof spirits
1 ounce of 100-proof spirits
But even moderate alcohol consumption has its drawbacks. A 2019 study of more than 17,000 people suggests that moderate consumption (7 to 13 drinks a week) can substantially raise your risk of hypertension. A 2020 study also found a link between moderate alcohol consumption and high blood pressure in people with type 2 diabetes.
Learn more about how you can reduce your alcohol consumption.
6. Caffeine
Up to 90% of people in the United States consume some form of caffeine each day. According to the AHA, caffeine isn't terrible for blood pressure unless you have too much. The AHA also acknowledges a possible link between drinking coffee and a lower risk of chronic illnesses, such as cancer and heart disease.
Drinking 3 to 4 cups of coffee a day is safe for most people with high blood pressure, according to a 2017 review of studies and a 2021 study. But drinking much beyond that can lead to anxiety and heart palpitations.
The FDA suggests a daily limit of 400 mg of caffeine for healthy adults. For reference:
An 8-ounce cup of coffee contains 80 to 100 mg of caffeine.
An 8-ounce cup of tea has 30 to 50 mg.
An 8-ounce energy drink has 40 to 250 mg.
A 12-ounce can of soda has 30 to 40 mg.
If you're concerned about your caffeine intake, it's best to check in with a healthcare professional. As caffeine is known to elevate blood pressure, wait 30 minutes before taking a blood pressure reading. An inaccurate reading can impact your care, according to a 2022 study.
7. Smoking
Smoking is the leading cause of preventable death in the United States. Smoking can contribute to many life threatening conditions, including heart attack, stroke, lung disease, and several cancers.
That said, the relationship between hypertension and smoking isn't yet clear. But smoking does lead to temporary spikes in blood pressure. It also contributes to atherosclerosis, the hardening of your arteries. Stiff arteries cause an increase in blood pressure.
8. Medication
Some medications can increase your blood pressure. A 2021 study of 27,599 adults found that 18.5% of people with high blood pressure take medication that could raise their blood pressure further.
Medications that might increase your blood pressure include:
steroids
nonsteroidal anti-inflammatory drugs (NSAIDs)
decongestants
antipsychotics
birth control pills
If you have high blood pressure, it's best to discuss all medications you're taking, including any over-the-counter (OTC) drugs, with a healthcare professional.
9. Not enough sleep
According to the CDC, most people older than 18 years need at least 7 hours of sleep a night for optimum health. But many people don't get enough. That can affect your health, especially if you have high blood pressure.
That's because when you sleep normally, your blood pressure goes down. That gives your body a break. Having insomnia or other sleep problems, or regularly getting too little sleep, means your body doesn't get as much of a break.
You can get enough rest by practicing good sleep hygiene. The CDC offers the following tips:
Go to bed at the same time each night and get up at the same time each morning, including on the weekends.
Get enough natural light, especially earlier in the day.
Get enough physical activity during the day. Try not to exercise within a few hours of bedtime.
Avoid artificial light, especially within a few hours of bedtime. Use a blue light filter on your computer or smartphone.
Don't eat or drink within a few hours of bedtime; avoid alcohol and foods high in fat or sugar.
Keep your bedroom cool, dark, and quiet.
10. Pregnancy
Hypertension that develops during pregnancy is called gestational hypertension. If you have it, it's imperative to manage it to avoid harm to you and your baby. Doctors generally define it as blood pressure at or over 140/90 mm Hg.
There are several possible causes of high blood pressure during pregnancy. They include:
being overweight or obese
not getting enough physical activity
smoking
drinking alcohol
having a first-time pregnancy
having a family history of pregnancy-related hypertension
carrying more than one child
being 35 years or older
having assistive reproductive technology, such as in vitro fertilization (IVF)
having diabetes or certain autoimmune diseases
You can help prevent high blood pressure in pregnancy by managing risk factors you can change — those that are related to lifestyle, such as being overweight, smoking, and alcohol use. Talk with a healthcare professional as soon as you think it may be a concern.
11. Age
High blood pressure typically becomes more of a concern as you age. The CDC reports that from 2017 to 2018, hypertension was more common in older adults.
Age range (years) Prevalence of hypertension
18–39 22.4%
40–59 54.5%
60+ 74.5%
All adults 45.4%
The National Institute on Aging (NIA) states that high blood pressure risk increases with age because your body's vascular system, or network of blood vessels, changes as you age. Your arteries can get stiffer, causing blood pressure to go up. That's true even for people with healthy habits.
The NIA recommends the same practices for older adults as younger ones, including modifying essential lifestyle factors like smoking (if you smoke), drinking (if you drink), exercise, and a balanced diet. They also recommend you take prescribed medications if needed and check in with a doctor regularly.
Learn more about managing your blood pressure as you age.
12. Genetics
If your parents have high blood pressure, you're more likely to develop it. Hypertension tends to run in families. This may be due to family members sharing similar habits, like exercise and diet.
But there appears to be a genetic component as well. Genetic factors may contribute to 30% to 60% of cases of irregular blood pressure. Some genetic variants can lead to syndromes that feature high blood pressure, including:
hyperaldosteronism
Gordon syndrome
Liddle syndrome
Other genes or combinations of genes might lead to an increased risk of high blood pressure. Research from 2019 suggests that a variation in the ARMC5 gene may explain the increased prevalence of hypertension in Blacks and African Americans.
Still, it's not yet known how much having a family history of the condition increases your risk. More research is needed in this area.
How can I prevent high blood pressure?
According to the AHA, the ways to manage blood pressure are also ways you can help prevent it:
Get regular physical activity.
Don't smoke, or quit smoking if you do.
Limit alcohol consumption.
Maintain a moderate weight.
Eat a balanced diet that's low in sodium.
Manage your stress.
Work with a healthcare professional.
Takeaway
Many factors contribute to your likelihood of developing hypertension. Some of them are within your control, such as your exercise habits, diet, and whether you drink alcohol or smoke. Others are not, such as genetics and age.
If you already have hypertension, you're not alone. Nearly half of all adults do. You can lower your blood pressure by changing your habits and seeing your healthcare professional for appropriate medication if necessary.
If you don't have hypertension, check your blood pressure regularly, especially if you have a family history of the condition. Many people, including those with healthy habits, don't know they have it. You can lower your risk by adopting a healthy lifestyle.