What Is the Main Cause of Hypertension?

Hypertension or high blood pressure can be caused by poor habits like smoking, drinking and eating too much junk food, as well as stress and some medications.

Hypertension is the medical term for high blood pressure, which describes a condition in which the force of blood pumping through the arteries is consistently too high. When this occurs, the walls of the arteries are extended beyond their normal limit, which can lead to damage and scarring and put people at risk for heart attack, stroke, and kidney disease. 

Blood pressure is expressed in two numbers: 

• Systolic blood pressure (the first/top number): measures the pressure in the blood vessels when the heart beats
• Diastolic blood pressure (the second/bottom number): measures the pressure in the blood vessels when the heart is at rest between beats

High, elevated, and normal blood pressure is usually defined in the following ranges: 

• High blood pressure (hypertension) is 140/90 mmHg or more
• Elevated blood pressure levels between 120/80 and 139/89 are considered prehypertension and mean a person is at higher risk for developing high blood pressure
• Normal blood pressure is less than 120/80 mmHg 

Hypertension is often called “the silent killer” because it’s common for people who have it to have no symptoms. A healthcare professional can measure your blood pressure to know for sure if you have hypertension.

Uncommonly, severe hypertension can cause or be accompanied by symptoms including: 

• Headaches
• Vomiting
• Dizziness 
• Facial flushing 
• Blood spots in the eyes (subconjunctival hemorrhage) 
  • More common in people who also have diabetes 

Risk factors for developing hypertension include:

• Family history of high blood pressure
• Age 
• Gender 
  • Men are more likely to develop high blood pressure than women up to age 64
  • Beginning at age 65, women are more likely to develop high blood pressure than men
• African-Americans in the U.S. tend to develop high blood pressure more often than other races 

Risk factors for developing hypertension that can be managed or prevented include:

• Sedentary lifestyle
• Poor diet, especially one that is high in salt (sodium), saturated and trans fats, calories, and sugars
• Being overweight or obese    
• Excess alcohol intake
• Untreated obstructive sleep apnea 
• Diabetes
• High cholesterol
• Smoking and tobacco use  
• Stress 

Blood pressure is measured with a pressure cuff (sphygmomanometer) placed around the upper arm and manually or electronically inflated. When inflated, the cuff compresses the brachial artery, the major blood vessel of the upper arm, stopping blood flow briefly. Then the air in the cuff is released slowly while the person performing the measurement listens with a stethoscope or monitors an electronic readout.

Adults 20 years of age and older should have their blood pressure checked during regular doctor visits.

Lifestyle changes are typically the first line treatment for hypertension, such as: 

• Eating a balanced diet that low in salt
• Limiting or avoiding alcohol
• Maintaining a healthy weight
• Exercising regularly
• Managing stress
• Not smoking
• Getting enough sleep
• Taking medications as directed

When medications are needed to treat hypertension, they may include: 

• ACE inhibitors
  • Examples include enalapril (Vasotec), captopril (Capoten), lisinopril (Prinivil), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), benazepril (Lotensin), trandolapril (Mavik), fosinopril (Monopril), moexipril (Univasc), enalaprilat, and lisinopril (Zestril)
• Beta-blockers
  • Examples include atenolol (Tenormin), metoprolol (Lopressor, Toprol-XL), propranolol (Inderal, Inderal LA), nebivolol (Bystolic), timolol, carvedilol (Coreg), nadolol (Corgard), betaxolol, penbutolol (Levatol), acebutolol (Sectral), labetalol (Trandate), pindolol, and bisoprolol (Zebeta)
• Calcium channel blockers
  • Examples include amlodipine (Norvasc), felodipine (Plendil), diltiazem (Cardizem, Dilacor XR, Tiazac), clevidipine (Cleviprex), isradipine (DynaCirc CR), nicardipine (Cardene), nifedipine (Adalat CC, Procardia), nimodipine, nisoldipine (Sular), and verapamil (Calan, Covera HS, Isoptin, Verelan)
• Peripherally acting alpha-adrenergic blockers
  • Examples include doxazosin (Cardura), phenoxybenzamine (Dibenzyline), prazosin (Minipress), and terazosin (Hytrin)
• Diuretics (“water pills”)
  • Examples include chlorthalidone, indapamide, hydrochlorothiazide (also called HCTZ), and furosemide (Lasix)
• Angiotensin II antagonists (ARBs)
  • Examples include candesartan (Atacand), valsartan (Diovan), Iibesartan (Avapro), Olmesartan (Benicar), losartan (Cozaar), azilsartan (Edarbi), telmisartan (Micardis), and eprosartan (Teveten)
• Vasodilators
  • Examples include hydralazine and minoxidil
• Centrally-acting alpha adrenergics
  • Examples include clonidine (Catapres) and guanfacine (Tenex)
• Renin inhibitors
  • Examples include aliskiren (Tekturna)
• Combination medicines, made up of two or more different kinds of blood pressure medicines

Complications of untreated or uncontrolled hypertension include:

• Heart attack 
• Heart failure 
• Stroke     
• Angina (chest pain)
• Kidney disease or failure    
• Vision loss     
• Peripheral artery disease (PAD) 
• Sexual dysfunction: erectile dysfunction in men or low sex drive in women