Risk Factors for High Blood Pressure

Non-Modifiable Risk Factors

Factors that can't be changed:

1Age

The risk of developing of high blood pressure, especially systolic, increases as you get older. Increase in blood pressure with age is mainly related to arteriosclerotic structural changes in the arteries and their calcification, or "hardening of the arteries"1.

High blood pressure risk factors infographic

2Race

African-Americans are more vulnerable to high blood pressure than Caucasians. Serious complications, such as stroke and heart attack, are also more severe in African Americans2.

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3Socioeconomic status

Hypertension is related to social factors such as urbanization and education. High blood pressure is more common among the less educated and lower socioeconomic groups3. Residents of the southeastern United States are more likely to have high blood pressure than Americans from other regions.

4Family history (heredity)

The tendency to have high blood pressure appears to run in families. Genetic heritability of blood pressure has been documented in familial and twin studies.

5Sex

Generally men have a greater likelihood of developing high blood pressure than women. This likelihood varies according to age and among various ethnic groups4.

6Environmental factors

  • Winter season - winter season is linked to higher blood pressure because low external temperatures cause blood vessels to narrow5.
  • Loud noise - roadway traffic, airplanes, and occupational noises. Brief exposure to loud noise significantly increases blood pressure within minutes. There is some evidence that nighttime loud noise is more detrimental than daytime loud noise6.
  • Air pollutants – Long‐term exposure to particulate matter can promote the development of hypertension.

Modifiable Risk Factors

Factors that can be changed:

8Excessive weight (obesity)

Excess body weight is one of the most serious risk factors for the development and progression of high blood pressure8. On the other hand weight loss is associated with a significant decrease of blood pressure.

9Waist circumference (abdominal adiposity)

Waist circumference, a measure of excess fat around the waist, is even more strongly associated with high blood pressure than overall obesity, particularly in young people8.

10Physical inactivity (sedentary behavior)

Physical inactivity is a significant risk factor for physical inactivity for cardiovascular diseases, including hypertension.

European study found that spending more than two hours a day in front of a screen increases the risk of developing high blood pressure by 30%11.

11Cigarette smoking

Cigarette smoking is a powerful risk factor for cardiovascular diseases12. Both cigarette smoking and exposure to secondhand smoke acutely elevate blood pressure, mainly through the stimulation of the sympathetic nervous system.

12Excessive salt consumption

High dietary salt intake is an established risk factor for high blood pressure13.

Moderate reduction of salt consumption is generally an effective measure to reduce blood pressure.

13Low potassium intake

High quality evidence shows that high potassium intake promotes significant lowering of blood pressure15. Higher consumption levels are protective against stroke, coronary heart disease, and myocardial infarction.

According to WHO the most benefitial dosage of potassium is at least 90 mmol/day (3.510 mg/day) for adults14.

14Stress

Stress can lead to a temporary but dramatic increase in blood pressure by stimulation of the nervous system16.

Moreover, work-related stress represents an important risk factor for high blood pressure and cardiovascular diseases17. There is also evidence that inappropriate and excessive activation of the sympathetic nervous system plays a role in the development of hypertension, particularly in its early stages.

15Depressive disorders

Major depression increases the risk for onset of hypertension7 .

16Medications

Medications that have been reported to cause increased blood pressure or hypertension:

  • NSAIDs
  • Steroids
  • Estroprogestinic compounds18
  • Immunosuppressants
  • Recombinant human erythropoietin
  • Ketamine
  • Inhibitors of angiogenesis
  • Ergot alkaloids

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Further reading

References

  • 1. Pinto E. Blood pressure and ageing. Postgrad Med J. 2007 Feb;83(976):109-14.
  • 2. Lackland DT. Racial differences in hypertension: implications for high blood pressure management. Am J Med Sci. 2014 Aug;348(2):135-8.
  • 3. Leng B, Jin Y, Li G, Chen L, Jin N. Socioeconomic status and hypertension: a meta-analysis. J Hypertens. 2015 Feb;33(2):221-9.
  • 4. Eghbali M, Khosravi A, Feizi A, Mansouri A, Mahaki B, Sarrafzadegan N. Prevalence, awareness, treatment, control, and risk factors of hypertension among adults: a cross-sectional study in Iran. Epidemiol Health. 2018 May 18;40:e2018020.
  • 5. Fares A. Winter Hypertension: Potential mechanisms. Int J Health Sci (Qassim). 2013 Jun;7(2):210-9.
  • 6. Brook RD, Weder AB, Rajagopalan S. Environmental hypertensionology the effects of environmental factors on blood pressure in clinical practice and research. J ClinHypertens (Greenwich). 2011 Nov;13(11):836-42
  • 7. Patten SB, Williams JV, Lavorato DH, Campbell NR, Eliasziw M, Campbell TS.Major depression as a risk factor for high blood pressure: epidemiologic evidence from a national longitudinal study. Psychosom Med. 2009 Apr;71(3):273-9.
  • 8. Narkiewicz K. Obesity and hypertension - the issue is more complex than we thought. Nephrol Dial Transplant. 2006;21:264–267.
  • 9. Tebar WR, Ritti-Dias RM, Farah BQ, Zanuto EF, Vanderlei LCM, Christofaro DGD. High blood pressure and its relationship to adiposity in a school-aged population: body mass index vs waist circumference. Hypertens Res. 2018 Feb;41(2):135-140.
  • 10. Sosner P, Gremeaux V, Bosquet L, Herpin D. High blood pressure and physical exercise. Ann CardiolAngeiol (Paris). 2014 Jun;63(3):197-203
  • 11. de Moraes AC, Carvalho HB, Siani A, Barba G, Veidebaum T, et al. Incidence of high blood pressure in children - Effects of physical activity and sedentary behaviors: The IDEFICS study. High blood pressure, lifestyle and children. International Journal of Cardiology, Int J Cardiol. 2015 Feb 1;180:165-70.
  • 12. Virdis A, Giannarelli C, Neves MF, Taddei S, Ghiadoni L.Cigarette smoking and hypertension.Curr Pharm Des. 2010;16(23):2518-25.
  • 13. Ha SK. Dietary salt intake and hypertension. Electrolyte Blood Press. 2014 Jun;12(1):7-18.
  • 14. Increasing potassium intake to reduce blood pressure and risk of cardiovascular diseases in adults. WHO
  • 15. Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ. 2013 Apr 3;346:f1378.
  • 16. Kulkarni S, O'Farrell I, Erasi M, Kochar MS. Stress and hypertension. WMJ. 1998 Dec;97(11):34-8
  • 17. Mucci N, Giorgi G, De Pasquale Ceratti S, Fiz-Pérez J, Mucci F, Arcangeli G. Anxiety, Stress-Related Factors, and Blood Pressure in Young Adults. Front Psychol. 2016 Oct 28;7:1682.
  • 18. Stokes GS. Drug-induced hypertension: pathogenesis and management. Drugs. 1976;12(3):222-30. PubMed

Published: March 27, 2019
Last updated: March 27, 2019

Written by eMedExpert staff

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