What Causes High Blood Pressure?

Every time your heart beats, it pumps oxygen-rich blood through your body. Your blood puts pressure on your arteries as it moves, a force medically referred to as blood pressure.

When your blood pressure becomes too high, it can damage your arteries over time, leaving them hardened and narrowed and thus forcing your heart to work harder to pump blood, which can increase your risk of heart attack, stroke and kidney disease.

Blood pressure readings consist of two measurements: systolic pressure, which measures the pressure when the heart beats, and diastolic pressure, which measures the pressure when the heart rests. There are five blood pressure stages: normal, followed by four stages of hypertension. Normal blood pressure for adults is marked by systolic readings between 90 and 120 mm/Hg and diastolic readings between 60 and 80 mmHg. Higher readings indicate high blood pressure.

“Everyone faces the same risks when it comes to hypertension,” says Ashul Govil, M.D., cardiologist and chief medical officer at Story Health in San Francisco. Exact causes of hypertension can vary, depending on your age, race and sex. But according to Dr. Govil, general factors that could contribute to high blood pressure include:

• Genetics and family history
• Eating a high-sodium diet
• A lack of physical activity
• Obesity
• A lack of sleep or sleep apnea
• Tobacco use or exposure to smoke
• Alcohol consumption

What Causes High Blood Pressure in Older Adults?

High blood pressure is common as people age, says Allen Jeremias, M.D., director of interventional cardiology research at St. Francis Hospital & Heart Center in New York. With age, blood vessels become less elastic, which causes blood pressure to rise, explains Dr. Jeremias. “This process can be accelerated by excessive salt and alcohol [consumption], as well as a lack of regular physical activity.”

Older adults also tend to experience higher levels of inflammation, which is linked to hypertension as well, though its exact role remains unclear.

What Causes High Blood Pressure in Young Adults?

High blood pressure affects approximately one in eight people between the ages of 20 and 40, according to research in the journal Hypertension^[2]Hinton T, Adams Z, Baker R, et al. Investigation and Treatment of High Blood Pressure in Young People. Hypertension. 2020;75:16–22. . For the vast majority of young adults, genetic predisposition and unhealthy lifestyle factors drive high blood pressure, says Dr. Jeremias.

Less often, an underlying medical cause may play a role in the development of high blood pressure during young adulthood, such as:

• Thyroid disease
• Renal arterial blockage
• Renal insufficiency
• Fibromuscular dysplasia
• Cushing syndrome
• Adrenal tumors

What Causes High Blood Pressure in Men?

On average, men are more likely to have high blood pressure before age 55 than women, according to the National Institute on Aging, though it’s unclear why^[3]High Blood Pressure and Older Adults. National Institute on Aging. Assessed 1/29/2023. .

“There aren’t many unique causes of hypertension for men, since the original research that found the traditional causes of high blood pressure was mostly done in middle-aged men,” explains Dr. Govil. However, certain risk factors may be more prevalent in men than women. For example, global data suggests obesity may be more common among men in some countries, including the U.S., according to research in the Journal of Obesity & Metabolic Syndrome^[4]Kim K, Shin Y. Males with Obesity and Overweight. J Obes Metab Syndr. 2020;29(1):18–25. .

What Causes High Blood Pressure in Women?

After age 65, women develop a greater risk of high blood pressure than men. That shift seems to coincide with menopause, which occurs at an average age of 51, although the link isn’t well understood.

Menopause may increase a woman’s sensitivity to sodium in her diet, according to Wanpen Vongpatanasin, M.D., professor in the UT Southwestern Department of Internal Medicine. Salty foods are closely associated with high blood pressure, which could explain the link.

In pre-menopausal women, both pregnancy and oral contraception could increase risk of high blood pressure, says Dr. Govil.

What Causes High Blood Pressure During Pregnancy?

High blood pressure affects one in every 12 to 17 pregnancies among those between the ages of 20 and 44, reports the CDC^[5]High Blood Pressure During Pregnancy. Centers for Disease Control and Prevention. Assessed 1/29/2023. . Left unchecked, it could lead to complications like preeclampsia, which can endanger both the pregnant person and their baby.

High blood pressure during pregnancy is more common if the person has a history of hypertension, experienced it with a previous pregnancy or is currently pregnant with more than one baby, explains Dr. Govil.

According to Dr. Govil, other factors that could contribute to high blood pressure during pregnancy include:

• Diabetes
• Obesity
• Kidney disease
• An autoimmune disease like lupus
• In vitro fertilization (IVF)
• Socioeconomic factors, such as lower income or reduced access to prenatal care

If your blood pressure remains too high for too long, you could risk damaging your heart, brain or kidneys, which makes early detection and management important.

According to Dr. Vongpatanasin, symptoms of high blood pressure to watch for include:

• Headache
• Vision changes
• Shortness of breath
• Chest pain or pressure
• Stroke-like symptoms

However, don’t wait to experience symptoms to make an appointment with your health care provider.

“Most people who eventually develop symptoms have had undiagnosed or untreated hypertension for a long time and are now experiencing damaging effects,” explains Dr. Govil.

Keeping an eye on your blood pressure with an at-home device or with the help of your doctor can increase your awareness of your numbers and help you take charge of your cardiovascular health before it’s too late.