There are two forms of high blood pressure: essential (or primary) hypertension and secondary hypertension. Essential hypertension is a far more common condition and accounts for 95% of hypertension.

Essential hypertension affects approximately 72 million Americans, yet its basic causes or underlying defects are not always known. Salt intake may be a particularly important factor in several situations, and excess salt may be involved in the hypertension that is associated with advancing age, African American background, obesity, hereditary (genetic) susceptibility, and kidney failure (renal insufficiency).
Approximately 30% of cases of essential hypertension are attributable to genetic factors. For example, in the United States, the incidence of high blood pressure is greater among African Americans than among Caucasians or Asians. Also, in individuals who have one or two parents with hypertension, high blood pressure is twice as common as in the general population.
Rarely, certain unusual genetic disorders affecting the hormones of the adrenal glands may lead to hypertension.

Secondary Hypertension tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:

• Kidney abnormalities
• Tumors of the adrenal gland
• Certain congenital heart defects
• Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs
• Illegal drugs, such as cocaine and amphetamines

Risk Factors
There are many risk factors associated with high blood pressure. Some, like heredity, are beyond your control but others such as diet and exercise can be modified to decrease your risk. High blood pressure risk factors include:

• Age. The risk of high blood pressure increases as you age. Through early middle age, high blood pressure is more common in men. Women are more likely to develop high blood pressure after menopause.
• Race. High blood pressure is particularly common among blacks, often developing at an earlier age than it does in whites. Serious complications, such as stroke and heart attack, also are more common in blacks.
• Family history. High blood pressure tends to run in families.
• Being overweight or obese. The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
• Not being physically active. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction — and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.
• Using tobacco. Not only does smoking tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure.
• Too much salt (sodium) in your diet. Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
• Too little potassium in your diet. Potassium helps balance the amount of sodium in your cells. If you don't consume or retain enough potassium, you may accumulate too much sodium in your blood.
• Too little vitamin D in your diet. It's uncertain if having too little vitamin D in your diet can lead to high blood pressure. Researchers think vitamin D may affect an enzyme produced by your kidneys that affects your blood pressure. More studies are necessary to determine vitamin D's role in blood pressure.
• Drinking too much alcohol. Over time, heavy drinking can damage your heart. Having more than two or three drinks in a sitting can also temporarily raise your blood pressure, as it may cause your body to release hormones that increase your blood flow and heart rate.
• Stress. High levels of stress can lead to a temporary, but dramatic, increase in blood pressure. If you try to relax by eating more, using tobacco or drinking alcohol, you may only increase problems with high blood pressure.
• Certain chronic conditions also may increase your risk of high blood pressure, including high cholesterol, diabetes, kidney disease and sleep apnea. Sometimes pregnancy contributes to high blood pressure, as well.

Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits such as an unhealthy diet and lack of exercise contribute to high blood pressure.

 

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