What causes high blood pressure (hypertension)?
Primary (essential) high blood pressure (hypertension)
Accounts for about 90% of cases, with no identifiable cause. It is likely multifactorial, involving genetics, lifestyle, and environmental factors:
- Family History: A family history of hypertension can increase an individual’s risk
- Age: Hypertension risk increases with age
- Ethnicity: Black and Asian people are more prone to hypertension. Black people can get severe hypertension.
- Lifestyle Factors: Excess weight, physical inactivity, and a diet high in salt and sugar can contribute to hypertension.
Secondary high blood pressure (hypertension)
This means the high blood pressure is caused by an underlying condition (about 10% of cases).
There are 5 main groups of causes of secondary hypertension.
1. Renal disease
- Chronic kidney disease (all causes), including:
- Renal artery stenosis (RAS; also known as renovascular disease, RVD; reflux nephropathy/chronic pyelonephritis (CP), diabetic nephropathy (DN), glomerulonephritis (GN), polycystic kidney disease (PCD), obstructive nephropathy (ON)
- Renal cell carcinoma.
2. Cardiac disease
- Coarctation of the aorta
- Aortic regurgitation (AR): with a wide pulse pressure.
3. Endocrine disease
- Cushing’s Syndrome
- Hyperaldosteronism (Conn’s Syndrome)
- Hyperthyroidism
- Acromegaly
- Phaeochromocytoma. This is very rare.
4. Medication
- Corticosteroids
- Oral contraceptives
- Sympathomimetics
- Other drugs: ciclosporin, cocaine, and non-steroidal anti-inflammatory drugs (NSAIDs),
5. Other
- Obstructive sleep apnoea (OSA)
- Pregnancy (pre-eclampsia and eclampsia).
Note. BP is normally low in pregnancy. So 130/80 can be a disease.
Summary
We have described what causes high blood pressure (hypertension). We hope it has been helpful.
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