Are you at risk for high blood pressure?

Essential hypertension has no clear cause. As a result, identifying risk factors can be difficult. Researchers have discovered certain patterns, however. Some factors are things you have no control over - for example, you can't alter your genes. But others, like smoking and heavy drinking, are habits you can change.

Risk factors you can't control

Even though you can't control these risk factors, that doesn't mean you can forget about them. Your doctor might want to screen you earlier or more often. Knowing that your risk is elevated can also provide you with extra incentive to adopt healthier habits.

Family history

Like many disorders, high blood pressure tends to run in families. In addition, a family history of heart attack, stroke, diabetes, kidney disease, or high cholesterol increases your risk of developing high blood pressure.

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High blood pressure often runs in families, but genetics are only part of the puzzle. Lifestyle factors such as your activity level and dietary habits also play an important role.

Although genetics provide a partial explanation, some of the similarities seen in families are likely the result of environmental influences. Children's eating patterns, coping skills, and propensity toward healthy and unhealthy habits are shaped by their parents' behavior and the environment in which they're raised.

Age

Although aging doesn't always lead to high blood pressure, hypertension becomes more common in later years. Systolic pressure tends to climb starting around age 30 and diastolic pressure usually increases gradually until late middle age, at which time it often begins to decline.

Sex

Up to about age 55, women are less likely than men to develop high blood pressure. But women's blood pressures, especially the systolic readings, rise more sharply after that. Indeed, after age 55, women are at greater risk for high blood pressure. This pattern may be partly explained by hormonal differences between the sexes. Estrogen tends to protect women against hypertension, but when the production of estrogen drops at menopause, women lose its beneficial effects, and their blood pressure climbs.

Race

Black Americans often develop high blood pressure earlier and to a greater degree than do people of other races. Although Black adults are 40% more likely to have high blood pressure than their white counterparts, they are significantly less likely to have the condition under control. Genetics may be partially to blame. But psychosocial factors such as discrimination and racism are now increasingly recognized as also playing a role.

Controllable risk factors

You may be able to bring your blood pressure readings into a safe range simply by making changes in your lifestyle, such as quitting smoking, reducing your salt intake, and losing weight, as outlined below.

Obesity

Excess weight and hypertension often go hand in hand, because carrying even a few extra pounds forces your heart to work harder. Being overweight increases the risk of high blood pressure approximately threefold. The risk continues to rise as body mass index progresses into the obesity range. By contrast, systolic and diastolic blood pressures drop an average of 1 mm Hg for roughly every pound or two of weight lost, although the actual amount varies widely from person to person.

Sedentary lifestyle

Compared with people who are physically active, those who are sedentary are more likely to develop hypertension and suffer heart attacks. Like any muscle, your heart gets stronger with exercise. A stronger heart pumps more blood more efficiently, with less force, through your body. Other benefits of exercise include raising levels of "good" HDL cholesterol and making stroke-causing clots less likely.

Smoking

Whether you smoke a cigarette, use e-cigarettes (vape), or chew tobacco, your body responds to nicotine by releasing a stress hormone called epinephrine, which increases your heart rate and blood pressure.

Excess salt

Doctors first noticed a link between hypertension and table salt (sodium chloride) in the early 1900s, when they found that restricting salt in people with kidney failure and severe hypertension brought their blood pressures down and improved their kidney function. When a massive effort began in the 1960s to educate the public about lowering the risk of heart disease, one recommendation was that all Americans reduce salt consumption to prevent hypertension. However, rather than decreasing, the average amount of sodium in the American diet has risen, likely as the result of our growing reliance on salt-laden processed and prepared foods.

Heavy drinking

Evidence suggests that even moderate drinking may contribute to high blood pressure, but having three or more drinks in one sitting certainly does. That spike is temporary, at first. Over time, excessive drinking - including binge drinking - can have longer-lasting detrimental effects on blood pressure. (Binge drinking is defined as drinking enough to attain a blood alcohol level of 0.08%, which typically happens when a man has five or more drinks or a woman has four or more within about a two-hour span.) Heavy drinking can also interfere with blood pressure medications and boost the risk of stroke and heart failure.