How to know your risk factors for hypertension — and whether high blood pressure is genetic

MK ManoylovMay 30, 2020, 03:01 IST

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Smoking cigarettes is one of the main risk factors for hypertension.Nopphon_1987/Shutterstock

The biggest risk factors for high blood pressure are a lack of exercise, an unhealthy diet high in sodium and low in potassium, smoking cigarettes, drinking too much alcohol, and chronic stress.
Hypertension also has a genetic component, and you're at a higher risk if it runs in your family.
Other factors, like age and race, as well as medical conditions like diabetes or obesity, can increase your risk for developing high blood pressure.
This article was medically reviewed by John Osborne, MD, PhD, and the Director of Cardiology for Dallas-based State of the Heart Cardiology.

Hypertension is the medical term for high blood pressure. It can cause serious health problems, like heart disease or stroke, if left untreated.

There are many risk factors that make it more likely for someone to develop hypertension. These include genetic factors, age, race, medical conditions, and unhealthy lifestyle choices.

Here's what you need to know about what increases the risk of high blood pressure.

Unhealthy lifestyle choices

Overall, one or more of these factors are most likely to cause high blood pressure:

Physical inactivity
High salt intake and low potassium
Excessive alcohol consumption
Smoking
Chronic stress

One of the biggest culprits is smoking, which can double or triple the risk of developing hypertension. That's because smoking damages blood vessels and can reduce blood flow to the heart.

But these factors won't always cause hypertension alone — genetics and medical conditions can also increase your risk.

Is high blood pressure genetic?

"I would say the simplest answer to this is, yes, there is a genetic component," says Joshua Shatzkes, MD, a cardiologist at Mt. Sinai Hospital.

If your parents have hypertension, you are at an increased risk for high blood pressure.

A 2018 study involving over a million people identified 500 genes that influence blood pressure. Some of these genes influence the cells lining blood vessels, causing them to be abnormally constricted and raise blood pressure.

Other genes can cause high cholesterol, especially in a condition known as hypercholesterolemia, which can also increase blood pressure.

In addition, genetic factors often combine with other adverse lifestyle choices, which can further increase the risk of hypertension.

For example, when you're growing up, if your family eats an unhealthy diet high in sodium, creates a high stress environment, smokes too many cigarettes, and doesn't exercise often, then you're more likely to inherit those behaviors — and more likely to develop hypertension.

Obesity

While there's no universal way to describe obesity, it's often considered a condition where someone has a high body mass index (BMI). A BMI over 40 can double or triple your likelihood of developing obesity-related illnesses.

"When someone is obese, it simply takes more work for the heart to pump blood throughout the whole body," says Christopher Granger, MD, a cardiologist at Duke Health. "And when it has to pump blood throughout the whole body, it has to generate a higher kind of pressure to do so."

In fact, a study from 2015 suggests that excess body fat accounts for 65% to 75% of hypertension cases. Moreover, a 2017 study found that childhood obesity increased the rate of developing adult hypertension by 65%.

Diabetes

Diabetes is a condition where your body doesn't react to high blood sugar properly, which may cause it to be too high or too low longer than normal. Insulin is the hormone designed to take glucose (sugar) from the blood to the cells, but if there's not enough insulin, glucose stays in the blood, elevating blood sugar levels.

Over time, high blood sugar can cause plaque to build up in your blood vessels, which narrows the vessel and increases blood pressure.

Granger explains that high blood sugar can cause the arteries to stiffen because it can increase the production of free radicals — tiny particles that damage cells — and reduce nitrous oxide, a chemical that dilates blood vessels.

As a result, 30% of people with type 1 diabetes develop hypertension. Those with type 2 diabetes are 2.5 times more likely to develop hypertension — and 50% to 80% will develop hypertension. However, diabetics who carefully control their blood sugar levels can effectively decrease the risk of developing hypertension.

Race or ethnicity

The American Heart Association has found that over 40% of non-Hispanic African-Americans have high blood pressure, and that it can develop earlier in their lives and become more severe.

Overall, black Americans are twice as likely to develop hypertension by the age of 55 compared to white Americans. Systemic issues could explain this increase in blood pressure.

There's an association between racism and higher blood pressure in African-American men, according to the CDC. Black Americans are also exposed to more factors that can increase chronic stress — such as discrimination and lower socioeconomic status — which may contribute to high blood pressure.

Age

Older people are more likely to develop hypertension because the arteries stiffen as we age. This process is called atherosclerosis, and it describes plaque build-up in blood vessels.

According to Granger, young people's arteries are able to expand and more effectively accommodate the pulse of blood flow.

Overall, your lifetime risk for developing hypertension is 90%, according to Johns Hopkins Medicine. Even if you have heart-healthy habits, you'll still most likely develop hypertension, according to the National Institute on Aging.

However, certain lifestyle changes, such as exercising every day, sleeping adequately, and avoiding smoking, can lower the risk of developing high blood pressure.

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