Causes of High Blood Pressure: Why It Rises

Blood pressure is the force with which blood presses against the walls of the arteries. At the moment the heart contracts it is at its maximum (systolic pressure), and between beats it falls (diastolic). Let us look at why these numbers rise and when an increase stops being simply a reaction to the day.

Why blood pressure rises at all

The mechanics are as simple as in a water pipe: there is a pump (the heart), pipes (the vessels), and the volume of fluid in the system. Narrow the pipes, add fluid, make the pump work with greater effort — and the pressure in the circuit rises. In the body, this is governed by nervous and hormonal regulation of vascular tone, blood volume, and the work of the heart.

In 90–95% of cases this is essential hypertension, or hypertensive disease: it develops gradually as a person ages. The rest are secondary hypertensions: renal (3–4%), endocrine (0.1–0.3%), hemodynamic, neurological, stress-related, substance-induced, and hypertension of pregnancy, where a rise in pressure is a symptom of an underlying disease. Predisposition is hereditary: more than 20 combinations in the genetic code that contribute to its occurrence have been described.

Main causes of high blood pressure

There are many causes, and each has its own logic. Renal hypertensions develop when the kidneys themselves or the vessels supplying them are affected. Endocrine ones are associated with excessive secretion of hormones — aldosterone, cortisol, thyroid hormones. Stress-related ones arise with prolonged psychoemotional tension: cortical and subcortical regulation of the vasomotor system is disrupted. A separate category is iatrogenic hypertension, associated with the intake of dietary supplements and medications. If the cause is another disease or a drug, eliminating the cause often lowers blood pressure.

Secondary hypertensions and specifics in women

A separate topic in women is hormonal contraceptives: hypertension develops more often against their background, especially in smokers, in women with obesity, and in older women; when blood pressure rises against the background of hormonal contraceptives, the question of the drug is decided by a doctor. When starting hormone replacement therapy in postmenopause, blood pressure is monitored more often.

Risk factors for hypertension

The chances of hypertension are increased by several groups of factors:

• age and close relatives with hypertension;
• excess salt in the diet;
• excess weight, smoking, alcohol;
• prolonged stress, physical inactivity;
• diabetes mellitus, elevated levels of atherogenic lipids and triglycerides.

When a rise in blood pressure requires seeing a doctor

Hypertension usually produces no symptoms; rarely do headache, blurred vision, or chest pain occur. It can only be detected by measurement. The threshold when checked by a healthcare professional is 140/90 and above, and with home measurement — 135/85 and above. Categories: below 120/80 — normal; 120–129 with diastolic below 80 — elevated; 130–139 or 80–89 — stage one; 140 and above or 90 and above — stage two; above 180 and above 120 — hypertensive crisis, help is needed immediately. The diagnosis is made based on two or more measurements on different days. A check is appropriate when hypertension is suspected, at age 40+ and if blood pressure has not been measured for more than five years. Without treatment, the vessels, heart, brain, kidneys, and eyes are affected: the risk of heart attack, stroke, heart and kidney failure, and vascular dementia increases.

High blood pressure by itself is not a reason to call an ambulance. 103 or 112 — if pressing chest pain appears that does not go away, pain radiates to the arm, neck, jaw, abdomen or back, and along with it there is sweating, nausea, dizziness or shortness of breath: this may be a heart attack.

This material is for reference: it explains the mechanics of the phenomenon and does not replace a doctor's consultation — tonometer readings are discussed with a doctor, not with a search bar.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer