High blood pressure risk factors: what raises it, and how to lower it

Risk factors you can and cannot change

The National Heart, Lung, and Blood Institute (NHLBI) says many factors raise your risk of high blood pressure. You can change some of them, such as unhealthy lifestyle habits. Others, such as age, family history and genetics, race and ethnicity, and sex, cannot be changed, but you can still take steps to reduce your risk and its complications (NHLBI).

Risk factors you cannot change

• Age. Blood pressure tends to rise with age, because blood vessels naturally thicken and stiffen over time. NHLBI adds that the risk is also rising for children and teens, possibly because more of them have overweight or obesity (NHLBI). See blood pressure by age.
• Family history and genetics. High blood pressure often runs in families. Many genes are linked to small increases in risk, and some people have a high sensitivity to salt, which can also run in families (NHLBI).
• Race or ethnicity. NHLBI says high blood pressure is more common in Black adults than in White, Hispanic or Asian adults, and Black people tend to have higher average numbers and get high blood pressure earlier in life (NHLBI).
• Sex. Men are more likely than women to develop high blood pressure through middle age. In older adults, women are more likely than men. Women who had high blood pressure during pregnancy are more likely to have high blood pressure later in life (NHLBI).

Lifestyle habits

NHLBI lists habits that can increase the risk of high blood pressure (NHLBI):

• often eating unhealthy foods, especially foods high in salt and low in potassium
• drinking too much alcohol or caffeine
• not getting enough physical activity
• not getting enough good-quality sleep
• high-stress situations
• using cocaine, methamphetamine, "bath salts" or other stimulants

NHLBI says some people are more sensitive to salt, including Black people, older adults, and people who have chronic kidney disease, diabetes or metabolic syndrome (NHLBI).

Medicines and other conditions

Some medicines can make it harder for your body to control blood pressure. NHLBI names antidepressants, decongestants, hormonal birth control pills, and non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen (NHLBI). Do not stop a medicine on your own; ask the person who prescribed it.

Conditions that can cause high blood pressure include some tumors, chronic kidney disease, metabolic syndrome, overweight and obesity, sleep apnea and thyroid problems (NHLBI). When another condition or a medicine causes it, MedlinePlus calls it secondary high blood pressure, which usually gets better once that condition is treated or the medicine is stopped. The most common type is primary, or essential, high blood pressure (MedlinePlus).

NHLBI also lists social and economic factors: income, education, where you live, the type of job you have and stress on the job, working early or late shifts, and experiencing discrimination or poverty (NHLBI).

Related pages: kidney disease risk factors, sleep apnea symptoms, dementia risk factors and the metabolic syndrome check.

Why it is often silent

High blood pressure usually does not cause symptoms until it has already caused serious problems, so NHLBI says to check your readings regularly and know your numbers (NHLBI). MedlinePlus says the only way to find out is regular checks, and that blood pressure that stays high over time can lead to heart attack, stroke, heart failure and kidney failure (MedlinePlus).

Undiagnosed or uncontrolled high blood pressure can lead to stroke, heart attack, heart failure, chronic kidney disease, eye damage, aneurysm, plaque buildup in the arteries and vascular dementia (NHLBI).

When to get help now. NHLBI says blood pressure above 180/120 mm Hg is too high and needs medical attention. Without symptoms, wait 5 minutes and check again; if it is still high, call your health care provider. If the second reading is also high and you have a sudden, severe headache, difficulty breathing, sudden severe pain in the abdomen, chest or back, numbness or weakness, a sudden change in vision or problems talking, call 911 (NHLBI).

How it is checked

Your provider takes two or more readings at separate appointments before diagnosing high blood pressure (MedlinePlus). The US Preventive Services Task Force suggests screening every year for adults 40 or older and for adults at increased risk, and every 3 to 5 years for adults 18 to 39 who are not at increased risk and had a normal reading before (USPSTF 2021). See what the numbers mean on blood pressure ranges, and how often to be checked on the high blood pressure screening check.

Normal blood pressure now but want to know your chance of developing high blood pressure? The hypertension risk calculator estimates it from a few numbers.

Steps that may help lower your risk

NHLBI says a heart-healthy lifestyle can help prevent high blood pressure and its complications (NHLBI):

• choose foods lower in salt (sodium) and rich in potassium, such as fruits and vegetables
• avoid or limit alcohol
• get regular physical activity; even modest amounts can make a difference, and sitting less can help
• aim for a healthy weight
• quit smoking
• control your cholesterol and blood sugar levels
• manage stress
• get enough good-quality sleep

Common questions

What is the most common cause of high blood pressure?

The most common type is primary, or essential, high blood pressure, which for most people develops over time as they get older (MedlinePlus).

Can you have high blood pressure and feel fine?

Yes. It usually has no symptoms, and regular checks are the only way to know (NHLBI) (MedlinePlus).

Does high blood pressure run in families?

Often, yes. NHLBI lists family history as a risk factor (NHLBI).

Can young people get high blood pressure?

Yes. NHLBI says the risk is rising for children and teens (NHLBI). For children, see the child blood pressure check.