What Causes High Blood Pressure and What You Can Do About It

I’m so glad you are here! We are going to learn about what high blood pressure is caused by and the long-term complications to understand why it needs to be reduced. 

A lot of people might know that they need to reduce their blood pressure or take medications every day, but a lot times they don’t understand WHY they need to reduce it, especially because most of the time you have no idea that it’s high.

But first, who am I and why are you even reading this? I am a pharmacist and I help people get off of their medications, reduce them, or manage them better. I believe that we truly have to understand the reason WHY something is happening and fix the root cause, if possible.

This series on high blood pressure will give you a better understanding of what high blood pressure is caused by, why it happens, common treatments, and what you can start doing about it now. 

This blog series is for you if:

  1. You have been recently diagnosed with prehypertension or high blood pressure

  2. Recently started medications for your high blood pressure and you're tired of the side effects

  3. Have been taking medications for a while but are ready to learn how to get off them- maybe you had a family member recently have a heart attack or stroke and now you want to know what your risk is

  4. It seems like every time you go to the doctor another medication is added and you want to reduce what you are taking

  5. Or just want to learn more and help out a family member that is struggling to understand their blood pressure

In this blog series we are going to cover:

  1. What is high blood pressure caused by and why it needs to be reduced <<<this one>>>

  2. How to calculate your average blood pressure and look at your trend. Because just one high reading isn't important....gasp!! 

  3. How to get started lowering your blood pressure naturally with your diet.

What is High Blood Pressure?

76.4 million Americans over the age of 20 years have hypertension (high blood pressure, HBP, HTN). Treatment of hypertension is the MOST common reason for doctor’s office visits in the US. It’s clear we have a high blood pressure problem nationwide. How many family members can you count that have high blood pressure or take medication to reduce their blood pressure? If you're like me, it's easier to count who doesn't. 

Hypertension is defined as persistently elevated arterial blood pressure.

It is the pressure on the walls of the arteries. Maintenance of blood pressure is necessary for organ perfusion. Kinda like having the water turned on to a water hose...too much and we're blasting the flowers off...too little and we can't water the flowers (kidneys, lungs, colon, muscles, etc).

Most patients with HBP have no symptoms and are completely unaware of their clinical condition, it's known as "the silent killer." 

Two numbers determine your blood pressure:

  1. Systolic

    • Number on the top

    • The pressure in your heart when your heart is contracting

    • Normal is less than 120 mmHg (measured in millimeters of mercury)

    • High is greater than 130 mmHg

  2. Diastolic

    • Number on the bottom

    • The pressure in your arteries when your heart is relaxed

    • Normal is less than 80 mmHg

    • High is greater than 90 mmHg

  • Elevated blood pressure is systolic 120-129 and diastolic less than 80. 
  • Stage 1 hypertension: systolic 130-140 or diastolic 80-89
  • Stage 2 hypertension: systolic greater than or equal to 140 or diastolic greater than or equal to 90

Stage 1 and 2 need to be treated with just lifestyle changes or lifestyle changes + medications. Notice both treatment options include lifestyle changes, you should NEVER just start medication without changing your lifestyle too. It would be like putting Miracle-Gro in your garden soil but never watering it. This is often missed at your doctor's office.

High Blood Pressure Classifications

  1. Primary Hypertension

    • The technical answer: HTN due to genetic and environmental factors that affect the sympathetic nervous system,  renin-angiotensin-aldosterone system, and the plasma volume.

    • Basically, things you were born with plus things in your life can affect how excitable you are, your kidney function, and how much blood volume you have.

    • We can look at risk factors for primary hypertension to narrow focus on what needs to be changed to affect your blood pressure (diet, exercise, alcohol intake).

  2. Secondary Hypertension

    • High blood pressure caused by medications, health condition, stress, etc.

    • Either stop, modify, or use different medications or treat underlying medical conditions if this is the type of high blood pressure you have.

    • When you visit with your doctor, it is very important that these factors listed below be looked at very closely and ruled out. Are you taking medications that alter your blood pressure? Do you have certain thyroid conditions that affect your blood pressure? These are the questions you can ask so you know WHY you have high blood pressure.

    • For example, my grandma was having issues controlling her blood pressure. She was on amlodipine, atenolol, lisinopril, and hctz. 4 medications to treat her blood pressure, but still was having issues. I asked her a couple of questions and found out her arthritis had increased lately and she was taking ibuprofen throughout the day every day. Ibuprofen and all anti-inflammatories have effects at the kidneys disrupting their regulation of your blood pressure. I told her to switch to acetaminophen (Tylenol) instead of ibuprofen and her blood pressure came back down to normal with her medications. Ibuprofen is like a kink in the hose causing the pressure to go up.

    • Prescription or over-the-counter drugs that can cause high blood pressure long-term or short-term:

      1. Birth control medications/hormone replacement: estrogens/progesterone/testosterone

      2. Anti-inflammatories: Ibuprofen, Naproxen, Aspirin, Meloxicam, Celebrex, Etodolac, Sulfasalazine, Nabumetone, Turmeric

      3. Decongestants: Pseudoephedrine, Phenylephrine

      4. Erythropoietin

      5. Cyclosporine

      6. Stimulants

      7. Illicit drug use: Cocaine, Methamphetamine

    • Kidney dysfunction

    • Obstruction sleep apnea

    • Pheochromocytoma

    • Cushing’s syndrome

    • Endocrine disorders: Hypo and hyperthyroidism, Hyperparathyroidism

Action Step: review your medication list including all supplements, vitamins, and over-the-counter medications. Talk with your doctor or pharmacist (like me, fill out a form here to get started) about which ones that might be causing your high blood pressure.

Other classifications:

  1. White coat

    • BP that is consistently elevated at the doctor's office but not during out-of-office readings (measured at home is fine but elevated at the doctor). Blood pressure measurement at home is critical to prevent the over prescribing of medications.

  2. Masked

    • Home readings are elevated but BP is normal at the doctor's office.

  3. Hypertensive emergency

    • Diastolic above 120 with end-organ damage (stroke, heart attack, kidney failure, etc.).

    • This is emergent and requires treatment in a hospital.

  4. Hypertensive urgency

    • Diastolic blood pressure above 120 with no symptoms and no sign of end-organ damage

What high blood pressure is caused by:

For primary hypertension, we can look at risk factors as whether they are modifiable or not, and we can change them and possibly reverse high blood pressure. 

There are some causes that are not changeable like age, race, family history, but other risk factors can be reduced to either prevent high blood pressure or reverse it.

There are a lot of variables that cause high blood pressure that you or your doctor can't do anything about, except take medication. It's very important to remember that taking your blood pressure medication is completely fine and normal and some people will be on medications for the rest of their lives.  

Action Step: Which risk factors do you have from the list below, which ones are modifiable?

  1. Age

    • Increasing age is a non-modifiable risk factor, you can’t do anything about it. Yes, as you get older you are more likely to have high blood pressure

  2. Obesity

  3. Family history

    • If your parents and grandparents had high blood pressure, you might have it too. But this doesn’t mean it isn’t preventable. It’s a good starting place to look at our genetics to see what we might be at risk for so we can change our habits now.

  4. Race

    • There is conflicting evidence on this, but some races may be at more risk for developing high blood pressure than others. This is not a modifiable risk factor so we will not focus on this.

  5. Reduced kidney size

    • Having smaller nephrons (kidney cell units) to filter blood into urine can affect your blood pressure. Kidneys are a valuable player in regulating your blood pressure so we always want to know how they are doing and avoid any medications that could interfere with how the kidneys work.

  6. High sodium or high sugar diet

    • Our diet is highly refined and quick to the plate, if it ever makes it to the plate. Eating foods that are sold in packages or located in the middle of the grocery store have massive amounts of sodium and sugar (even healthy foods). Eating out is also where sodium and sugar sneak in. Water always follows sodium, so if you have increased sodium in your diet now you have increased fluid retention and plasma volume. This also occurs with an insulin spike after a meal from the sugar content. Think of your blood vessels like a water hose. If you increased the volume of fluid, the pressure on the walls of the vessels increases and the water comes shooting out the other end. Check on my tips on reducing sodium in this post.

  7. Excessive alcohol consumption

    • Alcohol is a huge modifiable risk factor, something you can change today to reduce your blood pressure. I know you might not thing that a couple beers or glasses of wine is “excess” but drinking more than a couple times a week, is more than your body can compensate for. The damage isn’t worth it, enjoy the drinks, just not all the drinks all the time.

  8. Physical inactivity

    • Your heart is a giant pump for your blood and if it’s weak and having to work harder than normal, your body will overcompensate and constrict the blood vessel, increasing blood pressure. A lot of people associate losing weight with how much exercise they are doing. Unfortunately, for them exercise helps your heart get stronger and keep your blood pressure lower, it builds muscles which help your blood vessels get your blood back to your heart and overall keeps you healthy, but doesn’t always equal weight loss. Exercise to keep your heart strong and to relieve stress.

  9. Diabetes and high cholesterol

    • Having multiple other disease states complicates the picture and puts a person at risk for developing high blood pressure. Good news, if you are ready to make changes to reduce your blood pressure you will also see your blood sugar and cholesterol (not always, highly genetic) come down, too.

  10. Personality traits

    • Impatience and a hostile attitude

      • Getting angry for things we cannot control increases our sympathetic nervous system- this is our fight-or-flight system which revs your entire body up and releases stress hormones. All play a role in increasing your blood pressure unnecessarily.

  11. Anxiety/depression

    • Your mental state plays a huge role in how you handle stress and responds to different scenarios that can increase your blood pressure situationally but can have lasting effects.

How is blood pressure diagnosed:

  1. Initial BP screening of greater than or equal to 180/110 mmHg

  2. High office BP reading should be confirmed with a home reading or an ambulatory blood pressure monitor (ABPM)

    1. ABPM is a wearable device and the preferred method of diagnosis

    2. Measures BP every 15-20 minutes during the day and every 30-60 minutes during sleep

    3. Can identify white coat and masked HBP

  3. Or two or more readings at different office visits (home readings are important too, bring those to your doctor so you are not treated inappropriately)

Why your blood pressure needs to be reduced:

Having high blood pressure doesn't damage the body right away, but over time there are major complications that can occur. 

These are the main reasons to put behind your WHY. Why you want to do something provides value and a backbone to follow through with your plans.

Now that you understand what your high blood pressure is caused by, you want to make all the changes that you have control over to prevent these complications from happening.

Action Step: Have you had a family member or friend suffer from one of these? Did they have high blood pressure?

  1. Heart failure

  2. Stroke

  3. Heart attack

  4. Chronic kidney disease

If so, it's time to take action to get your numbers lower. Book a call with me here to get started lowering your blood pressure naturally. Nutrition plays a huge role and I help you get started eating a more whole foods diet and moving more. 

How to monitor your blood pressure:

  1. At home monitors

    • Always use an upper arm cuff to monitor your blood pressure at home, here are some reliable and affordable options.

  2. How to take your blood pressure

    1. Sit down in a quiet room for 5 minutes

    2. Sit in a chair with the back and arm supported at heart level

    3. Make sure you have not had any caffeine- coffee, coke, tea within the past 2 hours

    4. Follow the instructions for your specific monitor

  3. Record/log track

    • Measure in the morning and before bed for 1 week

    • Make note if you were on any prescription or over-the-counter medications or caffeine. Caffeine can transiently increase your blood pressure, so it is important to measure before you have had any coffee or tea.

    • This is a reliable source of information for you and your doctor. You need to establish your baseline blood pressure whether you have started medications or not. If the doctor makes changes to your medications, you will be able to measure and see the changes. Not all drugs work instantly, but over time you will see how your blood pressure averages.

    • A one time reading should never dictate your actions, you should measure in each arm after being seated for at least 5 minutes.

I hope you have learned what high blood pressure is caused by and starting to get the WHY behind what it takes to reverse or prevent high blood pressure. In the next post, we will go over what readings are important... just one or the average?

Here are the links in this blood pressure series:

  1. What is high blood pressure caused by and why it needs to be reduced <<<this one>>>

  2. How to calculate your average blood pressure and look at your trend. Because just one high reading isn't important....gasp!! 

  3. How to get started lowering your blood pressure naturally with your diet.

Grab my FREE Starter Kit to prevent or get off your medications. Click on the image below and I'll send over the kit plus 60 recipes to get you started.

Let me know in the comments below: 

  1. Are you taking any medications or have any other disease states that can alter your blood pressure?

  2. What are your modifiable risk factors?

  3. How many people in your family have high blood pressure or have had a heart attack or stroke?