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Hypertension 101: What is high blood pressure, what causes it, and how can you manage it?

Reviewed by: Teresa Coats, MD
Written by: Abbi Havens

Defining Hypertension

Simply put, high blood pressure (or hypertension) is when the force of your blood pushing against the walls of your blood vessels is consistently too high. Just like any trusty system of pipes, too much liquid rushing through too small a tunnel (or a damaged or clogged tunnel) can cause some major problems.

Let’s get into the nitty-gritty of how your complex system of blood vessels works to supply oxygen to the rest of your body. Take a trip down memory lane back to your 6th-grade biology class. Your heart beats an average of 60-100 times per minute (or more when your crush is assigned to be your lab partner, but that’s just speculation) to create a pressure that forces blood through your body’s complex network of arteries, veins and capillaries. When you get your blood pressure checked, the result will appear in two numbers, fraction-style (one above the other). The first or upper number represents your systolic pressure. Systolic pressure is the force that occurs as blood pumps out of the heart and into the arteries. The second or lower number represents your diastolic pressure. Diastolic pressure is the pressure that occurs when the heart rests in between beats. According to Dr. Teresa Coats, a Primary Care Physician at UT Health Austin, healthy blood pressure falls below 120/80. Any blood pressure over 120/80 and under 140/90 is considered pre-hypertension, and presents an opportunity to make lifestyle modifications to prevent the development of hypertension.

Damage Caused by Hypertension

Unfortunately, hypertension is often a silent predator. High blood pressure can quietly damage your body for years before you begin to show symptoms, so it’s important to regularly check your blood pressure and address any problems head-on! In order for blood to flow freely through veins and arteries, the vessel walls should be smooth, flexible, and strong. High blood pressure damages the cells that line the inner walls, causing fat and plaque to build up inside the arteries, making arteries stiff and blocking blood from flowing freely through them.

High blood pressure can cause extreme damage to your brain and heart. Your brain depends on oxygen from your blood to function properly. When blood does not adequately flow to the brain, you risk suffering from a stroke, a Transient ischemic attack (TIA) which is a temporary disruption of blood to the brain, dementia, and cognitive impairment. Your heart is responsible for pumping blood through your entire body and untreated hypertension can create extreme problems for the heart including coronary artery disease, heart attacks and heart failure, and an enlarged heart.

Another dangerous potential side effect of high blood pressure are aneurysms. An aneurysm is when a weakened section of an artery’s wall expands and forms a bulge as a result of constant pressure. Aneurysms can rupture and cause life-threatening internal bleeding. Additional risks of hypertension include kidney failure, bone loss, sexual dysfunction, sleep apnea, and damage to the eyes.

Surprising and Not-So-Surprising Causes of Hypertension

According to Dr.Coats, the most common causes of hypertension are obesity, inactivity and excessive salt intake. In addition to being the most common causes of hypertension, they are also the most familiar. Here are eight causes of hypertension that may surprise you.

Loneliness. Loneliness is officially defined as the gap between what you desire from social relationships and what you actually receive from social relationships. Humans are social creatures, and we require love and companionship for our mental health and our physical health. Loneliness greatly contributes to stress and anxiety, which increases your body’s production of the stress hormone, cortisol. Additionally, the impact of loneliness on your cardiovascular system worsens with time. One study shows that the systolic pressure of the loneliest participants rose by more than 14 points over the course of four years. This is especially concerning, considering elevated systolic blood pressure is a much higher risk factor for cardiovascular disease than diastolic.

Thyroid Imbalance. The thyroid is the swiss army knife of glands and produces hormones that regulate your metabolic rate, digestive function, muscle control, bone health and heart function. Hyperthyroidism (an overactive thyroid) causes your heart to beat faster. Hypothyroidism (an underactive thyroid) slows your heart-rate, which can result in a loss of elasticity and stiffness in arteries, causing blood to flow too quickly and raise blood pressure.

Dehydration. When you are dehydrated, so are your cells. When your cells do not have enough moisture, they restrict, causing the pathways through which blood travels to tighten and halt flow, adding pressure to the walls of your blood vessels. So when you feel thirsty, think about your hard-working cells and drink up!

Hormonal Birth Control. To be clear, this is not an absolute. However, hormonal birth control including pills, injections, and IUD’s use hormones that narrow blood vessels. This puts women who are over 35, smokers, or overweight at risk of increased blood pressure.

Talking. Research shows that communicating raises blood pressure instantly in hypertensive patients. However, the cause may not be linked to the act of speaking itself, but to the subject matter you are attempting to convey. Expressing stressful, emotional, or angry thoughts is more likely to raise your blood pressure. If you find yourself feeling worked up during a conversation, take a moment to close your eyes and practice deep breathing.

Added Sugar. Many of us have heard all our lives that salt raises your blood pressure, but did you know that added sugar can have a negative effect on your blood pressure, too? Foods containing added sugars like high fructose corn syrup raise both your systolic and diastolic blood pressure, so if you’re concerned about hypertension, reign in the soda, cereal, candy, condiments, and processed fruit juice.

Sleep Apnea. Up to 10 million Americans suffer from Resistant Hypertension, a condition in which blood pressure remains high even when taking at least two blood pressure medication. A possible cause of this is sleep apnea. When your sleep is regularly interrupted, your nervous system produces chemicals to raise your blood pressure. Additionally, your oxygen intake is lowered which can damage blood vessel walls, causing problems in the future.

Low Potassium Levels. Your kidneys need sodium and potassium to maintain a healthy amount of fluid in your blood. Start eating your bananas and leafy greens!

The symptoms of high blood pressure often go unnoticed until a serious problem occurs. Of course, the occasional spike in high blood pressure won’t do you much harm, but consistent unmanaged high blood pressure can lead to serious problems for your heart, kidneys, brain, and overall health. As always, be proactive in your own health and take a preventative approach by regularly visiting your primary care doctor and assessing your blood pressure levels. In addition to regular exercise, learning to manage stress and decreasing your salt intake, Dr. Coats recommends increasing your fruit and vegetable intake, as this is known to improve hypertension. Discuss tips for keeping your blood pressure within a healthy range with your primary care provider.

About UT Health Austin

UT Health Austin, the group practice designed and managed by the faculty and staff of the Dell Medical School, focuses the expertise of a team of experienced medical professionals to deliver personalized, whole-person care of uncompromising quality. Our experienced healthcare professionals treat each patient as an individual, with unique circumstances, priorities and beliefs. Working with you, your care team creates an individualized care plan to help you reach the goals that matter most to you — in the care room, and beyond. For more information, call us at 1-833-UT-CARES or request an appointment here.