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High blood pressure, or hypertension, is caused by a combination of lifestyle factors and genetics.

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  • The main causes of high blood pressure are lack of exercise, a high-sodium diet, smoking cigarettes, and obesity. 
  • A strong family history can increase the risk of high blood pressure, and people over 60 years old, African-Americans, and men are also more likely to have high blood pressure. 
  • This article was reviewed by Hina W. Chaudhry, MD, director of cardiovascular regenerative medicine at Mount Sinai School of Medicine.
  • Visit Insider’s homepage for more. 

High blood pressure, or hypertension, is a common condition. According to the Centers for Disease Control and Prevention, about one in three American adults have high blood pressure, and more than half don’t have it under control. 

There are two types of hypertension — primary and secondary — and they each have different causes. Here’s what you need to know about the biggest risk factors.  

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High blood pressure, or hypertension, occurs when the force of the blood against your artery walls is too high, and can potentially lead to heart disease, heart attack, or stroke. 

Primary hypertension tends to develop as you age and there is no one identifiable cause, says Sanjiv Patel, MD, a cardiologist with MemorialCare Heart & Vascular Institute at Orange Coast Medical Center. 

Secondary hypertension, on the other hand, is caused by other factors, such as adrenal gland tumors or kidney problems, like renal artery stenosis — a condition that narrows arteries resulting in less blood flow to the kidneys. 

Because secondary hypertension is the result of an underlying cause, it can be treated by addressing that cause, Patel says, while primary hypertension has no cure — but can be controlled with lifestyle changes or medication. 

Lifestyle factors often cause primary hypertension, Patel says. Some of the biggest risk factors include:

  • Smoking cigarettes. Smoking can cause your blood pressure to temporarily increase and damage your arteries, increasing your risk of heart disease
  • Lack of exercise. Regular physical activity strengthens your heart, helping it pump blood more effectively. Less physical activity can contribute to a higher heart rate, putting more strain on your arteries and increasing blood pressure. 
  • Obesity. Excess weight puts a strain on your circulatory system, and research shows it can contribute to hypertension
  • Diet — particularly consuming too much sodium. Salt causes your body to retain fluid, which can increase blood pressure. The American Heart Association recommends consuming no more than 2,300 milligrams of sodium per day. 
  • Stress. Stress can cause your blood pressure to temporarily spike, and can also contribute to other behaviors that increase blood pressure, like poor diet and tobacco use.

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Hypertension can cause headaches, blurred vision and shortness of breath, but you may not experience many symptoms until the condition is very severe, Patel says. 

However, certain people have a higher risk of hypertension. For example, older people — especially over the age of 60 — are more likely to have high blood pressure because blood vessels gradually lose flexibility as we age. 

Here are some other physical and hereditary risk factors

  • Family history. If you have a close family member who has high blood pressure before the age of 60, you are two times more likely to develop it. This doesn’t necessarily mean you will have high blood pressure, but it does increase your chances, particularly if combined with other risk factors like lack of physical activity and a poor diet, Patel says.  
  • Gender. Men younger than 65 years old have consistently higher levels of hypertension when compared with women of the same age group, according to several studies. Research has also shown that even in their twenties, 27% of men had high blood pressure, while only 12% of women did.

Regular blood pressure checks at your doctor’s office or at home with a home blood pressure monitor can be crucial to identifying hypertension. If you think you’re at risk of hypertension based on these factors, you should contact your doctor to discuss treatment options.

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