Updated on March 18, 2024.
One in three American adults has high blood pressure (hypertension) and only 54 percent of them have it under control. About 20 percent of those with high blood pressure have not been diagnosed and don’t know they have it.
While you can’t control all the factors that may increase your risk for high blood pressure, monitoring your risks more closely may help prevent serious issues like heart attacks, stroke, heart failure and kidney disease later in life.
If your blood pressure is under 120/80 mmHg, experts recommend checking it at least every two years beginning at age 20. If it’s higher or if you have any of the risk factors below, your healthcare provider (HCP) may suggest more frequent monitoring—which may mean checking it at home.
Here are seven factors that can increase your risk for high blood pressure and what you can do to protect yourself.
Family history
Like many health conditions, if your parents or close blood relatives have high blood pressure, you may be at higher risk for it. And if you or the parent of your children has high blood pressure, your children may be at increased risk. Research shows that certain genes and mutations may be associated with high blood pressure, and changes in DNA during fetal development may lead to high blood pressure later in life.
If you can, ask your relatives about their medical history and let your doctor know if you have a family history of high blood pressure.
Age
As you get older, your risk for high blood pressure and heart disease increases. In fact, 65 percent of Americans over age 60 have high blood pressure. Why? Over time your blood vessels and arteries lose flexibility and become stiff, contributing to increased blood pressure.
Experts recommend blood pressure screening starting at age 18, then every 3-5 years after that as long as blood pressure remains normal. Those ages 40 and older or those with an increased risk of high blood pressure will need annual screenings. If you’re between the ages of 65 and 75 with a history of smoking, also ask your doctor about screening for aneurysms, which are weakened or bulging areas of a blood vessel that can increase your risk for stroke.
Race
Experts believe African Americans are at greater risk for high blood pressure and are more likely to develop it earlier in life. Over 40 percent of non-Hispanic blacks have high blood pressure, possibly related to higher rates of obesity and diabetes. Researchers also think that African Americans may have a gene that makes the body more sensitive to salt (which is called salt-sensitivity), and that eating salt may cause a greater increase in blood pressure than it would for people who aren’t salt-sensitive.
Biological sex
Your biological sex assigned at birth may influence your risk for high blood pressure. Until the age of 45, men are more likely to be diagnosed with high blood pressure; from ages 45 to 64, the number of men and women with high blood pressure is about equal. During menopause a woman’s blood pressure may increase, and by the age of 65, women are more likely than men to have high blood pressure.
Pregnant women may also develop pregnancy-induced hypertension (PIH), also called gestational hypertension, which usually goes away after delivery. In severe cases, PIH can turn into preeclampsia, a condition that may harm both parent and fetus.
If you are experiencing these life stages, it’s important to monitor blood pressure more closely so your HCP can recommend treatment right away if you start to exhibit symptoms.
Weight
Extra weight can increase the resistance in your blood vessels, making your heart work harder and increasing your risk for high blood pressure.
A body mass index (BMI, a calculation based on height and weight) of 30 or more is considered obese, and a body mass index between 25 and 30 is considered overweight.
Losing 10 to 20 pounds can lower your blood pressure. Managing weight can take a combination of reduced calorie intake and increased physical activity. Thirty minutes of moderate exercise (like brisk walking or biking), five days per week is recommended. As you are able, you can start slow and build up. If you are new to exercise or have an underlying health condition, ask your HCP what type of exercise is right for you.
Diet
Eating a well-balanced diet is healthy for your body for many reasons, but it’s especially important for heart health. A high salt diet can make your body retain fluid, which puts more pressure on the heart. A diet high in sugar and saturated fat (which is solid at room temperature, like butter) can lead to weight gain, which can also increase the risk for high blood pressure.
The American Heart Association recommends a diet rich in fresh fruits, vegetables, lean protein, whole-grains, and healthy fats like canola or olive oil and fish, like salmon and trout. They also recommend limiting saturated fats, trans fats (often found in processed and junk foods), salt and added sugars.
When eating meats and fish, your cooking method could make a difference: Research presented at an American Heart Association meeting in March 2018 suggests that frequently eating meat cooked at high temperatures was associated with increased risk of high blood pressure.
People who ate grilled, broiled or roasted meat more than 15 times per month had a 17 percent increased risk of high blood pressure, compared to those who did so less than four times per month. High blood pressure risk was also elevated by 15 percent for people who ate well-done meat compared to those who ate meats cooked at lower temperatures. The researchers speculated that cooking meat at high temperatures may contribute to inflammation and insulin resistance, which could in turn increase blood pressure.
Sleep
Lack of sleep makes your heart work harder, and may eventually lead to high blood pressure. In fact, one study of people aged 32 to 59 found that those who got fewer than 5 hours of sleep a night for several years were twice as likely to develop high blood pressure compared to people who got the recommended 7 or 8 hours each night. Another study found that every additional hour of lost sleep was associated with 37 percent increased risk of high blood pressure.
Sleep apnea, when the airway briefly closes down and breathing repeatedly stops and starts during sleep, is also a risk factor for high blood pressure. An analysis of 51 studies found that two treatment methods—continuous positive airway pressure machines (CPAP, which uses a face mask to deliver low air pressure that keeps the airway open) and mandibular advancement devices (MAD, a device that moves the lower jaw forward to keep the airway open)—may help lower blood pressure.
Treatment for high blood pressure
If your blood pressure is between 120/80 mmHg and 139/89 mmHg, your doctor may recommend lifestyle changes to reduce your blood pressure. If your blood pressure is 140/90 mmHg or above, your doctor may prescribe blood pressure medications in addition to lifestyle changes.
