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High blood pressure is called the “silent killer” for a very good reason: it often doesn’t cause any symptoms. Therefore, people don’t know they have it.
Your doctor may notice it during a routine check-up. In this case, it may be the “white coat syndrome.” This is when the blood pressure is higher than usual at the doctor’s office in comparison to other settings (like at home).
For a long time, people thought that white coat high blood pressure was nothing to worry about. After all, it’s simply caused by stress from the doctor’s visit. However, recent research suggests that this problem may increase the risk of getting high blood pressure in the future. At the same time, “masked hypertension” is when you have normal blood pressure at the doctor, but higher-than-normal blood pressure at home. Either way, you are still at risk of long-term problems.
Ultimately, the best course of action is to take your blood pressure at home on a constant basis. If you notice changes, seek medical advice and treatment.
High Blood Pressure Causes
White-coat syndrome aside, the truth is we don’t know the exact cause of high blood pressure in the majority (95%) of cases. When the cause is unknown, it is called “essential” hypertension. However, there are several factors that play a role in the development of high blood pressure.
Risk Factors
- Stress – This is perhaps the most underestimated risk factor. Up to 80% of visits to the doctor may have a stress-related component. In addition to increased blood pressure, common stress effects include muscle pain and tension, fatigue, stomach upset, sleeping problems, chest pain, and low sex drive. Emotional symptoms can include anxiety, depression, lack of motivation, eating disorders, and social withdrawal.
- Diet – Excess salt is a key trigger. Also, overeating and Western-type diets that are high in empty calories lead to excess weight. Being overweight or obese increases the risk of high blood pressure. Losing those extra pounds helps lower blood pressure.
- Smoking and drinking alcohol (more than one or two drinks daily) increase the risk for high blood pressure.
- Lack of regular exercise contributes to excess weight. This is also a risk factor on its own. If you have a sedentary life, you are more likely to have high blood pressure.
- Age – The older you are, the more likely you are to have high blood pressure. High blood pressure slightly increases every decade, and that happens naturally. However, you can still manage it and keep it within a healthy range.
- Family history – If you have close relatives with high blood pressure, you are at higher risk of having high blood pressure yourself. Certain genes have been identified, but the genetic component is complex. It is no single gene playing a major role. Instead, many genes with mild effects react to different environmental factors that contribute to high blood pressure. Pay attention to other problems like diabetes, high cholesterol, excess weight (especially in the abdominal area), and fatty liver. These conditions correlate with high blood pressure.
- Hormonal imbalances – Adrenal and thyroid conditions and kidney diseases are risk factors for high blood pressure.
- Sleep apnea – Obstructive sleep apnea (OSA) correlates with high blood pressure as well as insulin resistance/diabetes and obesity. OSA affects about 4-7 % of people in the general population, but 30-40% of those with hypertension. OSA affects blood pressure at night and daytime blood pressure levels increase with sleep apnea severity. Both OSA and high blood pressure increase the risk for cardiovascular complications. More details about high blood pressure and sleep apnea in this article.
There are many possible causes and very few symptoms of high blood pressure. Do not ignore higher than normal readings thinking that a symptom may alert you to a greater problem. Do monitor your blood pressure regularly, and follow medical advice.
The American Heart Association recommends that if your blood pressure is unusually high, you should wait five minutes and check your blood pressure again. If the numbers are still high (180/120 mmHg or higher), call 911.
