What Causes High Blood Pressure: A Look at Essential Hypertension

The article describes probable reasons why blood pressure increases with essential hypertension.

All types of arterial hypertension are divided into two large groups:

• a group of primary hypertensions (they are also called essential hypertension). To put it briefly and simply, primary (or essential) hypertension is hypertension where there are supposedly no obvious reasons for the increase in blood pressure.
• a group of secondary hypertensions (they are also called symptomatic hypertension). Secondary (or symptomatic) hypertensions are hypertensions that occur as a result of a certain disease. That is, secondary hypertension is a kind of consequence of some disease.

Try to remember this division of hypertension into these groups. We will need them for consideration.

Further in the text, high blood pressure will be called “hypertension” for the convenience of presenting the material.

Let’s see how things are with high blood pressure among people.

According to the World Health Organization (WHO), by 2023, every fourth adult in the world suffers from hypertension. This means that about 1.3 billion people live with high blood pressure. It is noteworthy: over the period of time: from 1990 to 2019, the number of people with hypertension doubled – from 650 million to 1.3 billion. Interestingly, almost half of people with hypertension do not know about their condition, and four out of five patients diagnosed with hypertension do not receive the necessary treatment. (taken from here: Global report on Hypertension ).

It should be said that hypertension is among the three leading causes of death from cardiovascular diseases:

1. 1st place – coronary heart disease (CHD);
2. 2nd place – stroke;
3. 3rd place – hypertension with its complications).
   (taken from here: WHO reveals leading causes of death and disability worldwide: ).

As you can see, the picture is not exactly cheerful when it comes to hypertension. In this article, we will consider essential (primary) hypertension. Essential hypertension accounts for more than 90% of all cases of high blood pressure. Therefore, the fight against primary hypertension is a very urgent task.

Here is what official medicine says about the main causes of primary hypertension:

1. Genetic predisposition
   Studies show that if parents had hypertension, the risk of its development in offspring increases significantly.
2. Violation of vascular tone regulation
   Increased activity of the sympathetic nervous system can lead to vascular spasm and a persistent increase in pressure.
3. Excessive salt intake
   Excessive sodium intake contributes to fluid retention in the body, an increase in circulating blood volume and an increase in blood pressure.
4. Obesity and metabolic disorders
   Excess weight increases the load on the heart, contributes to the development of insulin resistance and metabolic disorders, which in turn contributes to an increase in pressure.
5. Sedentary lifestyle
   Insufficient physical activity reduces the elasticity of blood vessels, impairs blood circulation and leads to an increase in blood pressure.
6. Chronic stress and psycho-emotional stress
   Long-term stress stimulates the production of hormones such as adrenaline and cortisol, which contribute to vasoconstriction and increased blood pressure.
7. Age-related changes
   With age, the walls of blood vessels lose elasticity, making them less able to adapt to changes in pressure.
8. Hormonal disorders
   Hormonal imbalance (for example, in diseases of the thyroid gland or adrenal glands) can contribute to the development of hypertension.
9. Alcohol abuse and smoking (bad habits)
   Nicotine and ethanol cause vasospasm, damage the endothelium and contribute to the development of hypertension.

Let’s look at each point separately. Let’s approach this critically.

1. Genetic predisposition. Oddly enough, this happens: people whose parents suffered from hypertension often also have primary hypertension. Here, as the author, I would like to suggest that blaming genetics in medicine is not such a rare thing: it’s even convenient. This point can be argued.
2. Violation of vascular tone regulation. I believe that this is not an entirely correct formulation. Any type of hypertension is accompanied by a violation of vascular tone regulation in one way or another. This point should not be attributed to the causes of the disease, but as part of the pathophysiological process.
3. Excessive salt consumption. Unfortunately, regular table salt is currently “demonized”: for some reason, medicine calls salt a kind of “white death”. WHO recommends consuming no more than 5 grams of salt per day. But some nations take a lot of salt, for example, the Japanese, Koreans and Chinese in the north of their country sometimes eat even more than 10 grams of salt in their food.
4. Obesity and metabolic disorders. If obesity is considered a disease, then insulin resistance is often observed with obesity. It is more correct to single out metabolic disorders as a separate item from hypertension. Obesity should be considered only as one of the manifestations of metabolic disorders. Looking ahead, we will say that the basis of metabolic disorders (more precisely, “metabolic syndrome”) is insulin resistance. It is insulin resistance that can be considered the leading cause of essential hypertension. At least, this is what a number of studies indicate. Why is it better to single out metabolic disorders separately? Look. Obesity, in fact, increases the risk of primary hypertension. On the other hand, this hypertension also occurs in fairly thin people. Insulin resistance is a condition when there is an elevated level of insulin in the blood during the so-called “hunger” hours (outside of meals). Insulin is an anabolic hormone with a wide range of properties. And if insulin is elevated in the blood for a long time, it begins to negatively affect many tissues and organs of the body. In particular, elevated insulin over time begins to adversely affect the vascular endothelium. The vascular endothelium is the cells of the inner lining of blood vessels. The endothelium is also involved in the regulation of vascular tone, that is, it can affect the diameter of the arteries, which changes blood pressure readings. One of the substances that can dilate arteries and which is produced by the endothelium is nitric oxide (NO).
5. A sedentary lifestyle (hypodynamia). Hypodynamia in itself can significantly affect the occurrence of primary high blood pressure. Muscle movement has a beneficial effect on both the condition and the functioning of the body’s vessels. In addition, muscles work as some kind of pumps: they facilitate the movement of arterial blood to organs and tissues, improve the outflow of venous blood and lymph. And this is all provided by nature. Movement is life. If you move little, then stagnant areas will begin to appear in the body.
6. Chronic stress and psycho-emotional stress. Yes, we can agree with this: frequent and prolonged psycho-emotional stress has a detrimental effect not only on the body in general, but also on the heart and blood vessels. Here and the excessive release of the so-called “anxiety” hormones (adrenaline, cortisol). And then: frequent stress keeps the sympathetic nervous system in tension. Namely, the sympathetic nervous system is responsible for the increase in blood pressure.
7. Age-related changes. Yes, we can agree with this statement: the elasticity of blood vessels decreases. But here the matter is most likely not in the age itself, but in the lifestyle. A simple hypothetical example to illustrate: if, for example, you are given 1 year and 10 years to implement your plan. In which case will you most likely destroy, say, a wall: in 1 year or in 10 years? The answer is obvious. That is, it is quite possible that many people manage to ruin their body with their behavior over time. Therefore, I believe that age as a cause of disease should only be taken into account.
8. Hormonal disorders. I consider this point to be completely unnecessary here: if hormonal disorders can be identified and this is a manifestation of some disease, then this is secondary hypertension. Here, the underlying disease must be treated.
9. Alcohol and smoking. Yes, this is real evil. And they are the real enemies of both the heart and blood vessels (and the entire body as a whole). This is not so much a medical issue, but a question of the awareness and responsibility of the person himself for his health. Fortunately, most people are aware of the dangers of alcohol and smoking, but unfortunately, few are afraid of it (yes, yes, we are talking about “afraid”: what you are afraid of, you avoid. And if you do not avoid it, it means you like it).

Let’s draw conclusions from the above. Things that can lead to the development of essential hypertension are better called risk factors rather than causes. And from the 9 risk factors listed earlier, we will highlight the most significant ones. These are:

1. Metabolic disorders.
2. Sedentary lifestyle.
3. Chronic stress.
4. Bad habits (alcohol and smoking).

What to do with all this?

1. Metabolic disorders. Insulin resistance occurs for various reasons, but the most common cause of insulin resistance is “bad” eating behavior. More precisely, a passion and addiction to carbohydrate foods. You should try to eat foods that do not cause strong and prolonged jumps in insulin in the blood.
2. Sedentary lifestyle. Well, many people know very well that physical inactivity is bad. It is not enough to know, you need to do it. We lift our body off the couch and onto the street: walk, jump, breathe fresh air.
3. Chronic stress: our time is full of stressful situations, but often people run after something ephemeral, ghostly. Still, health is the most important wealth. Thanks to health, we can achieve a lot.
4. Bad habits. Everything is clear here.

The mechanisms of how and why blood pressure increases will be discussed in subsequent articles. By the way, you can read about secondary hypertension here.

Be healthy!