What Causes Hypertension? Diet Plays a Huge Role

It's a common question: What causes hypertension? Typically, a combination of factors comes into play, from processed foods and a sedentary lifestyle to smoking and stress.

what causes hypertension

Combining two hypertension drugs at a low doses may be just as effective as taking a full dose of one drug, according to a recent study.

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Hypertension, also known as high blood pressure, occurs when the force at which your blood presses against the inside of your arteries is too great. Over time, hypertension can increase your risk for cardiovascular problems such as heart disease, stroke, and heart attack, as well as damaging your kidneys. But what causes hypertension?

Hypertension can be one of two types: primary or secondary. Primary hypertension occurs gradually over time without a known cause. Secondary hypertension may develop due to kidney or thyroid diseases, a congenital defect, certain medications (prescriptions, birth control pills, cold remedies, and over-the-counter pain relievers), chronic alcohol use, adrenal gland tumors, or obstructive sleep apnea, among other factors. This type of hypertension usually develops more quickly.

Lifestyle choices such as excessive alcohol intake, smoking, and stress may also be what causes hypertension. Reducing alcohol and tobacco use as well as managing stress through yoga, meditation, or increased physical activity may help reduce blood pressure.


  • Choose products labeled “low sodium” at the supermarket; this label ensures the food has less than 140 mg of sodium per serving.
  • Replace salt with herbs, spices, or lemon when cooking at home.
  • Ask for low-sodium options when dining out.
  • Compare labels on food packages; sometimes, very similar items have vastly different sodium levels.

Diet is the Answer to What Causes Hypertension

To lower your blood pressure, decrease your sodium (salt) and increase your potassium. These two minerals have opposite effects on your blood pressure.

“High sodium intake increases your blood pressure, while potassium helps lower it,” says Jenna Rosenfeld, MS, RD, CDN, CNSC, a dietitian at Weill Cornell. “Highly processed foods, such as snack foods, pizza, breads and rolls, canned soups, premade sauces and condiments, processed meats, frozen meals, and fast foods, are some of the most common sources of dietary sodium. Bananas, spinach, tomatoes, avocados, beans, and dairy products are good sources of potassium.”

Sodium Recommendations

The American Heart Association recommends that adults limit their salt intake to 2,300 milligrams (mg) per day, the equivalent of about one teaspoon of table salt. If you already have high blood pressure, kidney problems, or other health concerns, your doctor may recommend limiting your salt intake further. Recent research estimates that most Americans consume between 3,400 mg and 4,000 mg of sodium per day. However, don’t cut out all sodium; research indicates that overly restricting sodium intake is not healthy either. Sodium is necessary for many functions in the body and should be consumed in moderation (between 1,500 and 2,000 mg per day).

“The easiest way to reduce your sodium intake is by replacing highly processed foods with fresh foods. For example, instead of eating canned soup, make your own bean or vegetable soups. The vast majority of salt in Americans’ diets comes from processed foods, not your salt shaker at home, so increasing fresh foods and home-cooked meals can reduce salt intake drastically,” says Rosenfeld.



Jonathan Wanagat, MD, PhD, Assistant Professor, Division of Geriatrics at UCLA and editor-in-chief of UCLA Healthy Years, addresses a reader question.

Q: What is metabolic syndrome?

A: This refers to a group of risk factors that increases your risk for heart disease and other health problems, such as diabetes and stroke. A patient is diagnosed with metabolic syndrome when three of the following five conditions occur:

  • The first risk factor is a large waistline, which is also referred to as abdominal obesity. In general, it means that a woman’s waistline exceeds 35 inches and a man’s, more than 40 inches. Excess weight in the waistline puts you at greater risk for heart disease versus excess weight in other parts of the body, such as the hips.
  • Having a high triglyceride level (or being treated for it) is a second risk factor. Triglycerides are a type of fat in the blood that also increase heart disease risk and other conditions.
  • Third, a low HDL cholesterol level is a risk factor because HDL helps remove fat from the blood. Taking medications for low HDL is also considered a risk factor because that condition exists.
  • High blood pressure (or taking medications to control it) is the fourth risk component of metabolic syndrome. Blood pressure that stays high can damage the heart and also lead to a buildup of plaque.
  • Finally, the fifth metabolic syndrome risk factor is a high fasting blood sugar number (or being on medicine for it). High blood sugar, even if it’s mild, is an early warning sign of diabetes.

These risk factors don’t generally have obvious signs, except for abdominal obesity, which can be readily seen and measured. Diagnosis is based on a physical exam and blood tests. You can prevent metabolic syndrome with a healthy lifestyle, meaning eat healthfully, exercise, and don’t smoke.

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Dawn Bialy

Dawn Bialy has been executive editor of Weill Cornell Medicine’s Women’s Health Advisor newsletter since 2007. Bialy also has served as managing editor for a variety of special health reports, … Read More

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