Wondering what really causes high blood pressure? You may be surprised to know the medical facts. Unfortunately, most physicians put you on a blood pressure medicine the moment they detect your blood pressure to be elevated. Often there is no discussion about the causes of high blood pressure. When your blood pressure stays elevated despite one blood pressure medicine, your physician will likely add another medicine. Most people end up on three or even four blood pressure medicines with the passage of time.
You cannot manage your hypertension effectively unless you fully understand what causes high blood pressure to begin with, right?
Ok, so let’s dive in and discuss what causes hypertension.
What Causes High Blood Pressure (Hypertension)?
Main causes of high blood pressure:
- Lack of exercise
- Vitamin D deficiency
- Family history
- Rare endocrine causes: Aldosteronism, Pheochromocytoma, Cushing’s Syndrome
The Relationship Between High Blood Pressure and Obesity
Individuals with hypertension usually also have obesity, low HDL cholesterol, high triglycerides, and impaired glucose tolerance or diabetes. This constellation of metabolic disorders was first described as Syndrome X by a famous endocrinologist, Dr. Gerald Reaven. His findings were published in Diabetes in 1988.
Insulin Resistance is the underlying metabolic defect in these individuals. Therefore, this syndrome is also known as Insulin Resistance Syndrome. More recently, it has also been called Metabolic Syndrome. It is unfortunate that the same syndrome has been given three different names as it just causes more confusion. It is my hope, that as more people learn about this syndrome, we will start to stick with one name. I have chosen to refer to it as Insulin Resistance Syndrome because I think it best describes the disease process.
Insulin resistance is present in the majority of individuals with high blood pressure. This association between insulin resistance and hypertension has been shown in several excellent studies.
One such study was published in 1987 in the New England Journal of Medicine. This study clearly provided the evidence that hypertension is an insulin resistant state.
In another study, published in 1986 in the Journal of Clinical Endocrinology & Metabolism, researchers found that the plasma insulin response to a glucose challenge in a glucose tolerance test was twice as high in individuals with hypertension and obesity as in the control subjects, indicating that these individuals were clearly insulin resistant. Systolic blood pressure was directly correlated to the two hours plasma insulin level. In other words, the more severe the insulin resistance, the higher the blood pressure.
In another recently published study, insulin resistance was carefully measured in patients with hypertension and it was found to be present in all of these individuals.
Several other studies have found high insulin levels to be associated with a risk for hypertension.
A high insulin level causes high blood pressure by the following mechanisms:
- It causes thickening of the walls of the arteries, which then become stiff. There is increased resistance to blood flow through these stiff blood vessels, which leads to an increase in blood pressure.
- It causes retention of sodium and water from the kidneys, which then leads to high blood pressure.
- It stimulates the sympathetic nervous system, which causes constriction of blood vessels, which then leads to high blood pressure.
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