causes of high blood pressure

Hello everyone,

Disclaimer: YANMD, I am not looking for medical advice, rather I’m looking for facts about high blood pressure using myself as the example case.

I have always been blessed with very good blood pressure, with it always registering on the low side. However my last couple of doctor visits (one month apart) has showed my bp hovering on the high side. The last reading the doc took was I believe 160/100. Doc showed done concern and had ordered A blood test and ifs putting me on some bp meds, temporary at this point.

Doc asked me some questions in an attempt to figure out what is causing the rise. One question that came up was salt intake. I told him I rarely ad salt to food, with one exception being popcorn. I had made done several days in a row about a week ago when watching movies and I did slather the corn with salt. The second possible cause he mentioned was my pain level. I’m a chronic pain patient and lately I’ve been in a bit more pain than usual. He said that thus could be a cause of the higher bp.

So my questions are, what can cause someone who had a history of good bp to suddenly start registering high? Can a heavier than journal sally intake a few says before the reading really have that much affect? What else causes high bp?

Basically, I don’t know much about high blood pressure and I’m trying to gather done information do that when I see my doctor again I understand what he us referring to. Thanks

I only know because I started watching my health some years ago in part because of some bad blood pressure readings, but all the research I’ve done suggests that there are many causes of high blood pressure and many things you can do to lower it that work for some people.

Once I started keeping a food diary (where you record all the nutrient info for foods you eat in a day over many weeks) I realized that table salt is basically negligible in terms of the food situation here in the United States. Unless you’re specifically trying to eat a small amount of sodium I would wager you average 3,000mg a day or more and possibly 5,000mg a day or more. Pretty much all restaurant food (from QSR to casual dining) is very high in sodium, pretty much all processed food is high in sodium (unless it is advertised as low sodium, in which case it may be low), and a large portion of frozen foods are very high in sodium as well. Exceptions to that last one are plain frozen produce as they tend to have little to no sodium. Canned vegetables (unless advertised as low salt) tend to be very high in sodium as that’s part of what the manufacturer is using to preserve the food. Plain frozen veggies tend to not be high in sodium because they are just relying on temperature for preservation.

Anyway, when I looked into it some years ago it was very unclear if sodium is truly the culprit in HBP…and from what I can tell conflicting studies since then have made the picture much less clear. But yes, based on my research back then an unusually high salt intake can definitely cause raised blood pressure. But so can drinking a huge amount of water and needing to urinate really badly right before getting the reading.

For me I started doing daily cardio 30m/day (which I used to do for basically my entire life as a teenager up through age 40 and stopped for 5 years out of laziness), kept sodium intake under 2500 and lost 60 pounds. My blood pressure wasn’t high after that, so I quit watching sodium so closely and it hasn’t changed since. So for me I think the return to doing cardio and shedding excess fat got my elevated blood pressure down (I was just pre-hypertensive), and since I haven’t really paid attention to sodium intake since then and my blood pressure is still fine I don’t believe I’m one of the individuals who is especially susceptible to sodium.

FWIW I tried to follow a version of the “DASH” nutrition plan at first, which basically specializes in low sodium. Also with sodium, it appears for most people you can consume a large amount of sodium as long as you also consume a large amount of potassium, and keep hydrated appropriately. Basically if you eat a lot of sodium but don’t have high blood pressure, then sodium probably isn’t actually a big concern for you. If you lower blood pressure through other means (as I did), and notice that subsequent unrestricted sodium intake has no measurable impact on blood pressure then that’s also probably indicative you don’t need to worry about your sodium intake.

By far the most likely cause of high blood pressure is ‘essential hypertension’ which often has a prominent familial component and typically starts in the 30’s. Causes of high blood pressure other than that are very uncommon with less than one percent of cases due to something else.

Assuming things such as ingestion of meds/substances that raise BP have been ruled out i.e. person isn’t taking NSAIDs (e.g. Motrin, ibuprofen, . . .), steroids, contraceptives, alcohol, cold remedies, cocaine, black licorice, stimulants (say for ADHD), then the following causes could be considered:

  1. renal artery stenosis (i.e. blocking of the artery going into the kidney)
  2. kidney disease
  3. endocrine diseases such as pheochromocytoma, Cushings Syndrome, Conn’s Syndrome, and some rarer entities
  4. coarctation of the aorta

Again, the above ‘secondary causes’ of hypertension are pretty uncommon and little in the way of investigation with respect to looking for them is needed - nothing more than a urinalysis, blood test for kidney function, and maybe potassium level. In the absence of suggestive symptoms, it is not usually indicated to look for things like Cushings or pheochromocytoma.

Menopause is another possible reason (if you’re female.)

My BP was always very low - 90 over 60 or thereabouts - but post-meno I’m about 30 points higher on both counts with nothing else, to my knowledge, changing.

Do you get nervous at the doctor? I have a touch of the old “white coat hypertension” that fades over the visit. In other words, my BP is much higher at the beginning of a visit than the end. My Dr. even put a note in my chart to always measure my BP on the way out the door.

Has there been any change in the sequence of your doctor’s visits as to when they take your blood pressure? Used to take it towards the end, now takes it first thing, or vice versa?

This. My blood pressure is usually 90something over 60something, but once my heart starting beating really fast for no reason as soon as the nurse pulled out the testing equipment and it went up to 134 over something (I forget the bottom reading now).

I also used to go to a doctor who had a nurse who freaked out once when my blood pressure was higher than normal. It was always higher than normal after that when this nurse would test it, I think because I was nervous about having high blood pressure and what her reaction would be. I was having my blood pressure tested regularly because of a medication I was on, so I think the medication was also a factor.

Also, make sure the nurse is using the correct size cuff during the reading. That can make a big difference, in my experience.

No, quite frankly I enjoy going to a my doctor. Over the years we’ve become friends and a visit to him it’s more lite visiting an old friend.

My blood pressure was well within the normal range until I had a minor heart attack. Since then it’s been on the high side and I have to take medications.

My blood pressure was very healthy, 110/60 kind of thing, every 6 months or so when I had it checked by my doctor if I was there with one of my kids. Then one time it was suddenly “dangerously high” 180 or 190 over 110 or 120. It was so sudden that my doctor suspected adrenal tumors. He immediately put me on medication and I started having all sorts of tests and going to many doctors. In the end the answer was “idiopathic hypertension” - no cause at all.

I ended up on 3 different meds for a long time but many years later I am down to one and may have to stop it soon because I am suffering bouts of postural hypotension.

All a bit of a mystery.

One of the things that has always bothered me is that when I get my blood pressure checked at the doctor it is always after I have been left for an indeterminate time sitting on a table with my back unsupported and my legs dangling. It is also a matter of chance whether the nurse will support the cuffed arm or not. There is a specific method to measuring blood pressure and it seems to me that most practitioners ignore it.

I have my own cuff and take my own measurements (many years ago I had a stethoscope and a sphygmomanometer but about 10 years ago I switched to the more convenient oscillometric variety). Fairly early in my life I was diagnosed with hypertension. I took my own readings and convinced my doctor that he had jumped the gun. Thereafter I kept a close eye on my blood pressure. About twenty years after that I did indeed develop hypertension and went on medication. BTW this is “essential” or “idiopathic” hypertension (is there a difference?).

One thing I have heard many times in my life from friends and colleagues is the phrase “I couldn’t have high blood pressure. It’s always been low!”. That doesn’t mean you don’t have it now.

Take your own readings and keep a chart (note what time of day it is). Bring the chart to your doctor. Bring your cuff to the doctor to make sure your device is reasonably accurate. When all is said and done, follow your doctor’s advice.

Having the correct size cuff is super important. I get readings more than 10mm/hg off with a too small or too large cuff… but not consistently enough off that mental gymnastics can account for it.

And ethelbert, you are so right about the need to support the arm. Last week a patient called me in a panic because her wrist cuff gave her a reading of 188/120. I was in her building with another patient, so i ran over and asked her to show me, and she was holding her arm in the air like she was saluting Hitler. With a properly supported arm, the same monitor read 118/64.

(Another reason I’m not crazy about those wrist reading monitors. Just for kicks and to demonstrate, I took her reading supported and unsupported with a manual cuff, and got 120/66 supported and 132/70 unsupported. Still a big difference, and clinically significant, but not as panic inducing a difference as with the wrist cuff.)

I had very low blood pressure for years, then I started to take eye drops for Glaucoma, one of the side effects is High Blood pressure… Now I have to take medication for high blood pressure.

I recommend folks wondering about an isolated blood pressure measurement have an assortment of pressures taken between physician visits. This may give a better idea of average or typical BPs.

The relationship between sodium intake, reduction of intake, and essential hypertension is not well defined. Some data suggests there may be differences in response to sodium intake among genetic backgrounds as well.

I had low blood pressure readings for years! Then, suddenly and unexpectedly at 57, out of the clear blue, I landed on the cardiac ward for five days after a frightening episode of hypertension urgency. It took over 5 weeks to recover from the concussion like effects on my brain. And I was exceedingly fortunate to have escaped a stroke, an aneurism, or life altering damage to my liver, kidneys or heart.

My husband has had hypertension for a few years, so our diet had already been adjusted to remove processed foods and reduce salt intake. I don’t drink coffee or alcohol, am not an ounce overweight and lead an active life, walking an hour a day, etc.

So don’t assume it’s your diet or that there is some other trigger beyond getting older, family tendency, possible genetic disposition, etc.

Most people develop high blood pressure as you have. Slowly over time, it creeps up. This is why the Dr always checks it, to catch it when it starts. 80 % of people will develop high blood pressure by the time they are 80 yrs old. Understanding and treating high blood pressure is a big piece of what extended life expectancies from around 57yrs to around 70 yrs.

Of course controlling your diet, and exercise are also an important element of the successful management of hypertension, regardless of trigger that causes the onset.