Introduction.
When a health checkup indicates that your blood pressure is high, many people may wonder why your blood pressure has become high.
When it comes to high blood pressure, it is often thought of as caused by excessive salt intake, lack of exercise, and stress. However, in reality, various factors are involved.It may also be caused by other conditions such as hormone abnormalities or sleep apnea syndrome.
In the treatment of hypertension, it is important not only to lower the blood pressure but also to consider the underlying cause.
This article explains the causes of high blood pressure and the tests used to diagnose it.
There are two main causes of high blood pressure:
High blood pressure is divided into two types depending on the cause: primary hypertension and secondary hypertension.
| ① Primary hypertension | ② Secondary hypertension |
|---|---|
| High blood pressure is caused by multiple factors, including lifestyle habits and body type. Excessive intake of salt • Obesity and lack of exercise • Alcohol consumption, stress, and lack of sleep • Genetics and aging | High blood pressure caused by certain diseases or medications • Diseases of the adrenal glands or thyroid gland • Sleep apnea syndrome • Kidney disease |
Most cases of high blood pressure are caused by factors such as lifestyle and genetics. In contrast, in the case of secondary high blood pressure, treating the underlying disease can significantly improve blood pressure.
Let's take a closer look at the causes of each one.
① Primary hypertension: High blood pressure related to lifestyle and genetics
Primary hypertension is the type that accounts for the majority of high blood pressure. It is not caused by a single cause; rather, multiple factors combine to cause elevated blood pressure.
Excessive intake of salt
Excessive intake of salt makes it easier for water to accumulate in the body, causing blood pressure to rise.
For those with high blood pressure,Reduce salt intake to less than 6 g per dayIt is recommended. However, I don’t think many people are aware of how much salt they are actually consuming.
There are also methods to estimate salt intake through urine testing, which can be used as a reference when reviewing your diet.
Obesity and lack of exercise
In particular, increased visceral fat affects the function of the sympathetic nervous system and hormones that regulate blood pressure, causing blood pressure to rise. Moderate exercise and weight loss may improve blood pressure.
Alcohol consumption, stress, and lack of sleep
Excessive drinking, chronic stress, and lack of sleep also have a negative effect on blood pressure. When the sympathetic nervous system becomes active due to stress, blood pressure temporarily rises.
Genetics and aging
Hypertension is also related to genetic factors. Additionally, aging can also lead to a decrease in the elasticity of blood vessels, which is another reason for elevated blood pressure.
② Secondary hypertension: High blood pressure caused by illness or other factors
Secondary hypertension is a type in which blood pressure rises due to specific causes such as hormone abnormalities or kidney disease.
By properly treating the underlying disease, blood pressure may improve or lowering medication may be reduced.
What causes secondary hypertension?
Typical causes include the following:
| Categories | Main causes of disease |
|---|---|
| Kidney disease | Chronic kidney disease, renal artery stenosis, etc. |
| Diseases of the adrenal gland | Primary aldosteronism, Cushing syndrome, and brown cell tumor |
| Other hormone abnormalities | Hyperthyroidism/hypothyroidism, hyperthyroidism of the parathyroid gland, and giant hyperparathyroidism |
| Diseases related to sleep | sleep apnea syndrome |
| Due to medication | Some painkillers, steroids, and herbal medicines containing licorice, etc. |
| Other | Arterial stenosis, a rare genetic disease, etc. |
Particularly,People who develop high blood pressure at a young age, those who experience sudden increases in blood pressure, and those who find it difficult to lower their blood pressure even when using multiple medicationsTherefore, it is important to consider the possibility of secondary hypertension.
There are various causes of secondary hypertension, such as the one described above. However, we would like to introduce a little more about the disease that you should be aware of, specifically.
Primary aldosteronism
Primary aldosteronism is a condition in which the adrenal gland overproduces the hormone aldosterone.
Aldosterone has the function of retaining salt and water in the body, and when excessive amounts are present, it can cause high blood pressure.
It is said to affect about 5 to 10% of people with high blood pressure, and it is by no means an uncommon disease.
It is known that people with high blood pressure are at a higher risk of developing conditions such as stroke and heart disease, and early detection is important.
Measuring aldosterone and renin levels in blood tests is the first step in the diagnosis.
Thyroid disease
Thyroid hormones regulate the body's metabolism and the function of the heart.
When thyroid hormones are excessive due to conditions such as Graves' disease, blood pressure may rise along with palpitations and an increased pulse rate.
On the other hand, hypothyroidism can also cause high blood pressure, and in particular, the systolic blood pressure tends to rise.
If thyroid disease is suspected, blood tests are performed to check for thyroid hormones and TSH.
Sleep apnea syndrome (SAS)
Sleep apnea syndrome is a condition in which breathing stops repeatedly during sleep.
When oxygen is not available during sleep, the sympathetic nervous system becomes active, making it easier for blood pressure to rise.
In particular, caution should be exercised with the following groups of people:
- I snore a lot
- There is a strong drowsiness during the day
- My blood pressure is high in the morning
- Even when taking the medicine, the blood pressure does not seem to drop.
Sleep apnea syndrome can be detected through sleep tests that can be performed at home.
Kidney disease
The kidneys play an important role in excreting salt and water, and in regulating blood pressure.
When kidney function declines due to chronic kidney disease, blood pressure may rise. There is also a condition called “renal vascular hypertension,” in which the renal arteries, which carry blood to the kidneys, become narrowed.
Evaluation is performed through blood tests, urine tests, and, if necessary, imaging tests.
Tests to determine the cause of high blood pressure
In the treatment of hypertension, it is important to assess not only blood pressure levels but also lifestyle habits and other potential causes of the disease as a whole.
At Ikiridobashi Serra Clinic, depending on the patient's condition, we combine the following tests:
Estimated intake of salt
The urine test estimates the amount of salt consumed per day. Although the estimated value is subject to error, it can be used to review your diet and provide specific advice on reducing salt intake.
Hormone testing
We measure aldosterone, renin, thyroid hormones, and other substances to check whether high blood pressure caused by endocrine disorders is not hidden.
Tests for sleep apnea syndrome
In those who experience snoring or daytime drowsiness, a sleep test that can be performed at home assesses the breathing patterns during sleep.
Blood tests and urine tests
We examine kidney function, electrolyte levels, and whether you have diabetes or lipid abnormalities, and determine the cause of high blood pressure and the risk of complications.
Not everyone needs the same tests. We select the tests that are necessary based on age, blood pressure level, symptoms, and previous treatment history.
Summary: In addition to lowering blood pressure, let’s also focus on the causes.
The causes of high blood pressure can be broadly divided into “essential hypertension,” which is related to lifestyle and body type, and “secondary hypertension,” which is caused by specific diseases.
There may be hidden illnesses that can be treated, such as primary aldosteronism, thyroid disease, and sleep apnea syndrome.
By investigating the cause in detail, we can provide treatment tailored to each individual and help them improve their lifestyle habits.
At Ikiridashi Serara Clinic, we utilize the specialized perspectives of the Internal Medicine Department of Diabetes and Lifestyle Diseases and the Thyroid and Endocrine Diseases Department to provide care that not only manages blood pressure but also addresses the underlying causes.
If you have been diagnosed with high blood pressure during a health checkup, find it difficult to lower your blood pressure with medication, or would like to learn more about the causes of high blood pressure, please feel free to contact us.