From the Guidelines
Essential hypertension is primarily caused by a combination of lifestyle factors, including high sodium intake, obesity, physical inactivity, and excessive alcohol consumption, as well as genetic predisposition and environmental factors, as supported by the most recent guidelines 1. The development of essential hypertension is a complex process involving multiple factors. Lifestyle factors play a significant role, including:
- High sodium intake, which causes fluid retention and increased blood volume
- Obesity, which increases cardiac output and peripheral resistance
- Physical inactivity, which reduces cardiovascular fitness
- Excessive alcohol consumption, which directly affects vascular tone Additionally, genetic predisposition and environmental factors, such as family history and age, also contribute to the development of essential hypertension. According to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APHA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults, various environmental exposures, including components of diet, physical activity, and alcohol consumption, influence blood pressure 1. Managing these modifiable risk factors through lifestyle changes, such as reducing sodium intake, increasing physical activity, and maintaining a healthy weight, is essential for prevention and treatment of essential hypertension, as emphasized in the guidelines 1. It is also important to note that certain medical conditions, such as diabetes, kidney disease, and sleep apnea, can also contribute to hypertension development, and periodic blood pressure screening can identify individuals who develop elevated blood pressure over time 1.
From the Research
Factors Contributing to Essential Hypertension
The development of essential hypertension is a complex process involving multiple factors. Some of the key factors include:
- Genetic predisposition: Studies have shown that genetic factors play a significant role in the development of essential hypertension 2, 3, 4.
- Environmental factors: Environmental factors such as exposure to chronic stress, obesity, alcohol and salt intake, and physical inactivity have been proposed as contributing factors to essential hypertension 5, 6.
- Lifestyle factors: Lifestyle factors such as job strain, urbanization, and education have also been linked to the development of essential hypertension 5, 6.
- Sympathetic nervous system: Overactivity of the sympathetic nervous system has been shown to play a role in the development of hypertension, particularly in its early stages 5.
- Epigenetic modifications: Epigenetic modifications, such as changes to DNA structure and non-coding RNAs, have been recognized as important factors in the development of essential hypertension 4.
- Kidney function: The primary or secondary inability of the kidney to excrete sodium at a normal blood pressure has been identified as a key factor in the pathophysiology of essential hypertension 2.
- Central nervous system and endocrine factors: The central nervous system, endocrine factors, the large arteries, and the microcirculation also have roles in the disorder 2.
Interaction of Factors
It is likely that these factors operate interactively rather than independently to promote hypertension 5. For example, environmental and lifestyle factors may operate via the sympathetic nervous system to contribute to the development of hypertension. Further research is needed to understand the complex interactions between these factors and to develop effective strategies for preventing and treating essential hypertension.