Risk Factors for Hypertension

Non-Modifiable Risk Factors

Age >65 years is a major risk factor, with hypertension prevalence increasing substantially with advancing age 2, 3, 4
Male sex confers higher risk than female sex, though this difference diminishes after menopause 2, 3, 4
Family history of hypertension significantly increases risk, though genetic variants collectively account for only about 3.5% of blood pressure variability 2, 3, 4, 5
Early-onset menopause increases cardiovascular and hypertension risk in women 2, 3, 4
Ethnicity plays a role, with certain populations showing higher prevalence 6

Overweight/obesity affects 40% of hypertensive patients and may be responsible for up to 78% of hypertension cases in men and 65% in women 1, 2, 3, 4, 5
Increased waist circumference is an independent risk factor 2
High sodium intake is positively associated with blood pressure and accounts for much of the age-related increase in blood pressure 5
Excessive sodium consumption is independently associated with increased risk of stroke and cardiovascular disease beyond its blood pressure effects 5
Insufficient intake of potassium, calcium, magnesium, protein, fiber, and fish fats are associated with high blood pressure 5
Physical inactivity/low fitness level is a major modifiable risk factor present in a large proportion of hypertensive patients 1, 2, 3, 4
Smoking/tobacco exposure is present in 15.5% of U.S. adults with hypertension 6
Excessive alcohol consumption contributes to hypertension development 1, 2, 3, 4, 5

Diabetes mellitus affects 15-20% of hypertensive patients, and conversely, 71% of U.S. adults with diagnosed diabetes have hypertension 1, 2, 3, 4, 6
Dyslipidemia is present in 30% of hypertensive patients 1, 2, 3, 4
Metabolic syndrome affects 40% of hypertensive patients 1, 2, 3, 4
Hyperuricemia is present in 25% of hypertensive patients 1, 2, 3, 4
Chronic kidney disease affects 15.8% of hypertensive patients, and conversely, 86% of patients with CKD have hypertension 6
Chronic inflammatory diseases increase cardiovascular risk in hypertensive patients 1, 2, 3, 4
Chronic obstructive pulmonary disease is associated with increased hypertension risk 1, 2, 3, 4
Obstructive sleep apnea is a secondary cause that presents with snoring and hypersomnolence 5
Psychiatric disorders and psychosocial stressors increase hypertension risk 1, 2, 3, 4

Heart rate >80 beats/min is considered a risk factor 2, 3, 4
Left ventricular hypertrophy detected on ECG indicates hypertension-mediated organ damage 2, 3, 4

Primary aldosteronism presents with hypokalemia, muscle cramps, and weakness 5
Pheochromocytoma causes blood pressure lability, episodic pallor, and dizziness 5
Cushing's syndrome presents with central obesity, facial rounding, and easy bruisability 2, 5
Hyperthyroidism causes weight loss, palpitations, and heat intolerance 5
Nonsteroidal anti-inflammatory drugs elevate blood pressure 5
Cocaine and amphetamines cause hypertension 5
Corticosteroids and calcineurin inhibitors raise blood pressure 5

More than 50% of hypertensive patients have additional cardiovascular risk factors, with multiple risk factors present proportionally increasing the risk of coronary, cerebrovascular, and renal diseases 1, 2, 3, 4
Among U.S. adults with hypertension, 41.7% have a 10-year coronary heart disease risk >20% 6
Poor diet, physical inactivity, and excess alcohol consumption, alone or in combination, are the underlying cause of a large proportion of hypertension, yet these modifiable factors are often inadequately addressed in clinical practice 5