Hypertension, or high blood pressure, means that the force of blood against the artery walls is higher than recommended levels. People with a family history of hypertension are more likely to develop the condition.

In adults, typical blood pressure measures 120/80 millimeters of mercury. Almost half of all adults in the United States have high blood pressure, which puts them at risk of cardiovascular disease, including stroke and heart attack.

Certain factors increase an individual’s risk of developing hypertension, including age, weight, diet, and genetics.

Hypertension is a widespread problem affecting 47% of adults in the U.S. — a figure that amounts to 116 million people. The condition affects 50% of males and 44% of females. However, only 1 in 4 have their hypertension under control. In 2019, the condition caused or contributed to more than 500,000 deaths.

Keep reading to learn more about hypertension, including the role genetics play in its development and other potential risk factors.

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If an individual has family members with hypertension, they have an increased risk of developing the condition.

Hypertension can run in families because of shared genes, environments, and lifestyle habits. The risk increases even more if an individual with a genetic link to hypertension also engages in unhealthy lifestyle choices.

According to some research, when biological parents and grandparents have hypertension, there is a risk of the same condition occurring in their children and grandchildren. Specifically, the biggest risk is when individuals in a family develop hypertension before the age of 55 years. And this is independent of lifestyle factors, such as physical activity, alcohol intake, and a diet high in salt.

Research in twins and families has suggested that up to 30–50% of the variance in blood pressure readings could be due to family history. It seems that genes play a role in hypertension, and family members can pass these genetic traits from one generation to the next.

However, genes are only part of the reason for heredity hypertension. Another factor is that people who live in common environments may eat the same non-nutritious diet or share habits such as smoking or drinking excessive alcohol. Along with genetics, these factors increase the likelihood of developing hypertension.

If an individual has a family history of hypertension, they should understand the risk factors for the condition and reduce them wherever possible.

Doctors refer to risk factors that someone can change as modifiable. An individual can work with their doctor to lower these risk factors as much as possible. This could involve maintaining a moderate weight, eating a nutritious diet, quitting cigarette smoking if applicable, and drinking less alcohol. Research has found that adhering to a healthy lifestyle has associations with lower blood pressure, regardless of underlying genetic risk.

Besides taking these steps, a doctor may suggest regular blood pressure monitoring so they can assess and address any changes in blood pressure over time.

Hypertension can occur in people for various reasons. It is important to note that in about 95% of cases, the cause of the condition is unknown.

Health experts do not fully understand what causes primary hypertension, which they also refer to as essential hypertension. In this type, people can develop high blood pressure over time. Additionally, there is no underlying cause for this increase. In contrast, secondary hypertension can result from other disorders that increase blood pressure.

Essential hypertension is complex — many environmental and genetic factors contribute to its development. There are many genetic variations in humans that have links to essential hypertension. Examples might include genes that play a role in regulating the following:

The renin-angiotensin-aldosterone system

This plays a role in regulating blood pressure in the body. Scientists believe that genetic changes in a person might impair their body’s ability to control blood pressure, and hypertension can occur.

The lining of blood vessels, or vascular endothelium

Any changes to the genes that contribute to the typical functioning of the lining can lead to a difference in blood vessel structure and impair its abilities. Blood vessels might become narrower, which can result in high blood pressure.

Environmental factors can also contribute to the development of hypertension in some people.

Learn more about the causes of secondary hypertension.

Besides a family history of hypertension, various risk factors can increase an individual’s likelihood of developing the condition.

The lifestyle risk factors for hypertension include:

  • A non-nutritious diet: Consuming foods with a lot of sodium or salt can increase the risk of hypertension. Often, processed or fast foods are high in this mineral. Additionally, not eating enough potassium can increase blood pressure. Certain foods, such as bananas and beans, are rich in potassium.
  • Physical inactivity: Regular exercise helps the heart and blood vessels stay strong, which is important for reducing hypertension. It also helps a person maintain a moderate weight, which in turn positively affects blood pressure.
  • Obesity: The heart has to work hard to pump blood and oxygen around the body if a person has excess weight. Unfortunately, doctors also associate obesity with higher “bad” cholesterol, heart disease, and diabetes.
  • Excessive alcohol: Drinking large amounts of alcohol can increase blood pressure, so people should aim to consume alcohol moderately.
  • Tobacco use: Smoking damages the heart and blood vessels. It also increases the risk of developing high blood pressure. Carbon monoxide from cigarette smoke also reduces the amount of oxygen that blood can carry.

Other risk factors for hypertension include:

  • Diabetes: Around 6 out of 10 people with diabetes also have hypertension. They also have an increased risk of heart disease.
  • Age: The risk of hypertension increases with age. Around 9 out of 10 Americans develop the condition during their lifetime.
  • Race and ethnicity: Black people in the U.S. have an increased risk of hypertension compared with other races or ethnic groups. They are also more likely to develop it early in life. There are multiple reasons for this, including environmental factors such as discrimination, lack of healthcare access, lack of access to nutritious foods, and living in under-resourced neighborhoods.

A doctor will likely recommend lifestyle changes and medications if they diagnose someone with hypertension.

Lifestyle changes include:

  • eating a nutritious diet and reducing salt intake
  • managing body weight
  • moderating alcohol consumption
  • getting regular exercise
  • reducing stress where possible

An individual may also benefit from antihypertensive medications. They may use a single medication or combine two or more to control their blood pressure.

Depending on the individual’s overall medical health, a doctor may prescribe one or more of the following:

Learn more about blood pressure medications.

Hypertension, or high blood pressure, is a common condition that can lead to serious health complications without treatment.

Experts believe there is a link between a family history of hypertension and the condition occurring. However, many factors contribute to the risk, including lifestyle, age, race or ethnicity, and other health conditions.

Making healthy lifestyle choices, such as maintaining a moderate weight, eating a nutritious diet, and getting regular exercise, can help reduce the risk of developing hypertension. If lifestyle changes are not enough to control blood pressure, a doctor may prescribe medication.