Understanding High Blood Pressure: Causes and Risks
Amilcar Rios Reyes
System Platform in Cuzco (Peru)
“Many people say that they consider health as a priority in their life, but smoke, drink too much, and do not pay attention to what they eat.”
Dr. Lair Ribeiro – from his book: Increase Your Self-Esteem.
What is High Blood Pressure (HBP)?
It is a systemic disease characterized by chronically elevated blood pressure above normal values.
Traditionally, it is considered Hypertension (HTA) when blood pressure numbers are equal to or greater than 140 mmHg systolic blood pressure (SBP) and 90 mmHg diastolic blood pressure (DBP).
It is a systemic disease because it affects various body organs, primarily affecting the heart, kidney, arteries, eyes, and brain. Doctors refer to these organs as target organs that are affected by hypertension.
How do you Classify High Blood Pressure?
Perhaps it is difficult for the patient to understand the different classifications of blood pressure. Here, we describe two of the most important rankings in the world of medicine: the American classification (Table No. 1) and the European classification (Table No. 2).
Table No. 1 – Reference Values of Blood Pressure (In, The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure – JNC 7, U.S.)
| Category* | SBP (mmHg) | DBP (mmHg) |
| Normal | <120 | and <80 |
| Prehypertension | 120-139 | or 80 to 89 |
| Hypertension: | ||
| – Stage 1 | 140-159 | or 90 to 99 |
| – Stage 2 | greater than or equal to 160 | or greater than or equal to 100 |
* It is classified as the highest value of SBP or DBP
Table No. 2 – Reference Values for Blood Pressure (In, The European Society of Hypertension)
| Category* | SBP (mmHg) | DBP (mmHg) |
| Optimal | <120 | <80 |
| Normal | 120-129 | 80 to 84 |
| Normal-high | 130-139 | 85-89 |
| Hypertension: | ||
| – Grade 1 | 140-159 | 90 to 99 |
| – Grade 2 | 160-179 | 100-109 |
| – Grade 3 | greater than or equal to 180 | greater than or equal to 110 |
* It is classified as the highest value of SBP or DBP, i.e., when SBP and DBP fall into different categories, the higher category will be applied.
These classifications are intended to guide physicians toward choosing prevention or treatment for our patients.
What are the Causes of High Blood Pressure?
In 90% of cases, we do not know the causes; we call it primary or essential hypertension.
In 10% we find the causes, we call it Secondary Hypertension.
The following are identifiable causes of secondary hypertension:
- Sleep apnea
- Drugs: corticosteroids, NSAIDs, some oral contraceptives, cyclosporine, tacrolimus, some antidepressants
- Renal diseases: glomerulonephritis, kidney tumors, polycystic disease, renal vascular stenosis
- Hormonal disorders: pheochromocytoma, Cushing’s syndrome, primary hyperaldosteronism, thyroid diseases, diseases of the parathyroid
- Consumption of psychoactive substances: cocaine, alcohol, amphetamines, etc.
- Coarctation of the aorta
What Risk Factors are Involved in the Development of Cardiovascular Disease in Addition to HTA?
It is important to know the risk factors for cardiovascular disease because cardiovascular disease is one of the leading causes of death in all countries.
Major risk factors, and therefore extremely important in the development of cardiovascular disease, include:
- HTA
- Smoking
- Obesity (body mass index greater than or equal to 30 kg/m2)
- Physical inactivity
- Dyslipidemia (high cholesterol or high triglycerides)
- Diabetes Mellitus
- Microalbuminuria (loss of albumin above the normal values in urine, which may go unnoticed, but when diagnosed is an indicator of renal severity)
- Age > 55 for males and 65 for women
- Family history of premature cardiovascular disease (having relatives with the disease: males under 55 and women under 65 years)
In this case, if there are factors associated with hypertension, there will be a greater likelihood of developing cardiovascular disease in the near future. As you will notice, only age and family history are risk factors beyond our control.