No matter whether you have hypertension or not, it is important for everyone to understand the risk factors of hypertension and try to reduce or avoid these risk factors to reduce the chances of developing hypertension. When you confirm that your blood pressure is elevated, it is even more important to identify and analyze the causes and risk factors of hypertension. Only by recognizing the potential risk factors that can lead to hypertension can we better prevent and control hypertension. Although we have a superficial understanding of the dangers of hypertension in our daily lives, many people know that overweight individuals are more prone to hypertension, but this understanding alone is not enough. The second lesson on the prevention and treatment of hypertension helps us understand which people are more likely to develop hypertension and need to be vigilant, as well as the classification of hypertension.
High Blood Pressure in Different Populations: Smoking, Drinking, and Emotional Stress
To understand the risk factors leading to hypertension, we first need to know which populations are more prone to hypertension. Among the following six categories of people, which do you think are the high-risk populations for hypertension? Obese individuals, smokers and drinkers, long-term tea drinkers, people with a family history of hypertension, menopausal women, and those under emotional stress.
In long-term clinical observations, experts have found that obesity, smoking, genetic factors, menopause, and heavy taste (high salt consumption) are all risk factors for hypertension. Let's analyze these factors separately.
Firstly, genetic factors. There are many people with a family history of hypertension, and studies have shown that genetic factors account for 30% to 40% of blood pressure variation. Hypertensive patients are more likely to have a family history of hypertension, and the blood pressure levels of their direct relatives are higher than those of non-direct relatives of the same age. Children with both parents having hypertension have a higher risk of developing hypertension. The probability of developing hypertension for children whose parents have normal blood pressure is only 3%, while the probability is 45% for children whose parents have blood pressure higher than normal. The heritability coefficient of hypertension-related factors in monozygotic twins can reach 55%.
The above information indicates the importance of genetic factors and suggests that people with a family history of hypertension should take preventive measures from childhood. These measures include reducing salt intake, drinking less alcohol, participating in appropriate physical exercise, controlling diet, avoiding excessive obesity, avoiding excessive mental stress, and undergoing regular annual check-ups to detect blood pressure abnormalities early and provide timely and effective treatment.
Another factor is age. As people age, their blood pressure gradually increases. Statistics show that patients under 40 years old account for only about 10% of the total number of patients, while patients over 40 years old account for about 90% of the total number. Early statistics on hypertension in China showed that the incidence rate was 0.86% for patients aged 4-14, 3.11% for patients aged 15-20, 3.91% for patients aged 20-29, 4.95% for patients aged 30-39, 8.60% for patients aged 40-49, 11.38% for patients aged 50-59, and 17.23% for patients aged 60-69. It can be seen that the incidence rate increases significantly after the age of 40.
The influence of obesity on blood pressure is also evident. Excessive fat storage in the body not only makes people bloated and clumsy, but also increases the burden on the heart and other organs, leading to hypertension, heart disease, and other conditions.
Obesity is an important factor in the rise of blood pressure. Follow-up studies over the past decade have found that at least 60% of overweight individuals have hypertension, and the incidence of hypertension in obese individuals is three times higher than that in people of normal weight in the same age group. The incidence rate of hypertension in overweight individuals is four times higher than that in individuals of normal weight, and the incidence rate is 3.6 times higher in individuals with a family history of hypertension and normal weight. When both obesity and a family history of hypertension are present, the incidence rate of hypertension is 13 times higher than that in individuals of normal weight. The incidence of hypertension increases in overweight individuals, especially in young people (20-30 years old), where the incidence rate of hypertension is twice as high as that in non-obese individuals. In individuals aged 40-60, the incidence rate of hypertension in obese individuals is 1.5 times higher than that in individuals of normal weight.
The incidence of hypertension and cardiovascular diseases increases with the increase in body weight, especially in men. When men are overweight by 25% compared to normal levels, their systolic blood pressure increases by 18%. When their body weight decreases to 75% of normal levels, their systolic blood pressure decreases by 10%.
Overweight individuals also have a slight increase in blood cholesterol levels and are more prone to atherosclerosis on the basis of hypertension. The occurrence of stroke and coronary heart disease is also increased in obese individuals. When middle-aged men exceed 30% of their body weight, the incidence of sudden death and angina is five times higher than that in individuals of normal weight, and the incidence of stroke is eight times higher. Obesity and hypertension are both risk factors for cardiovascular diseases, and the risk is even greater when both are present. Additionally, obesity, hypertension, diabetes, hyperlipidemia, and coronary heart disease are a group of interconnected and causative diseases, known as the "five-disease syndromes" or "quintet". Once these five diseases join forces, the consequences can be imagined, and obesity is often the "pioneer" of this "quintet".
Smoking and excessive alcohol consumption are also risk factors for hypertension. Modern medicine considers nicotine in tobacco to be the main factor causing hypertension. After nicotine in tobacco enters the bloodstream, it can stimulate the release of a large amount of catecholamines from the heart and adrenal glands, causing increased heart rate, vasoconstriction, and elevated blood pressure. Research has shown that smoking a cigarette can increase systolic blood pressure by 10-25 mmHg. Long-term heavy smoking can cause sustained contraction of small arteries, smooth muscle degeneration in the walls of small arteries, gradual thickening of the vascular intima, and thickening of the walls of small arteries, leading to systemic arteriosclerosis and exacerbating hypertension.
Furthermore, nicotine can increase the secretion of adrenaline. Adrenaline can not only constrict small arteries but also mobilize subcutaneous fat into the bloodstream, leading to an increase in cholesterol and low-density lipoprotein in the blood and a decrease in high-density lipoprotein. Therefore, it can exacerbate the occurrence and development of arteriosclerosis. Nicotine can also increase blood viscosity and slow down blood flow. Smoking can also affect the metabolism of blood sugar and blood lipids, promote blood clot formation, and thus contribute to the occurrence of cardiovascular diseases.
Excessive alcohol consumption has been proven to be an independent risk factor for hypertension through numerous epidemiological studies. Studies conducted by medical experts in Sweden, the United States, and the United Kingdom have found a clear positive correlation between excessive alcohol consumption and the incidence of hypertension. This relationship between alcohol consumption and hypertension persists even after controlling for variables such as age, gender, body mass index (BMI), and smoking. The results of a hypertension sampling survey in China show that the prevalence of hypertension in the alcohol-drinking group is 39.9% higher than that in the non-drinking group, and there is a dose-response relationship between alcohol consumption and blood pressure levels. After controlling for alcohol consumption, blood pressure levels can significantly decrease.
As women age and enter menopause, they may also develop hypertension and other conditions. Inactive individuals who lack physical labor may also develop hypertension and its complications.
In addition, a factor that has received attention recently is sleep. Lack of sleep and sleep apnea are also risk factors for hypertension. Whether it is brief respiratory cessation during nighttime sleep or falling asleep immediately after lunch, both can trigger hypertension. For a long time, although many people despise snorers, they would only think that these people have bad habits and generally not consider them as having a disease. In fact, this condition has only recently gained attention in the medical field and has been recognized as a separate disease. Many years ago, if you went to see a doctor because you wanted to treat snoring, you would probably be sent home with the answer, "Snoring is not a disease, no need to see a doctor."
Nowadays, it is clear that snoring (obstructive sleep apnea) is indeed a disease. Patients with obstructive sleep apnea syndrome wake others up during sleep when they are young, which affects relationships with classmates, friends, or spouses and may even lead to divorce. They often feel drowsy during the day and have low work efficiency, which may result in job loss. In middle and old age, people who have been suffering from this condition for a long time may experience arrhythmias, myocardial infarction, stroke, and even "failure to wake up from sleep" and die during sleep. Therefore, using the saying "toothache is not a disease, but it can be deadly when it hurts" as an analogy, "snoring is not a disease, but it can be deadly when it occurs!" According to surveys, more than 50% of patients with obstructive sleep apnea syndrome also have hypertension, and 30% of primary hypertensive patients have obstructive sleep apnea syndrome.
Emotional stress is also a common risk factor for hypertension. We often see elderly people in movies or in real life who feel dizzy when they become excessively agitated. This shows that emotional stress has a significant impact on blood pressure.
[Case Study]
Mrs. Xu is a very emotional person. We invited her specifically to help us with blood pressure testing. Her blood pressure is normally 120/80 mmHg. We showed her a touching scene from a TV drama and interrupted her during her most emotionally charged moment to measure her blood pressure. At that time, her blood pressure reading was 130/85 mmHg.
[Analysis]
From this case, we can see that emotional stress can indeed increase blood pressure. Mrs. Xu in our case is a person with normal blood pressure. If it were a hypertensive patient, excessive emotional stimulation could lead to fainting and accidents. If a person is exposed to these factors, their likelihood of developing hypertension is higher than that of the general population. If their parents happen to have hypertension, their likelihood of developing hypertension is even greater.
