More often than not we do not know why somebody has high bloodpressure. Medical science is progressing but we still refer to most cases of high blood pressure as ‘essential or primary hypertension’. If we really find a cause, we call it secondary hypertension and for this last group often a more permanent treatment is available.
Essential hypertension
90% of all hypertensive patients suffer from ‘essential hypertension’. The causes, albeit unknown, are likely to be a complex combination of genetic, environmental, and other factors. This type of bloodpressure problem is most commonly treated with lifestyle modifications and medication if that is not sufficient
Genetic factors: a number of these have been identified in essential hypertension. Experts think that some of our chromosomes (the cellstructures where our genetic information is stored), namely nr 13 and 18, house the genes responsible for blood pressure regulation. These genes interact with a hormonal system called the renin-angiotensin-aldosterone system (RAAS). See also under medication: ACE inhibitors. This system influences all aspects of blood pressure control, including making the bloodvessels contract, arrange sodium and water shifts in the body and cell development in the heart. Interestingly, and also showing that genetic factors play an important role, is the finding that healthy children of a parent with essential hypertension frequently have an abnormal salt handling by the kidneys. They may never get hypertension in their life, but risk factors like smoking, overconsumption of alcohol and overweight may trigger high blood pressure.
Insulin resistance and Type 2 Diabetes: Hypertension is strongly associated with diabetes, both type 1 and 2. Kidney damage becomes even more likely if diabetes and hypertension exist together. Type 2 diabetes is caused by insulin resistance. in contrast to type 1 diabetes, where no insulin can be found in the blood, these patient have an overproduction of insulin. The cells of our body do not know how to handle the insulin and we find high levels of this hormone. This very frequently goes together with hypertension.
