High blood pressure means the force of blood flowing through your arteries is greater than it should be. If not controlled, it could damage your blood vessels and cause other health problems.

High blood pressure (hypertension) tends to be a condition we associate with being too sedentary or getting older. But high blood pressure can also be a genetic condition, affecting people who are otherwise fit and healthy.

A parent with high blood pressure can pass along a gene to a child, raising that person’s risk of developing hypertension one day. Familial hypertension may also result from a family lifestyle that includes high blood pressure risk factors, such as smoking or an unhealthy diet.

Blood pressure is the force of circulating blood against the inner wall of your arteries. It’s measured in millimeters of mercury (mm Hg) and is presented as two numbers:

  • The first (top) number is the systolic pressure, which is the pressure inside the artery walls during a heartbeat.
  • The second (bottom) number is the diastolic pressure, which is the pressure when the heart is at rest.

According to the American Heart Association, healthy blood pressure is a systolic pressure of less than 120 mm Hg and a diastolic pressure of less than 80 mm Hg. This is a blood pressure of less than 120/80 mm Hg.

If your blood pressure is higher than that, doctors consider you to have elevated blood pressure or stage 1 or 2 hypertension.

AssessmentSystolic pressure (mm Hg)Diastolic pressure (mm Hg)
healthyless than 120andless than 80
elevated120–129andless than 80
stage 1 hypertension130–139or80–89
stage 2 hypertension140 or greateror90 or greater

Risk factors for high blood pressure include a family history of hypertension, as well as:

  • excessive alcohol consumption
  • high sodium diet
  • little or no physical activity
  • obesity
  • smoking
  • stress
  • insufficient sleep

What makes high blood pressure so dangerous is that it can exist for a long time without presenting any obvious symptoms. Measuring your blood pressure is the only way to know if you have hypertension.

In extreme cases, when blood pressure exceeds 180/120 mm Hg, you have a medical emergency known as a hypertensive crisis. Symptoms can include:

  • severe headache
  • chest pain
  • nausea
  • shortness of breath
  • fainting and becoming unresponsive

Research from 2017 suggests that high blood pressure results from a combination of factors, including genetic, environmental, and behavioral components.

Unlike some diseases with only one or a few genes as risk factors, familial hypertension can result from variations in hundreds of different genes, according to a 2019 study of more than 750,000 individuals. This makes it difficult to pinpoint specific genes that could be treatment targets.

The Centers for Disease Control and Prevention (CDC) also notes that families may affect a person’s hypertension risk because of the home environment.

Smoking or even breathing in secondhand smoke can raise blood pressure risks. A diet high in sodium and saturated fat may also cause a blood pressure increase. If physical activity and good sleeping habits aren’t part of a family dynamic, blood pressure can also be negatively affected.

Does familial hypertension affect some groups of people more than others?

A 2021 study examining how sex differences may affect the genetic risk for hypertension suggests that the effects of genes may be greater in women than in men. Beyond this, men and women are at equal risk for hypertension, though men tend to develop it at a younger age.

Research from 2019 notes that the prevalence of hypertension among African Americans is higher than in other ethnic or racial groups in the United States. A variation in the ARMC5 gene may help explain why.

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Monogenic hypertension refers to blood pressure caused by one genetic variant inherited from a parent. Monogenic hypertension accounts for about 30 percent of hypertension cases. Most of those are associated with imbalances of electrolytes, such as potassium.

There are several types of monogenic hypertension syndromes, each with a unique set of origins and symptoms. These include:

Knowing about your family medical history is important for many reasons. A history of certain cancers, for example, may determine when you get screened for those cancers. If high blood pressure runs in your family, it’s important to share this information with your doctor and regularly monitor your blood pressure.

One way to organize information about your family health history, as well as your own, is to use My Family Health Portrait, an online tool created by the National Institutes of Health. You can gather your family medical history, share it with other relatives, and learn about your risk levels for conditions that tend to run in families.

Lifestyle changes

If your blood pressure is currently at a healthy level, you can make several key lifestyle adjustments to lower the odds of it rising too much. If your blood pressure is higher than usual, these steps, along with medications, may help you bring it back down to a healthy range:

  • maintaining a moderate weight
  • limiting the amount of alcohol you drink
  • staying physically active
  • avoiding smoking

Dietary changes

The National Heart, Lung, and Blood Institute developed the Dietary Approaches to Stop Hypertension (DASH) eating plan as a heart-healthy eating strategy.

This plan focuses on managing blood pressure by emphasizing fruits, vegetables, whole grains, lean proteins, and sodium reduction. It’s also flexible enough to let people enjoy many of their favorite foods.

Better sleep

Sufficient sleep is essential to good overall health, especially for brain and heart function. Blood pressure is especially susceptible to problems related to poor sleep.

A 2022 study suggests that frequent sleep disturbances and short sleep, or less than 5, 6, or 7 hours, can contribute to hypertension.

Taking steps to improve sleep duration and quality may improve more than just your cardiovascular health. It can also improve your mood, concentration, energy, metabolism, and more.

What puts me at higher risk for hypertension — genetics or lifestyle factors?

Despite considerable research into the causes of high blood pressure, there is still a lot that scientists are learning about the factors that influence hypertension risk.

A 2018 review of studies suggests that the impact of hereditary factors is anywhere from 20 to 55 percent. However, a 2017 study suggests that regardless of a person’s genetic predisposition, a heart-healthy lifestyle can significantly lower the risk of high blood pressure.

This means that even if you inherited a gene that raises your hypertension risks, a lifestyle consisting of regular aerobic exercise, no smoking, and a low sodium diet could help offset the inherited risks.

While you should take a family history of high blood pressure seriously, you are at even greater risk of hypertension and its related health complications if you engage in lifestyle factors that negatively influence heart health.

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Hypertension is a major risk factor for cardiovascular disease, the leading cause of death in the United States. High blood pressure is also a leading cause of stroke and a risk factor for chronic kidney disease and other health problems.

If your family medical history includes high blood pressure, start taking steps to lower your risk through heart-healthy behaviors. Even if you don’t know your family history or don’t have a close relative with hypertension, it’s still important to take steps to keep your blood pressure under control.

There’s a variety of anti-hypertensive medications that can help. But these medications don’t take the place of a healthy diet, exercise, and getting plenty of sleep to help maintain a healthy blood pressure.