Doctors do not know what causes high blood pressure in 90 to 95 percent of people who have it. In about 10 percent of patients, the disease can be traced to specific causes: heredity, kidney abnormalities, adrenal gland tumors, diabetes, chronic kidney disease, hormone abnormalities, use of birth control pills, pregnancy or a congenital narrowing of the aorta. Other possible causes of higher blood pressure are weight gain and decreased physical activity in winter. The nicotine in cigarettes and other tobacco products causes your blood vessels to constrict and your heart to beat faster, which temporarily raises your blood pressure. In some people, alcohol causes blood pressure to rise quite a lot.
The key for any high blood pressure treatment is to bring the condition under proper control. Treatment depends on how high your blood pressure is, whether you have other health problems such as diabetes, and whether any organs have already been damaged. Treatment begins with changes you can make to your lifestyle to help lower your blood pressure and reduce your risk of heart disease. You want to achieve your treatment goal, but sometimes it seems your blood pressure just doesn't want to budge. You and your doctor can carefully review your treatment and lifestyle to see what's going on. For hypertension that isn't controlled by diet and exercise, new treatment guidelines for hypertension recommend that most patients be started on a thiazide-type diuretic, unless there is a compelling need for a different class of medications. However, the biggest problem with treatment of high blood pressure is not a lack of knowledge, but a lack of the application of our current knowledge.