Getting Heart Healthy For The Holidays:
Managing Your Blood Pressure
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What Are the Risk Factors?
Age: The risk for hypertension increases with age. Generally both systolic and diastolic blood pressure increase with age in women and men up to middle age. By age 50, the diastolic pressure levels off, while the systolic pressure continues to increase. It is estimated that half of all women over age 65 have high blood pressure.
- Children can get high blood pressure too, especially those who are obese. Interestingly, newborns who are underweight are at greater risk for high blood pressure when they reach adulthood.
African American race: African American women are at greatest risk for getting high blood pressure more frequently, more seriously, and at a younger age.
Smoking: If you smoke, just quit.
Being overweight.
Family history of high blood pressure.
Inactive lifestyle.
Excess alcohol intake (more than 1 glass of wine, beer or spirits per day)
Excess sodium (salt) intake
Use of certain medications (e.g. birth control pills, steroids, decongestants, certain anti-inflammatory drugs, or estrogen replacement therapy). The data on the influence of estrogen therapy on blood pressure is conflicting. Most studies show that estrogen replacement therapy actually lowers blood pressure in post menopausal women; a recent large study of menopausal women showed that blood pressure elevations were most closely linked to weight gain, regardless of estrogen status. There is a small subgroup of women, however, whose blood pressure will become significantly elevated while on estrogen, so doctors will monitor blood pressure closely in all menopausal women. In some women who develop high blood pressure after starting birth control pills or estrogen therapy, doctors will recommend discontinuing the medication for 2-3 months to test the effect on blood pressure. It is very important to remember that essential hypertension-the most common type-is very common and has no known cause. This means that many women who take birth control pills (one in four women of reproductive age) or women who take estrogen therapy, for example, will have essential hypertension whether or not they were taking these medications.
People who are anxious or depressed may have over twice the risk for high blood pressure than those without these problems. It is not clear whether these disorders contribute to high blood pressure due to some direct effect on blood vessels or if they lead to behaviors, such as weight gain or alcohol abuse, which are also risk factors for hypertension. Anger does not appear to predict high blood pressure, although suppressed anger may.
Seasonal changes may influence variations in blood pressure, with hypertension increasing during cold months and declining during the summer, particularly in smokers. While cold may narrow blood vessels, lack of light has also been associated with higher blood pressure.
Clearly you can't do anything to change your age, race or family history. But the good news is that reducing the behavioral risk factors can reduce risk at any age.
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 Despite all we know about the dangers of high blood pressure, it is estimated that a third to one half of all Americans with high blood pressure are unaware that they have this dangerous condition. Of those who know they have high blood pressure, only one in four have their blood pressure properly controlled. 
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