High Blood Pressure in Young Adults: What Causes It, and How Do We Treat It?

by Nicholas Paivanas, MD, Cardiologist
February 17, 2020

High blood pressure, also known as hypertension, is a fairly common reason we see older adults. In addition to genetics, there are many environmental factors that can raise a person’s blood pressure, and by controlling these factors we can lower blood pressure before it leads to more serious cardiovascular disease, such as heart attacks, strokes, heart failure, and kidney failure.

In recent years, however, we’ve seen increasing numbers of younger patients—people in their 20s or 30s—present to our offices because of elevated blood pressure. It is especially important to get high blood pressure under control in younger patients because of the long term effects on health.  Sometimes, simple changes can be made without needing medication, such as avoiding workout supplements which can inadvertently raise blood pressure.

For other patients, high blood pressure in young adults can be a sign of serious health issues. As a result, we test for key factors that can raise blood pressure and work with these patients to get their blood pressure under control before it becomes a chronic, lifelong problem.

Common Reasons for High Blood Pressure in Young Adults

There are two common presentations of young adults who tend to see us about their blood pressure. Either they’re experiencing common symptoms (headaches or feeling tired), or they went to a health fair, a job physical, or their primary care doctor, and someone noticed that they had elevated blood pressure.

Normal, healthy blood pressure is less than 120 millimeters of mercury (mmHg) of systolic pressure and less than 80 mmHg of diastolic pressure. A blood pressure measurement is commonly read as “120 over 80.” The first number, systolic pressure, is a measure of blood flow when the heart is actively beating. The second number, diastolic pressure, measures blood flow when the heart is between beats. If we get numbers that are above that 120 over 80 range, it’s time to start looking at what could be causing that patient’s blood pressure to be too high.

Related reading: What do the new blood pressure guidelines mean?

People in their 20s and 30s generally are pretty healthy, so we have to make sure they don’t have a significant underlying condition that is raising their blood pressure. A general workup for a young person with high blood pressure includes:

  • Checking for renal artery disease, a narrowing of the arteries that bring blood to each of the kidneys
  • Looking for possible hormonal causes of high blood pressure, such as hyperaldosteronism (overproduction of the hormone aldosterone, which raises the blood’s sodium levels) or pheochromocytoma (a type of adrenal tumor that causes the release of high levels of hormones that control blood pressure)
  • Performing an echocardiogram, a type of ultrasound exam that uses sound to see the heart and how it’s working
  • Testing for sleep apnea, which can cause blood pressure to rise

Many times, if we can successfully treat these issues, we cure the patient’s high blood pressure in the process. However, in some cases, the real culprit is found elsewhere. For example, consuming excess salt, stimulants, or supplements.  Obesity and inactivity are additional common factors that can lead to an increase in blood pressure in some individuals.

Another common factor we see in young patients with high blood pressure is stress. Stress does an unbelievable amount of damage to the body. When you’re stressed, your body produces hormones that narrow the blood vessels, which increases blood pressure and makes the heart work harder to pump blood. Stress can also cause you to lose sleep, and lack of sleep is associated with a higher incidence of increased blood pressure.

You can test the effects of stress on your blood pressure if you have the equipment to monitor your blood pressure at home. Check your blood pressure, and write down the numbers you get. Then meditate for 15 to 30 minutes before checking your blood pressure again. You’ll likely see lower numbers the second time.

#Stress can cause high #bloodpressure, which increases your risk for #heartdisease. @NickPaivanas recommends taking time to control work and home issues that have you #stressed so you can protect your heart https://bit.ly/2SuuqNa via @MedStarWHC

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How We Work to Lower Young Patients’ Blood Pressure

Once a person’s systolic blood pressure starts getting into the 140 mmHg range, we need to get serious about discussing solutions for whatever is causing their high blood pressure.

Of course, a young person who’s stressed about their work or family life can’t just quit their job and go do yoga in the Caribbean. But they can visit us and learn ways to reduce their stress in their current situations. That’s often not easy, as many young adults feel guilty when they take time for themselves. They may feel they should be taking care of their families or doing work instead. We often talk about how they can take 15 to 30 minutes for themselves to meditate, take a walk, or otherwise lower their stress levels to reduce the load on the heart and blood vessels.

Additionally, we work with patients to identify how their diet, activity levels, and other physical factors might contribute to their high blood pressure. Together, we come up with a plan to address those concerns, whether that’s through lifestyle changes, medications, or some combination of the two.

A Success Story

Many patients have experienced dramatic improvements from our work together, and often it can be a simple solution that makes the difference. One patient was in her 20s and had been diagnosed with high blood pressure when she was 18. Her blood pressure was difficult to control, and she’d been on many different medications before she visited us. By the time she presented to our office, she had already had two pregnancies that had been delivered early because of complications from her high blood pressure.

One of the major components of this young woman’s care involved adjusting her medications. She needed a simpler regimen that didn’t interfere so much with her daily life. For example, while her old regimen had been effective, it made her have to go to the bathroom a lot, and she had to take medicine multiple times per day. Because she has a long commute to work, she wasn’t taking her medication Monday through Friday when she was about to get in her car in Washington traffic. With a simple switch in her regimen, we were able to get rid of her side effects, and allow her to take her blood pressure medicines just once every day.

Don’t Wait to Get Help With High Blood Pressure

You might not see the urgency about treating high blood pressure. After all, it usually has no symptoms when it starts. But it’s known as the “silent killer” for a reason. The longer you have high blood pressure, the harder your heart has to work, and the more damage you could be doing to your arteries. You could develop serious, even fatal, heart problems before you realize what’s happening.

The good news is that you don’t have to wait for a heart attack, stroke, or some other serious issue to develop before you take action. Talk to your primary care doctor or a cardiologist about your elevated blood pressure so we can help you get it under control.

Your heart deserves expert care.

Our specialists are here to help.

Call 202-644-9526 or  Request an Appointment

Category: Healthy Living     Tags: elevated blood pressureHeart and vascularhigh-blood-pressurehypertension