Updated 07 July 2014

Why do some people have hypertension and not others?

Hypertension can seem like some cruel lottery – why me and not them? And yes, many people simply inherit hypertension. But there are factors you can control.


Hypertension can seem like some cruel lottery – why me and not them? And yes, many people simply inherit hypertension. But there are factors you can control.

If you have a family history of heart attack or stroke, or inherited a predisposition to hypertension, there are some things that are beyond your control. Other factors can be controlled: leading a sedentary lifestyle, smoking and eating fatty foods will all increase your troubles.

You should follow these guidelines:

  • Stop smoking: Smokers are at least twice as likely to develop cardiovascular disease. Do whatever it takes to give up.
  • Cut back on booze: Because alcohol reduces your heart’s ability to do its job, limit your intake to two drinks a day. Occasional bingeing can do a lot of damage, so going dry for days and then drinking your week’s allowance in one night isn’t the answer either. You should not drink at all at least two days of the week and if you have hypertension you’re better off abstaining completely.
  • Get active: Aim for at least half an hour of exercise three times a week. Brisk walking, jogging, swimming, cycling, and aerobics all help to strengthen your heart and reduce blood pressure. Exercise is also good for stress, which contributes to high blood pressure. If you’ve been inactive for some time you should consult your doctor before taking up a vigorous routine.
  • Relax: This is difficult when you’re fighting traffic, trying to meet deadlines, survive office politics and help raise socially adjusted kids. Most people simply don’t set aside any time for themselves. They feel guilty about it, but it’s actually vital to leading a balanced life. So relax – it’s what the doctor ordered.
  • Toss the salt: If you’re the average eater you consume much more salt than you need. Salt pushes up your blood pressure, so limit yourself to a flat teaspoon a day. Examine you intake carefully, especially if you’re African or older than 65. Look for hidden salt in processed meat, pickles and crisps.
  • The pill: Most oral contraceptives can be taken safely by women with hypertension. If you’re uncertain about this, speak to your doctor.
  • Age and gender: Women are less likely to develop hypertension than men, until they reach menopause, when the risk becomes more or less equal to both groups. Men older than 45 face an increased risk of hypertension - in women the risk increases after 55. Nearly 75 percent of women older than 75 have hypertension.
  • Heredity doesn’t mean you’re fated to have a heart attack, but can be an indication that you should take preventative steps. Speak to your doctor if you have a family history of heart disease, particularly if you have a father, son or brother who suffered a heart attack or stroke before age 55, or a sister or daughter who had one before age 65.
  • Race: African people or people of African descent have a higher incidence of hypertension.
  • Diabetes accelerates the onset of arteriosclerosis, which increases the risk of heart attack, stroke and reduced circulation in the feet. How this works isn’t clear yet, but what is known is that female diabetics are five times more likely and male diabetics twice as likely to develop heart disease than people who don’t suffer from diabetes.

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Dr Jacomien de Villiers qualified as a specialist physician at the University of Pretoria in 1995. She worked at various clinics at the Department of Internal Medicine, Steve Biko Hospital, these include General Internal Medicine, Hypertension, Diabetes and Cardiology. She has run a private practice since 2001, as well as a consultant post at the Endocrine Clinic of Steve Biko Hospital.

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