What Causes High Blood Pressure? Cardiologists Explain the Truth Behind High BP

Plus, exactly what you can do to get your numbers back down.By Stephanie EckelkampPublished: Oct 30, 2025Save Article

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High blood pressure and the effect it has on cardiovascular health is a big concern for many. And yet, you’re likely only getting your blood pressure checked at your yearly physical or other check-ups, which can allow high blood pressure (aka hypertension) to fly under the radar—especially if you don’t know the most common causes of high blood pressure. “High blood pressure, in most cases, is asymptomatic,” said Lawrence Phillips, M.D., cardiologist and associate professor of medicine at NYU Langone Health. “So people don’t feel that they have it, which is why regular screening is so important.”

Meet the experts: Lawrence Phillips, M.D., cardiologist and associate professor of medicine at NYU Langone Health; Amnon Beniaminovitz, M.D., a cardiologist at Vivify Medical in New York City.

Here, cardiologists explain the lifestyle choices and health conditions that can contribute to high blood pressure, plus the changes you can make to address them and bring your numbers back down into a healthy range.

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What is high blood pressure?

They don’t call high blood pressure a “silent killer” for nothing. Turns out, about half of Americans have this condition, which, left unaddressed, can cause hardening of the arteries, stroke, kidney damage, and even early cognitive decline and dementia. Yet most people with high blood pressure have no idea they’re affected.

In the simplest terms, blood pressure is the force of your blood against the walls of your blood vessels and arteries, and it is expressed as two numbers: The top number (systolic blood pressure) represents the pressure or force in the arteries when your heart beats, and the bottom number (diastolic blood pressure) is the pressure measured between heart beats, explained Amnon Beniaminovitz, M.D., a cardiologist at Vivify Medical in New York City.

While normal blood pressure is necessary for survival, high blood pressure is dangerous because it means your heart is working much harder to pump blood throughout your body. “You can sort of think of high blood pressure as your blood punching the walls of the heart and other organs over and over again,” said Dr. Phillips. “If that punching is at a high force, you’re going to develop thickening and damage over time.”