One of the most common questions the patients ask their primary care physician when they are first diagnosed with high blood pressure is: “what caused the high blood pressure and do I have to be on the blood pressure treatment for the rest of my life/”.

The classic answer is: “we do not really know what causes the high blood pressure but it might be something in your genes and yes, you will have to be on these medications for the rest of your life.”

In this article, we will offer another answer to both questions:

There are two main types of high blood pressure.

The less common one is called secondary hypertension and it is caused by other diseases such as: kidney disease, primary aldosteronism, obstructive sleep apnea, pheochromocytoma, and Cushing’s disease. It also can be a side effect of some medications such as oral contraceptives, antidepressants, steroids, weight loss medications, and amphetamines.

Secondary hypertension only accounts for 5-10% of the cases of high blood pressure.

Usually in the cases of secondary hypertension, once the main disease is treated the blood pressure often returns to normal pressures.

The most common type of high blood pressure, which is the one most commonly taken care of the in primary care physician office, is called primary or essential hypertension. It accounts for 90-95% of all cases of high blood pressure and these patients are usually the patients prescribed blood pressure medications.

There are many factors that can predispose the patient to having high blood pressure such as age, race, and family history which are unmodifiable factors. That does not mean that the disease is permeant and irreversible. High blood pressure is mainly a metabolic disease and it occurs in patients with underlying metabolic abnormalities. These patients usually have a combination of obesity, high blood pressure, insulin resistance, elevated cholesterol, type 2 diabetes, and sometimes gout.

There are two main factors that cause hypertension in the overweight and obese patient.

  1. The state of chronic inflammation.
  2. Excess insulin that drives insulin resistance.

High insulin levels cause salt and water retention through its effect on the kidney which causes the pressures in the body to be higher because of more volume in the circulatory system.

Obesity itself is not a direct cause of hypertension. It is the chronic inflammation and the insulin resistance that are associated with obesity are the underlying causes.

The Metabolism Correction Program treats obesity, insulin resistance, and chronic inflammation. Patients are often able to come off their blood pressure medications after many years of taking these medications. High blood pressure can be lowered by addressing the most common causes of it. As a result you do not have to be on blood pressure medications for the rest of your life.


The Metabolism Clinic is established as the destination for weight loss and reversal of diabetes. Based in Charlotte, North Carolina.