Hypertension is reported to be two to three times more common in women who use hormonal contraceptives than in those who do not. The risk increases significantly in women aged 35 and older who smoke cigarettes. These women should be strongly encouraged to quit smoking, and if they continue to smoke, they should be discouraged from using hormonal contraceptives due to the increased risk of cardiovascular events.

Elevated blood pressure can develop either suddenly or gradually. A sudden and severe rise in blood pressure—exceeding 180/110 mm Hg—may indicate a hypertensive crisis, a potentially life-threatening condition. Even moderate increases may be clinically significant if they accompany or signal conditions such as:

• Dissecting aortic aneurysm

• Increased intracranial pressure

• Myocardial infarction

• Eclampsia

• Thyrotoxicosis

While essential hypertension is the most common cause of elevated blood pressure, secondary causes should also be considered, including:

• Renal or endocrine disorders

• Fluid imbalance due to treatments like dialysis

• Adverse effects of medications

• Dietary triggers, such as excessive intake of black licorice or aged cheeses

In some cases, elevated readings may be the result of inaccurate blood pressure measurement techniques, underscoring the importance of proper measurement procedures.