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12 Surprising Things That Can Raise Your Blood Pressure

It’s not just salt and stress — foods, drinks, drugs and other factors can affect your numbers

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People who watch their blood pressure are generally familiar with the more common factors that can cause their numbers to spike — salt and stress, for example.

But a handful of unsuspected foods, habits and health issues can play a role, too, and sabotage well-intentioned efforts to lower high blood pressure, or hypertension, a condition that affects nearly half of U.S. adults.

Here are 12 surprising things that can send your numbers soaring.

1. Sleep apnea

Sleep apnea, a sleep disorder in which a person stops and restarts breathing several times throughout the night, can cause a bump in blood pressure. And it’s becoming increasingly common in the U.S. as more Americans struggle with being overweight, says Donald Lloyd-Jones, M.D., chair of the Department of Preventive Medicine at Northwestern University Feinberg School of Medicine and former president of the American Heart Association. Excess weight is one of the foremost risk factors for developing sleep apnea; age is another big one.

Why is high blood pressure dangerous?

High blood pressure can wreak havoc on the body, causing damage to the blood vessels, heart, brain, kidneys, eyes and more. If left undetected or uncontrolled, it can lead to:

  • Heart attack
  • Stroke
  • Heart failure
  • Kidney disease
  • Vision loss
  • Sexual dysfunction
  • Angina
  • Peripheral artery disease

Nearly half of U.S. adults have high blood pressure; only about 1 in 4 adults have it under control.

Source: American Heart Association, Centers for Disease Control and Prevention

When a person with sleep apnea stops breathing, the brain steps in and wakes the body up to take a breath; this can happen up to 30 times an hour. “And when we don’t get good quality sleep — and particularly if we’re not getting good quality sleep because our airway gets closed and our brain and our body has to maintain enough awareness to try to open up the airway — that is very, very hard on the vascular system,” Lloyd-Jones says.

All the stress and strain drives up blood pressure — “and not just when we’re asleep, but also when we’re awake for the rest of the day,” Lloyd-Jones says. It can cause a whole host of other health issues, too, including an increased risk for heart attack, type 2 diabetes and liver problems. Researchers at Johns Hopkins Medicine found that severe sleep apnea in middle or old age can increase risk of premature death by up to 46 percent.

A common warning sign of sleep apnea is snoring, so if someone tells you that you snore loudly or gasp often during sleep, it may warrant a discussion with your health care provider. A number of devices and therapies can help to treat sleep apnea, and studies suggest that treatment with one of the more common options — a continuous positive airway pressure (CPAP) machine — may even improve blood pressure numbers.

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2. An unpredictable sleep schedule

It’s not just apnea during your sleep cycle that can cause your blood pressure to go through the roof. “People who don’t get six to eight hours of uninterrupted sleep can have elevated blood pressure,” says Luke Laffin, M.D., codirector of the Center for Blood Pressure Disorders at the Cleveland Clinic.

Several studies have found that sleepless nights raise blood pressure not only throughout the night, but the next day as well. 

For quality sleep, go to bed and wake up at the same time every day, avoid drinking and eating 90 minutes before bed, and don’t watch television in bed. If you wake up and are unable to get back to sleep in 20 minutes, get up and do something else, Laffin says.

3. Holding it when you have to go

When you have a full bladder but wait to urinate until the next rest stop or commercial break, your body increases your blood pressure. “A full bladder raises blood pressure about 10 to 15 points,” Laffin explains. That’s why he and his colleagues encourage people to urinate before they measure their blood pressure, particularly if they’re doing so to monitor the medications they’re taking at home.

“It’s fine to hold your urine if you’re in a situation where you cannot urinate freely. But if you have to urinate and can use the restroom, then you shouldn’t necessarily delay,” he says. So do a preemptive pee before heading into the theater or beginning a long car ride.

Speaking of urination, getting up frequently at night to relieve yourself may be a sign of hypertension. “If your blood pressure is elevated, that causes the body to say, ‘I need to lower my blood pressure.’ One way to do that is to urinate,” Laffin says. ​

4. Air pollution

Nearly 40 percent of Americans live in places with unhealthy levels of air pollution, a 2024 report from the American Lung Association finds — and that’s bad news for our blood pressure.

Research reveals that exposure to both “fine particulate matter” air pollution (what you’d find from car exhaust and fuel burning, for example) and coarse particulate matter air pollution (like dust from roads and construction sites) can boost blood pressure in adults. The link has also been established in children.

One study led by researchers at the University of Michigan found that even short-term exposure to high levels of air pollution can impact the blood pressure of healthy adults. The change was typical of what a person might see if his weight increased by about 5 or 10 pounds, the researchers noted in a news release.

Another study, also led by University of Michigan researchers, demonstrated that filtering the air can lower a person’s blood pressure, study coauthor and assistant professor of internal medicine J. Brian Byrd, M.D., told AARP. Exercise can also lower high blood pressure, even in places where pollution levels are high, a 2020 study found.

In addition to the pollution from cars, traffic noise has been linked to an increased risk for high blood pressure.


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5. Black licorice

No trick on this treat: Black licorice — we’re talking the real deal, not licorice-flavored candy — can be a health hazard, and not just because of its sugar content. The candy contains the compound glycyrrhizin, derived from the licorice root, which can cause the body to hold on to lots of salt and water, thereby driving blood pressure up.

Consuming black licorice can also lead to low potassium levels and abnormal heart rhythms. In fact, the Food and Drug Administration (FDA) cautions against eating large amounts of black licorice at one time. Eating just 2 ounces a day for at least two weeks could land adults 40 and older in the hospital, the agency says.

6. Alcohol

Although it’s often repeated that wine is good for the heart, alcohol can send blood pressure soaring, both in the short and long term. Lloyd-Jones explains that while alcohol initially relaxes the blood vessels, those vessels start to constrict once the liver metabolizes it. Blood pressure can remain at higher-than-normal levels the day after imbibing. And if drinking too much becomes a pattern, so will higher blood pressure numbers.

Heavy drinkers (more than three drinks a day for women, four for men) who cut back to moderate drinking (up to one drink a day for women, two for men) can lower the top number in their blood pressure reading by about 5.5 mm Hg (millimeters of mercury, a measurement for pressure) and their bottom number by about 4 mm Hg, according to the Mayo Clinic.

7. Lack of fruits and veggies

Too much sodium is a long-established catalyst for hypertension. But a diet rich in produce can help counter these effects, thanks to the potassium found in many fruits and vegetables. Salt increases blood pressure; potassium decreases blood pressure by causing our bodies to release sodium, says Seamus Whelton, M.D., an assistant professor of medicine at the Johns Hopkins Medicine Division of Cardiology. Men should aim for 3,400 milligrams of potassium per day, and women need about 2,600. 

There’s no need to take potassium supplements unless your doctor recommends it. Foods including bananas, dried fruit, potatoes and beans will help keep your salt-to-potassium ratio in check. “About 75 percent of the sodium most people consume is already in food when they buy it,” Whelton says. So swapping out processed foods and eating more produce is key to reducing your sodium and upping your potassium. He advocates eating the American Heart Association’s recommended four to five servings of fruits and four to five servings of vegetables per day.

8. Your social life — or lack thereof

“As a species, we’re not meant to be without other people,” says Annalijn Conklin, associate professor at the University of British Columbia. “If you are socially isolated, it raises your cortisol levels to put you in a fight-or-flight response.” A study Conklin conducted of 28,238 adults ages 45 to 85 found that for women, being single, having limited social activity or being part of a smaller social network was linked to higher average blood pressure. 

Interestingly, Conklin’s study found that men who lived alone or had small social networks were less likely to have high blood pressure than those who lived with others or had large networks (greater than 220 people). It’s unclear whether the difference was due to biological reasons or simply because there’s less stigma around the idea of men going it alone. 

That said, feeling isolated is not good for your arteries. Another, smaller study of adults ages 50 to 68 found that those with the highest scores on a loneliness survey had a systolic blood pressure (the first number in a blood pressure reading) that was 10 to 30 points higher than their less lonely counterparts.

9. Common medications

Headache? Joint pain? Be mindful of what you reach for when you head to the medicine cabinet. Nonsteroidal anti-inflammatory drugs like ibuprofen (Advil) and naproxen (Aleve) can raise blood pressure. And so can regular use of acetaminophen (Tylenol), according to a new study published in Circulation, the journal of the American Heart Association.

“Any time people are using those types of medications for pain control, if they’re using them continuously, they need to get with their doctor,” Lloyd-Jones says.

Other over-the-counter products to be aware of: decongestants, which relieve stuffiness by narrowing blood vessels to reduce swelling in the nose. This can also raise blood pressure. “So you don’t want to use them consistently or routinely,” Lloyd-Jones says. Even supplements like ginseng and ephedra are associated with increased blood pressure.

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10. Added sugar

When we eat sugar, our bodies release insulin to help clear the sugar from the blood and get it into the cells where it can be used for energy.

“But insulin itself tends to drive up blood pressure in many people,” Lloyd-Jones says. “So if you’re eating a lot of added sugar or simple starches, you’re having these more intense and longer bursts of insulin, which will raise blood pressure.”

Added sugar is common in soft drinks, cakes and cookies. Some yogurts and breakfast cereals can also be high in added sugar.

11. Smoking

Yet another reason to kick the habit: Smoking, a proven risk factor for heart attack and stroke, can also mess with your blood pressure. According to the American Academy of Family Physicians, nicotine is to blame. It causes the blood vessels to narrow and the heart to beat faster, which makes your blood pressure get higher.

“If you look at the monitoring, it’s clear that the blood pressure [of smokers] over a 24-hour period is higher than [of] nonsmokers,” Byrd says.

12. Another health condition

The overproduction of a hormone called aldosterone can cause high blood pressure and even make it difficult to control with medication. Byrd says people who haven’t had any luck lowering their high blood pressure with multiple medications should talk to their doctor because “there’s a reasonably good chance that they have a condition called primary aldosteronism.” The condition often is missed, Byrd says, but medications can treat it.

High blood pressure could also point to an issue with the kidneys or the thyroid gland.

As your age increases, so does your risk of a thyroid disorder. Both overactive and underactive thyroids can raise blood pressure; a severely overactive thyroid can boost your risk of cardiovascular issues, says Nicole Ronda Bloom, M.D., an accredited endocrinologist based in New Hyde Park, New York. 

Bloom encourages patients to get their levels checked annually during physicals, or every six months if they have a strong family history of thyroid disease or symptoms. And if you are on thyroid medication, make sure you’re taking it as prescribed. “Skipping medicine for low thyroid doesn’t often cause high blood pressure, but missing medicine for high thyroid can be problematic,” Bloom adds.

Don’t forget about the usual suspects

It’s important not to overlook the biggest drivers of high blood pressure in the U.S., chief of which is weight. If you’re overweight, losing even a few pounds can have a big impact on blood pressure — you can reduce your numbers by 1 mm Hg for every 2.2 pounds you lose, according to the Mayo Clinic.

And don’t discount your diet. Americans consume, on average, about 3,400 milligrams of sodium each day, the majority coming from packaged foods and restaurant meals. That number should be closer to 1,500 milligrams, the American Heart Association says.

“There is too much sodium in our food supply, we are not getting enough physical activity, we are gaining too much weight and we are drinking too much alcohol. And every single one of those things contributes to increasing blood pressure levels,” Lloyd-Jones says.

To stay on top of your blood pressure, take your measurements often and “understand where you are on the spectrum,” Lloyd-Jones adds. You can do this at home with a cuff-style biceps monitor. If you notice your blood pressure is starting to increase or if it’s already elevated (a systolic, or top, number that’s less than 120 and a diastolic, or bottom, number that’s less than 80 is considered normal), it’s important to be careful around the foods and habits that can make it worse, Lloyd-Jones notes. It’s also important to work with a doctor to find the best way to control it, be it with medications, lifestyle changes or both.

“Home blood pressure monitoring is a really important and empowering way for patients to take control of this,” Lloyd-Jones says.

White Coat Fever

Have you ever had your blood pressure read higher at the doctor’s office than it typically does at home? A 2017 study in the Journal of Hypertension found that up to 30 percent of people with increased blood pressure have discordant in-office and out-of-office blood pressure.

This condition, known as “white coat hypertension,” could be due to many factors, including feeling stressed in the presence of health care providers. It’s not a trivial thing: White coat hypertension is linked to a higher risk of heart attack, stroke and cardiovascular disease.

“For a diagnosis of hypertension, you want two elevated readings on at least two separate occasions,” Johns Hopkins professor Seamus Whelton says. “So we never want to adjust somebody’s medications based on a single blood pressure reading.” If your doctor rechecks your blood pressure during your appointment and it’s still high, they’ll likely advise you to continue checking it at home in the weeks that follow and report those numbers at your next appointment.

Editor’s Note: This story, originally published April 21, 2022, has been updated to reflect new information. .

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