By Rachel Nania, AARP, April 2022
It’s not just salt and stress — foods, drinks, drugs and other factors can affect your numbers.
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 eight 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., president of the American Heart Association and chair of the department of preventive medicine at Northwestern University Feinberg School of Medicine. Excess weight is one of the foremost risk factors for developing sleep apnea; age is another big one.
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 have 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.
2. Air pollution
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, 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 2019, 99 percent of the global population lived in places where air quality did not meet World Health Organization guidelines.
In addition to the pollution from cars, traffic noise has been linked to an increased risk for high blood pressure.
3. Black licorice
No trick on this treat: Black licorice — we’re talking the real deal, not just 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 age 40 and older in the hospital, the agency says.
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.
Why is High Blood Pressure Dangerous?
High blood pressure — also known as hypertension and called the “silent killer” because it often comes with no symptoms — 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:
Peripheral artery disease
It’s estimated that nearly half of U.S. adults have high blood pressure; only about 1 in 4 adults with hypertension have it under control.
Source: American Heart Association, Centers for Disease Control and Prevention
5. Common medications
Headache? Joint pain? Be mindful 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.
6. 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.
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 non-smokers’,” Byrd says.
8. 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. It can even signal low levels of potassium. Increasing the amount of potassium in your diet (fruits and vegetables are great sources) can lower blood pressure, Lloyd-Jones says.
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 (mg) of sodium each day, the majority coming from packaged foods and restaurant meals. That number should be closer to 1,500 mg, the American Heart Association says.