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4 causes of high blood pressure you might not expect

An arm with a blood pressure cuff.

Aug. 14, 2023— Nearly 120 million American adults have high blood pressure, also known as hypertension, according to the Centers for Disease Control and Prevention (CDC). While the condition often has no symptoms, it's a serious health concern. High blood pressure can lead to serious health problems like heart attack, stroke and heart failure.

If you have high blood pressure, knowing what's causing the problem may help you control it. You might already know some of the common problems that can lead to high blood pressure, such as:

  • Excess sodium (salt).
  • Obesity.
  • Lack of exercise.

But when it comes to hypertension, the causes may not always be obvious. That matters: Addressing your risk factors for hypertension can help you control it—or avoid it.

Hidden causes of hypertension

Here are four blood pressure risks to be aware of, based on information from the American Heart Association (AHA), the National Heart, Lung, and Blood Institute (NHLBI) and other experts.

1. Smoking. Smoking raises blood pressure by making blood vessels narrower. Smoking also leads to the buildup of fatty substances in blood vessels. This limits the space available for blood to flow, raising blood pressure even more, according to the AHA.

What to do about it: If you smoke, quitting may help to lower your blood pressure and keep your heart healthy. Quitting smoking can be challenging, but it's worth the effort. Ask your doctor for help.

2. Pregnancy. High blood pressure during pregnancy (pre-eclampsia) poses risks to the mother and baby. According to the NHLBI, the risk doesn't end when the baby is born. Pre-eclampsia raises the chance of a mother having long-term high blood pressure.

What to do about it: Make sure you get the prenatal checkups your doctor recommends. Safe and effective medications are available to manage blood pressure during and after pregnancy.

3. Sugar. Eating too much sugar can contribute to high blood pressure. When you eat sugar, insulin (a natural hormone) gets released to help lower the amount of sugar in your blood. However, the release of insulin can increase blood pressure.

Foods with added sugars lead to an increase in blood pressure, reports AARP. Examples include sodas, breakfast cereals, and desserts.

What to do about it: Consider cutting back on added sugars to help prevent insulin-related spikes in blood pressure.

4. Medications. A study from the NHLBI found that 20% of people with high blood pressure unintentionally take medicine that makes their hypertension worse. Medicines or supplements can affect the way blood pressure medicines work. Others raise blood pressure directly.

Common over-the-counter (OTC) medications that can affect blood pressure include:

  • Anti-inflammatory medicines, such as ibuprofen and naproxen.
  • Sinus decongestants like pseudoephedrine.
  • Steroid nasal sprays, such as fluticasone.

What to do about it: If you have high blood pressure, play it safe. Talk to a doctor or pharmacist before taking an OTC medication. And make sure your doctor knows all the medicines you take, including supplements.

Take a team approach

Your doctor can help you control—or avoid—high blood pressure. Ask yours about your risk factors. They might recommend medications, lifestyle changes or other treatments to help you stay healthy.

In some cases, your doctor might recommend tracking your blood pressure at home. Try these tips to get an accurate reading.


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