5 Sneaky Reasons Your Blood Pressure Is High, According to a Dietitian

You might not be thinking about your blood pressure right now—but you might want to. "High blood pressure is a silent killer. Most people have no [warning] signs or symptoms, and unless their blood pressure is measured, it's easy to miss," says Jill Weisenberger, M.S., RDN, CDE, a registered dietitian nutritionist who specializes in diabetes and heart health.

Over time, high blood pressure, also called hypertension, can damage your heart, brain, kidneys and eyes, according to the Centers for Disease Control and Prevention (CDC).

Diet choices and lifestyle habits play an important role in keeping blood pressure levels in the normal range. Normal blood pressure is considered less than 120 mm Hg for systolic (top number) and less than 80 mm Hg for diastolic (bottom number).

Here are some of the top surprising factors Weisenberger sees that may be behind your rising numbers.

1. You're Skimping on Fruits and Vegetables

When you think about high blood pressure, you might assume it's all about your sodium intake. And sodium does play a role. It raises blood pressure because it pulls water into blood vessels, according to the American Heart Association (AHA). Increased blood volume means that there's more coursing through vessels, which raises your blood pressure.

Potassium, on the other hand, is the counter to sodium, helping to flush the mineral out of the body, per the AHA. Potassium also helps to relax blood pressure walls—and more relaxed walls mean lower blood pressure.

So, while you may be getting too much sodium, you might also be falling short in your potassium intake. "One of the biggest problems I've seen in my practice over the years is that people are not eating enough potassium," says Weisenberger. "When someone has low potassium intake—especially in the presence of high sodium intake—they're much more likely to have high blood pressure."

Potassium is considered a nutrient of "public health concern" by the USDA. This is likely because just one in 10 adults are eating adequate amounts of produce, notes the CDC.

While there are certain foods known for their potassium—like bananas—you can get the potassium you need through a variety of plants, including fruits, veggies and legumes. The number you should eat per day depends on a variety of factors, but the 2020-2025 Dietary Guidelines for Americans recommends adults eat 1.5 to 2 cup equivalents for fruit and 2 to 3 cup equivalents for vegetables each day.

2. You're Not Checking for Hidden Sodium

Think you'll automatically know when a food or meal is high in sodium? "People think that they can taste a high sodium food. They cannot. If something is baked or cooked in salt, the salt becomes mixed within the dish and it doesn't go directly to your tastebuds, as it does in the case of chips or [salted] peanuts," explains Weisenberger, who also notes that innocuous-sounding foods like instant pudding, instant oatmeal and lemon-pepper seasoning can all be hidden sources of sodium.

A good rule of thumb is to look at nutrition labels, specifically the percent daily value for sodium. 5% daily value is considered "low," whereas 20% is considered "high." Go for options that have a lower amount of sodium per serving.

Read More: Best and Worst Foods for Healthy Blood Pressure

Restaurant dishes are other big culprits. To choose lower sodium foods, Weisenberger suggests asking if the chef can cook or use a light hand with salt—and if they're willing to do it. "It's not going to be easy. If you're truly trying to follow a low-sodium diet, it pays to make friends with people who work at restaurants," says Weisenberger.

3. You're Missing Out on Sleep

It's easy to neglect sleep to make time for everything else you need to do in your day, but enough shut-eye is necessary for healthy blood pressure. "Not getting enough sleep is like a physical pain to the body, and it can raise blood pressure," says Weisenberger.

In a large 2021 review in the International Journal of Environmental Research and Public Health, people who experienced poor sleep quality, had sleep disorders or did not clock in at least seven hours of sleep a night had an increased risk of high blood pressure.

In addition, sleep also changes how you eat. This might not be a problem if the poor sleep munchies had you reaching for carrot sticks, but you're more likely to eat processed high-sodium snack foods or high-sugar options—another factor that plays into the development of high blood pressure, according to the AHA.

Poor sleep triggers changes in appetite hormones that prompt you to make less healthy choices—and overeat, explains Weisenberger. Adults should consistently aim for 7-9 hours of sleep each night, per the CDC.

See More: 4 Ways to Get a Better Night's Sleep, According to an Expert

4. You're Hitting Happy Hour a Little Too Hard

When consumed in moderation, alcohol, especially wine, has a heart-healthy reputation. However, compared to those who skip alcohol altogether, men and women consuming more than two alcoholic beverages per day, increase their risk of having high blood pressure by 51% and 42% respectively, according to a review and meta-analysis published in 2018 in the Journal of the American Heart Association.

While the reasons alcohol might raise blood pressure are still being looked at, alcohol may affect the way blood vessel walls contract and relax. It might also generate free radicals that damage the cells that line blood vessels, according to 2019 research in Nutrients. Even though women may be slightly less prone to the increase in blood pressure from a glass of wine, the AHA still recommends that women stick to one drink per day and men limit themselves to two.

5. You're Not Dealing with Stress

Contrary to popular belief, stress is not a direct cause of high blood pressure, says Weisenberger. In reality, stress is more of a transient cause. For example, you get a bad phone call, and your blood pressure surges, but after you relax, it calms, explains Weisenberger.

A 2021 large-scale study in the journal, Proceedings of the National Academy of Science of the United States of America supports this idea that more highly-charged negative emotions tend to be associated with an increase in blood pressure. There is some evidence, too, of a link between high levels of perceived stress over time and high blood pressure, per a 2019 study in the Journal of the American Heart Association.

Weisenberger points out that when you're stressed out, you lose focus on the health habits you're trying to establish. "In the same way with sleep, when you're stressed, it's harder to muster the motivation to go for a walk or jog or prep a meal from scratch," says Weisenberger.

The ultimate goal would be to aim for a lifestyle that supports a healthy heart. "Engaging in regular healthy habits, such as good sleep, meditation, and time with friends, yourself and nature, will improve blood pressure indirectly," advises Weisenberger.

The Bottom Line

High blood pressure tends to have no outward physical symptoms, so it's important to get it checked now and then. Like many other health measurements, blood pressure can be affected by several factors. Evidence shows links between higher blood pressure and diet, sleep, alcohol and stress.

The good news is, eating more fruits and vegetables, watching your sodium intake, getting plenty of quality sleep, limiting your alcohol intake and practicing healthy stress-reducing strategies can help keep your blood pressure in a healthy range—which will help improve your overall health. Getting more physical activity won't hurt, either.