14 Mistakes That Are Making Your High Blood Pressure Worse
One in three Americans has hypertension and 81% are unaware they have the risk factor for the two leading causes of death of adults in the United States—heart disease and stroke. That's right, you could be walking around with high blood pressure without even knowing it.
"High blood pressure is often called the 'silent killer' because most people who have it don't have any symptoms," says Ismail Tabash, M.D., cardiologist at Mayo Clinic Health System in Eau Claire, Wis.
Controlling hypertension is even more critical today during the coronavirus pandemic. You may have a hidden disease that if left uncontrolled or untreated, puts you at greater risk of getting severely ill with COVID-19 and even dying.
Even if you haven't been diagnosed with hypertension, there are a multitude of seemingly innocuous ways that you could be unwittingly raising your blood pressure into the danger zones. Here are the biggest mistakes that are making your blood pressure worse.
You don't know your numbers.
If you don't check your blood pressure, you won't know if there's a potential problem. Data from the National Health and Nutrition Examination Survey (NHANES) shows that 13 million people in the United States are not aware that they have hypertension and therefore are not making lifestyle changes or taking medication to help control it.
You don't know what those numbers mean.
OK, so you checked your blood pressure on the machine at your local CVS, but what does 130/90 mean?
Well, it means you may have elevated blood pressure and now have a reason to see your doctor. The top number stands for systolic pressure, the pressure in your blood vessels when your heart beats or pumps. The bottom or diastolic number represents the pressure when your heart relaxes and fills with blood. The official guidelines say that normal blood pressure is under 120/80.
You do things that give you incorrect numbers.
Blood pressure readings can vary widely, which is why it's recommended that you take two or more measurements on two or more occasions and average them to get the most accurate numbers, suggests Lawrence Fine, MD, DrPH, at the National Heart, Lung, and Blood Institute of the NIH. To get the most useful measurement, be sure you don't make these mistakes that can easily cause an artificially high blood pressure reading:
- You're nervous about going to see a doctor. These natural jitters about doctor appointments can actually raise your BP. And it's one reason taking a blood pressure reading in the comfort of your stress-free home may give you a more accurate result.
- You are slouching or sitting in a sofa. Bad posture during a test can skew results.
- You cross your legs, which can squeeze the large veins in your legs and raise blood pressure.
- You're making conversation with the nurse who is checking your blood pressure. Talking can actually boost your pressure.
- You had a double shot of espresso this morning. Caffeine jolts up blood pressure, too!
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You're not going to the bathroom enough.
Blood pressure goes up as your bladder fills up. This is one reason you should empty your bladder before having your blood pressure measured—to get the most accurate reading.
You eat in the evening.
It may not surprise you that late-night eating can cause high blood pressure, but even having a big dinner in the evening can do it, too. Consuming 30% or more of a day's calories after 6 p.m. was associated with a 23% higher risk of developing hypertension, according to a study funded by the American Heart Association (AHA). The fix: Eat most of your calories before dinner.
You're a 'non-dipper.'
Blood pressure change typically follows your circadian rhythm, with arterial blood pressure dipping more than 10% during sleep. If your blood pressure doesn't drop at night, you are considered a "non-dipper," and are at greater cardiovascular risk.
Non-dipping blood pressure can be caused by sleep problems, sleeping position, medications, smoking, and not enough physical activity. If you want to find out if you dip or don't, ask your doctor to provide you with a Holter monitor, a battery-operated device that you wear for 24 hours to monitor your blood pressure while you sleep.
You don't floss.
A survey by the American Academy of Periodontology found that 27% of U.S. adults admit to lying to their dentist about how often they floss their teeth. So, fess up, and then consider this: Flossing prevents periodontal disease (gum disease), which is associated with high blood pressure, according to a meta-analysis of 81 studies from 26 countries published in Cardiovascular Research, a journal of the European Society of Cardiology. The study linked moderate gum disease to a 22% increase in risk for hypertension, while severe periodontitis was associated with a 49% higher risk of high blood pressure. The average systolic blood pressure was 4.5 mmHg higher in study patients with gum disease. That's significant, suggested lead author Dr. Eva Munoz Aguilera of UCL Eastman Dental Institute. "An average 5 mmHg blood pressure rise would be linked to a 25% increased risk of death from heart attack or stroke," she said.
You rarely go outside.
Binging a new show on Netflix for days on end while quarantining inside your home should protect you from COVID-19, but it could increase your blood pressure or worsen existing hypertension, suggests a study in the Journal of American Heart Association. And why is this? It's the lack of sunlight that's boosting your blood pressure.
In the observational study, researchers analyzed 46 million blood pressure readings from 342,000 patients in 2,200 dialysis clinics and found that exposure to UV sunlight was associated with lower systolic blood pressure. For decades, scientists have known of seasonal variation in blood pressure, but had linked it to factors such as air temperature and vitamin D, which is produced when sunlight hits the skin. This new study found that temperature played a role, but "half the seasonal variation in blood pressure is independent of temperature. It's due to the UV alone," said lead author Dr. Richard Weller of the University of Edinburgh in Scotland.
You don't drink enough water.
While drinking water has been shown to boost metabolism and slightly raise blood pressure, being dehydrated can also raise blood pressure. A study in the journal Sports Medicine found that acute body water loss (hypohydration) due to sweating can disrupt proper function of the lining of blood vessels, the endothelium, impairing blood pressure regulation. Even mild dehydration can thicken blood and impede blood flow and raise bp, the study found.
You have a beer every day, or many on weekends.
It has long been known that heavy drinking can boost blood pressure. Research presented at the American College of Cardiology's annual scientific meeting demonstrated that even moderate alcohol consumption—seven to 13 drinks per week—substantially raises a person's risk for hypertension. Data for the research came from the large, decades-long NHANES study that followed 17,000 U.S. adults between 1988 and 1994. Researchers found that compared with people who never drank, moderate drinkers were 53% more likely to have stage 1 hypertension and twice as likely to have stage 2, while heavy drinkers (more than 14 drinks a week) were 69% more likely to have stage 1 hypertension and 2.4 times as likely to have stage 2.
You take Ibuprofen every day.
Maybe you regularly take Advil for nagging low-back pain or arthritis in your hips or knees. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen reduce pain and inflammation, but they also can cause your blood pressure to rise, according to the Centers for Disease Control and Prevention (CDC). NSAIDs cause the body to retain fluid and sodium, and they can affect the function of your kidneys, raising blood pressure. Acetaminophen, the active ingredient in Tylenol, may be a better option for pain because it doesn't raise blood pressure. Doctors also believe that aspirin, another NSAID, is safer for people with high blood pressure. You'll want to ask your doctor what's best for you.
You caught a cold.
You're sneezing, sniffling and all stuffed up, so you've reached for your go-to decongestant. And now your blood pressure is through the roof. That's because decongestants work by narrowing the blood vessels in your nose, making them less swollen so it's easier to breathe. Problem is, constricting blood vessels makes it harder for blood to flow through them, which raises blood pressure.
Check your cold and allergy medicines and avoid decongestants like pseudoephedrine (Sudafed) and Phenylephrine (Neo-Synephrine). While you're at it, give your doctor a list of all the OTC and prescription medications (and even herbal supplements) you take regularly since certain drugs and supplements can also raise blood pressure or reduce the effectiveness of medication you may be taking to control your hypertension.
You stay up late.
Didn't get enough sleep last night? Even one bad night of sleep can result in a spike in blood pressure during the night and the following day, according to University of Arizona researchers' reporting in the journal Psychosomatic Medicine. In the study, researchers recruited 300 men and women ages 21 to 70 who had no history of heart disease and asked them to wear portable blood pressure cuffs, which recorded their blood pressure during 45-minute intervals throughout the day and night. Participants also wore movement monitors, which determined "sleep efficiency," or how soundly they slept After two nights of recordings, the researchers found that the poor sleepers had increased blood pressure during the restless night and higher systolic blood pressure readings the following day.
"Blood pressure is one of the best predictors of cardiovascular health," said lead study author Caroline Doyle. "There's a lot of literature out there that shows sleep has some kind of impact on mortality and on cardiovascular disease. We wanted to see if we could try to get a piece of that story—how sleep might be impacting disease through blood pressure."
You ordered a sodium-packed meal.
Restaurant meals are typically loaded with salt, and Chinese foods and fried foods are among the worst offenders. Sodium causes the body to retain fluid, which we've learned leads to an increase in blood pressure. So how much is too much sodium? The American Heart Association recommends that Americans consume no more than 2,300 milligrams per day for heart health.
If you stop by P.F Chang's, for example, and order a Hot & Sour Soup Bowl, you'll be consuming 1,500 milligrams more than that recommended daily amount—a total of 3,800 milligrams per bowl. Eating at home isn't much less risky—if you're eating processed and packaged foods, that is. Many frozen dinners deliver more than 700 milligrams of sodium per serving and canned soups typically weigh in at 600 to 800 milligrams. And a homemade sandwich with a couple slices of deli meat and cheese can equate to 1,000 milligrams of sodium.