The Surprising Causes of High Blood Pressure and What You Can Do About It
Today I am tackling a serious health topic that often flies under the radar: high blood pressure. It's time to shine a spotlight on this sneaky culprit known as the "silent killer." Believe me, it can wreak absolute havoc on your well-being, all without giving you a single warning sign. In this post, I will arm you with knowledge about the telltale signs and causes of high blood pressure, so you can take charge and protect yourself from its nasty complication.
What are the symptoms of high blood pressure?
Often, there are no symptoms that would alert you to having high blood pressure. It’s not called “the silent killer” for nothing. However, the world health organization provides the following lists of symptoms that could indicate high blood pressure including
Severe headaches
Chest pain
Dizziness
Difficulty breathing
Nausea/vomiting
Blurred vision
Anxiety, confusion
Bussing in the ears
Nose bleeds
Complications of high blood pressure include heart attacks, heart failure, stroke, and kidney damage. And you don’t always get a second chance with these, so I don’t recommend waiting around until they happen. Even kidney damage is not reversible.
What are the causes of high blood pressure?
Sometimes, high blood pressure can be due to an underlying health condition or medication.
Health conditions include kidney disease, diabetes, sleep apnea, endocrine disorders, lupus or scleroderma.
Medications that can elevate blood pressure include birth control pills, steroids, ibuprofen, some cold medicines, amphetamines, and some antidepressants.
However, the majority of us with high blood pressure have it because of diet and lifestyle factors. These can include:
Excess alcohol consumption
Poor sleep
Not enough exercise
Too much salt and not enough potassium or magnesium
Smoking
Being overweight
Insulin resistance/prediabetes
Stress
If you are diagnosed with high blood pressure, you might hear that “You just need to reduce your stress,” or “You just need to lose weight.” In fact, your diet and lifestyle can make a huge impact.
However, it helps to know what is actually causing your high blood pressure before you formulate a strategy to reduce it.
Note: You CAN lower your blood pressure without medication… most of the time. But if you aren’t going to take action, then medication is a good idea. This is not one of those things to stick your head in the sand on. So be realistic. You can always start medication and then address root causes and come off medication later when you’re ready.
How common is high blood pressure?
VERY common.
About 50% of people over 50 years old have high blood pressure.
Race plays a role with black people having a higher incidence of high blood pressure than others.
And that rate just starts climbing every 5 years. So if you are over 50, home monitoring just has to be happening if you care about your health and longevity. (1)
Monitor your blood pressure at home
This is probably the single most important thing you can do. Not only will you catch high blood pressure early, but you have an opportunity to sleuth out what the causes are.
Because high blood pressure is so dangerous, it’s important not to wait a year between checking it. This is pretty logical. However, most of us still only check our blood pressure once per year at the doctor’s office! In that time, you could have high blood pressure creeping up for months without knowing it doing its damage. Also, the measurement you get in the doctor’s office is rarely under ideal conditions. You want to optimize the conditions for testing AND test under different conditions to assess what could be driving your blood pressure up.
Please refer to my earlier article on how to accurately check your blood pressure at home.
How do I lower my blood pressure?
The answer to this question lies in first understanding the cause of YOUR high blood pressure.
Think of it this way… If you’re a business owner and want to increase your profits, what’s the first thing you do? Do you fire a few employees? Redo your website? NO!
The first thing you do is look at your data. Your balance sheet might tell you where you’re bleeding money. Look at your website analytics to see if your website is bouncing. Then invest your time and money where you’ll get the best return on investment.
Similarly, doesn’t make sense to give you random advice that applies to “most people”. You’re not most people and personalized nutrition doesn’t work that way. You want to know what will work best for YOU.
So let’s first look at the causes and see which ones likely apply to you.
What are the causes of high blood pressure?
(And how can that inform your strategy?)
Insulin resistance and diabetes
For many of my patients, we find insulin resistance/prediabetes is a big factor. High levels of insulin drive up blood pressure. So if your fasting blood sugar or HA1c levels are creeping up, your insulin levels probably are too. In my practice, we address this relatively quickly by monitoring glucose levels using a continuous glucose monitor for a few weeks and quickly find the things that lower blood sugar (for you!), and therefore insulin and blood pressure.
Poor sleep
We see poor sleep as a factor when monitoring blood sugar. One poor night of sleep causes blood sugar to be elevated all day long. That’s because it causes a rise in cortisol and this causes insulin resistance. If you sleep well the following night, it will reverse. But most people I see are pretty consistent with their poor sleep. And as stated earlier, elevated insulin also drives up blood pressure. So assessing and improving sleep is a big factor. I’ve got a concise program to help you optimize your sleep - click here to access it.
High stress
Of course, your blood pressure goes up when you are stressed. The question is, how often are you in that state? Monitoring your blood pressure daily in the morning when things are calm, and then checking it in the middle of your workday could shed some light on the issue. Another strategy would be to use a health tracker like an Oura ring or Fitbit to track your heart rate throughout the day and your HRV on a daily basis.
Alcohol
Excessive alcohol consumption is one of the most common causes of high blood pressure. In fact, I remember one (very tall/large) man who used to drink in the neighborhood of 5 beers daily and was being advised by his doctors to begin blood pressure medication. He dropped his intake down to 2 beers and his blood pressure dropped to within acceptable levels. (2)
Exercise
Regular exercise is an excellent way to lower blood pressure. In one study, they demonstrated that while exercising for 30-60 minutes/week helped to lower BP, exercising for 61-90 minutes showed greater improvements (3). So if you’re not exercising at all, adding three 30-minute brisk walks per week could lower your blood pressure significantly. I’ll refer to our Zone 2 Walking Guide to give you some ideas for bringing that into your routine.
Salt
We’ve all grown up hearing that salt raises blood pressure. But when I read Dr. Richard Johnson's book, Nature Wants Us to Be Fat, I learned something fascinating. It’s not the salt itself that raises blood pressure, but the increase in osmolarity (or concentration) of the blood. What this means is the greater the concentration of dissolved particles (glucose or sodium) in the blood, the more it raised blood pressure. You could affect that in 2 ways. You could reduce the number of dissolved particles (eating less sugar or salt) or increase the amount of water before eating. This is why in our “Hack Your Blood Sugar” programs, we teach the order of eating which always starts with drinking water. Some people are indeed more salt-sensitive than others. But staying well-hydrated and doing so PRIOR to eating salty foods can serve a lot of different functions.
Mineral balance
Sometimes it’s less about what you need to remove and more about what we need to add. Include more foods that are high in potassium and magnesium in your diet. Potassium is relatively easy. Any whole food is pretty high in potassium as potassium is the #1 cation inside all cells. But if the cellular structure has been destroyed by processing (grinding flour, for example), you lose it. Any whole fruit, vegetable, and even meat has potassium. And when you make soup, any potassium lost in cooking stays in the broth you drink. Potassium supplements are not recommended.
Most Americans are low in magnesium. Adding this as a supplement or (preferably) with food can help lower blood pressure. Literally, anything green will be high in magnesium so think avocados, arugula, broccoli, or kale as a great option (There is a magnesium atom at the center of every chlorophyll molecule.) These foods are all also high in potassium.
Magnesium supplements are a safe option too. Many also take this to aid sleep or relieve constipation. Magnesium glycinate is a well-absorbed form of magnesium and is not going to cause diarrhea. But for those who would like their magnesium supplement to double as a laxative, Magnesium citrate in liquid or powder form taken in the evening can be a very helpful twofer. Both forms of this magnesium are available in my FullScript Dispensary.
What next?
I recommend you go back to my other article, How and Why to Check Your Blood Pressure at Home, find my list of verified home monitors, and start monitoring. If you are over 50, this is a no-brainer. Because I believe in getting a high ROI for my patient’s efforts, I like to dive into the data before taking action. So rather than recommend a standard low-sodium and low-calorie diet to every person with high blood pressure, I think it’s worth looking a little more closely.
Are there signs of insulin resistance? Let’s try a CGM and get to the root cause of that.
Is it poor sleep? Let’s assess for sleep apnea, get to bed on time and start tracking sleep.
Moderate to heavy drinker? Have a dry couple of weeks and see what that does to blood pressure.
Being data-driven this way is how we do personalized nutrition. Together, we find out what the root causes are and then take action by working smarter, not harder. Want a little help on this to get faster results and some accountability? Then schedule a discovery call with me and we’ll see if I’m a good fit for your needs.
References
https://www.cdc.gov/bloodpressure/facts.htm
Cochrane Database Syst Rev. 2020; 2020(7): CD012787.
Ishikawa-Takata K, Ohta T and Tanaka H. How much exercise is required to reduce blood pressure in essential hypertensives: a dose-response study. 2003. American Journal of Hypertension, 16(8): 629-633.