The Truth Behind High Blood Pressure: 21 Frequently Asked Questions and Answers

We're going to talk about the truth behind high blood pressure and frequently asked questions and answers. High blood pressure or hypertension is a leading cause of heart disease, strokes, and kidney failure. Many people have hypertension yet not many people know how to control it. So today I'm going to give you the top questions answered about high blood pressure. I'm Dr. Frita, an MD who has been triple board-certified in nephrology, which is the study of high blood pressure and kidneys, as well as internal medicine and pediatrics.
High Blood Pressure Frequently Asked Questions and Answers
1. What Is Considered High Blood Pressure?
First, let's talk about what normal blood pressure is. Normal blood pressure is when that top number or systolic blood pressure is less than 120, and that bottom number or diastolic blood pressure is less than 80. You have elevated blood pressure when that systolic blood pressure is between 120 and 129, and the diastolic is still less than 80. What is hypertension or high blood pressure? You have stage one hypertension when that systolic blood pressure is between 130 and 139, or that diastolic blood pressure is between 80 and 89. And you have stage 2 hypertension when that systolic blood pressure is 140 or greater, or that diastolic blood pressure is 90 or greater. Many people listening will say, "Oh no, high blood pressure is normal for me. My blood pressure runs in the 150s over the 90s and I'm fine, I feel good. That's normal for me." No, it's not, so be sure to consult your doctor.
2. What Is The Difference Between Systolic and Diastolic Blood Pressure?
The systolic blood pressure is the top number on your blood pressure reading and the diastolic blood pressure is the bottom number of your blood pressure reading. And here's what it means. So first off, blood pressure refers to the force that blood exerts on your blood vessels. And so the systolic blood pressure is the pressure in your blood vessels when the heart is contracting or squeezing. The diastolic blood pressure is the pressure in your blood vessels where the heart is relaxed.
3. Can Dehydration Cause High Blood Pressure?
Typically, when we think of dehydration which is when your body does not have enough fluid, or when you're not hydrated. Dehydration initially will cause low blood pressure or hypotension. But if you have long-standing dehydration, then your body can react in a certain way that can actually cause high blood pressure.
If you have prolonged dehydration then your body has a mechanism where it activates the renin-angiotensin-aldosterone system. And this sets off a cascade that allows your body to hold on to sodium in the vessels. And when you hold on to sodium in the vessels then the water follows and you end up with high blood pressure.
So longstanding dehydration can cause a mechanism that actually leads to high blood pressure. The other thing is that when you're chronically dehydrated that can cause renal failure. Even if you are acutely or quickly dehydrated it can cause an acute kidney injury or a quick renal failure. If this happens, and if it's prolonged especially, then you can get prolonged kidney disease or chronic kidney disease. And of course, chronic kidney disease can lead to high blood pressure. And so yes, there are mechanisms in which dehydration can ultimately lead to high blood pressure.
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4. Can High Blood Pressure Cause Headaches?
Absolutely, yes. When you have hypertension, this can lead to elevated pressure inside of your skull. It can specifically cause high pressure within the blood vessels in your brain which can cause a headache. And if this pressure is prolonged, or if this pressure is very high, it can even cause a rupture in some of the blood vessels in the brain. You can also get a pounding in the ears which can be associated with a type of headache.
5. Why Is High Blood Pressure Known As The Silent Killer?
High blood pressure is known as the silent killer because the body is a very beautiful thing in that it will compensate and when you have high blood pressure for a long period of time, or if you have a gradual onset of high blood pressure, you can ultimately feel no symptoms. What does that mean? That means that even with sky-high blood pressure, a person can walk around and not even know that he, or she even has high blood pressure. Meanwhile, hypertension is still doing damage to the heart, to the kidneys, and to the brain, but the person with high blood pressure, if it's not checked, if you're not seeing your doctor regularly, you won't even know it. So the high blood pressure can be killing you, leading to heart disease, strokes, and kidney failure without you even knowing it. Silent killer.
6. Does Covid Cause High Blood Pressure?
That's another interesting question because the answer is yes, it can. The infection with the SARS-CoV-2 virus, or COVID-19 infection can lead to hypertension. You see COVID can actually cause issues with the kidneys, it can be nephrotoxic and COVID-19 disease can cause blood clots in tiny vessels. If it causes blood clots in the tiny vessels in the kidney, that can lead to kidney failure which can lead to hypertension.
7. Can High Blood Pressure Cause Dizziness?
The answer is yes. When you have hypertension, if it leads to elevated pressure in the brain, then this can lead to dizziness, it can lead to confusion, and it can even lead to weakness, especially if you have a stroke because of hypertension.
8. Does High Blood Pressure Make You Hot?
High blood pressure directly does not tend to make you hot but it can be associated with other factors or other disorders that can make you hot. And so sometimes that can be confusing. For example, if you have an elevated thyroid function or hyperthyroidism (graves disease), hyperthyroidism can cause you to be hot or have heat intolerance.
Hyperthyroidism can also cause you to have hypertension. And so some people may associate the two together. Also, if you are a lady who is going through menopause being a female of an older age does put you at risk for having hypertension. And so you may have hypertension during that time, at that same time you may also notice that you're having hot flashes. So you may associate the two, hypertension and high blood pressure.
However, high blood pressure typically does not in and of itself cause you to be hot. Another disorder that can sometimes be associated with being hot and linked to high blood pressure is anxiety, or if you're having panic attacks. Many times people who are having panic attacks and sweating feel hot. And with that stress of the anxiety disorder or the panic attack, they may also have hypertension. So you see, there are a lot of disorders that are associated with hypertension, but really it's the underlying factor or disorder that's causing the person to be hot. And they may falsely associate it with hypertension.
9. Can Alcohol Cause High Blood Pressure?
Ooh, I get this question a lot. And the answer is yes. An excessive alcohol intake can be associated with high blood pressure. And so there are some recommendations that you should limit your alcohol. And with those recommendations, they state that most women should have no more than one drink a day. Most men should have no more than two drinks a day. And for men over the age of 65 no more than one drink a day.
Now, what's the definition of a drink? When I say drink, I'm not talking about a 32-ounce tumbler filled with vodka or with bourbon or some other dark liquor. No, that's not a drink. Just because it's one container, does not mean it's one drink. Drinks have very specific definitions. For example, five ounces or up to eight ounces of wine is considered one drink depending upon the alcohol concentration.
12 ounces of beer is considered one drink. And if you're dealing with a stronger liquor like an 80 proof alcohol, then 1.5 ounces is considered one drink. If you have more than the recommended amount of alcohol each day, then yes, you are putting yourself at risk for high blood pressure. Also, there was a time when red wine was considered to be helpful for heart disease, and actually, in some circles, it was recommended. That recommendation is no longer here. We do not recommend that you have alcohol intake. If you do partake in alcohol, do it in moderation. And please have no more than one or two drinks a day, but be sure to consult your doctor.
10. Can Anemia Cause High Blood Pressure?
Typically when we think about anemia, especially if it's anemia that's due to blood loss, we think about low blood pressure or hypotension. And if someone, for example, is in an accident where they're bleeding out, or they have gunshot wounds where they're bleeding out, then that anemia will typically cause low blood pressure.
However, the body does have a mechanism, if you are losing blood, then again, your body will try to activate a mechanism that will cause you to hold onto sodium and to have high blood pressure. But again, typically anemia is more associated with low blood pressure.
11. Does Lack Of Sleep Cause High Blood Pressure?
Yes. Lack of sleep or sleep deprivation definitely can cause high blood pressure. Now, most people need about seven hours of sleep a night or even nine hours of sleep a night. I'm talking uninterrupted, restful sleep. This allows your body to rejuvenate, it allows your mind to rejuvenate. It allows your brain to rejuvenate. And when this happens, it helps you to decrease the stress and it allows your cells to be ready for the next day.
If you are a person who lacks sleep it may lead to high stress. And if you have high stress that can lead to high-stress hormones like cortisol and adrenaline. When these hormones surge, these stress hormones, it can cause your blood vessels to constrict or to tighten. And if the blood vessels tighten then the pressure against them is high. You get high blood pressure. So yes, lack of sleep can lead to high blood pressure. So go to bed.

12. Can Sleep Apnea Cause High Blood Pressure?
Yes, sleep apnea can cause high blood pressure. So let's first talk about what sleep apnea is or obstructive sleep apnea. If you are a person who snores; and you know if you snore because someone has told you.
If you're calling hogs at night and you're snoring, snoring, snoring but then all of a sudden you stop breathing, that's apnea. And then after you stop breathing there's a little struggle, sometimes some snoring and then you start breathing again. That is obstructive sleep apnea.
Now of course you want to consult with your physician to get an official diagnosis. But that is typically how it presents. And people have a certain look usually, when they have obstructive sleep apnea, they often have a thick neck. And they can get symptoms like headaches during the days and even nights, or they can have daytime somnolence meaning they're sleepy all the time. But guess what? Thin people with thin necks can also have obstructive sleep apnea.
What happens when you stop breathing is that your oxygen level goes down. And when your oxygen level is low, your body compensates for it by your heart rate increasing and your blood pressure increasing. And so you can get elevated blood pressure from sleep apnea. So here's the thing, if you have chronic sleep apnea then even when you're walking around breathing well and you're not actually having the low oxygen, well over time your body's blood pressure will increase consistently. So can sleep apnea cause high blood pressure? Yes.
13. Does Aspirin Help High Blood Pressure?
This is actually a very complex question about aspirin. Because aspirin does have many great properties but it has some risks as well. So let me just start by talking about that really quickly. We do know that a baby aspirin or an 81-milligram tablet of aspirin has been shown to help to reduce heart disease and strokes. However, however, aspirin can also have some harmful effects.
Aspirin can cause increased bleeding like stomach bleeding, GI bleeding, or intestinal bleeding. And so you have to weigh the risks and the benefits. When it comes to aspirin for heart attack prevention you absolutely must consult with your physician because taking a daily aspirin is not for everyone.
If you are between the age of 40 and 59 and you are at high risk for a heart attack, for example, meaning you have a 10% risk or greater of having a heart attack or a stroke within 10 years, then your doctor may feel like the benefits of aspirin outweigh the risks.
However, if you are someone who is much older, then yes your risks for heart attacks will increase as you get older. But guess what? So does the risk for bleeding, for hitting your head and having a brain bleed, or from having a stomach bleed. So again, do not take a daily aspirin unless you consult with your physician.
Does aspirin reduce high blood pressure? Well, there was actually a study that was done, a relatively small study, where they gave a certain group aspirin in the morning. Another group aspirin at night. And another group got no aspirin. Now for people who had pre-hypertension or elevated blood pressure or people who had just mild high blood pressure, when they took that aspirin at night it did decrease their blood pressure significantly.
However, other portions of the study showed that for patients who were on blood pressure medications or who had moderate or really high blood pressure, aspirin didn't help them at all. What does that mean? We don't have sufficient data to support the idea of aspirin lowering blood pressure.
Should you take aspirin to lower your blood pressure? No, that is not a recommendation. Again, make sure you consult with your physician in everything you do. But at this time there are no recommendations to take aspirin to lower blood pressure.
I want to give you even more information about hypertension and how to control it. That is why I wrote a book, "Under Pressure: A Guide to Controlling High Blood Pressure". This is your step-by-step guide to managing your high blood pressure. We know that blood pressure is a silent killer, meaning that you can have high blood pressure, and it can be damaging your organs, your heart, your lungs, and your kidneys, and you may not even know it! It's a silent killer.
In order to stop yourself from being stalked by the silent killer, you want this guide. Please make sure you go out and get it today and share it with your loved ones.
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14. Can Hypothyroidism Cause High Blood Pressure?
Classically when we talk about the thyroid causing high blood pressure, we talk about hyperthyroidism or Graves' disease. Because we know that can cause heat intolerance, a fast heart rate, and it can cause high blood pressure.
Hyperthyroidism can also cause you to have frequent bowel movements, hair loss, or thinning. We think of hypothyroidism as being an underactive thyroid where you get a slow heart rate, you get weight gain, and lower metabolism, things of that nature. But guess what? Hypothyroidism can actually also be associated with high blood pressure. So yes, even hypothyroidism can be associated with hypertension.
15. Is Oatmeal Good For High Blood Pressure?
First, let's talk about oats, grains, and fiber. If you're talking about whole grains then whole grains have a lot of fiber which has some very heart-healthy effects. And we know that anything that's heart-healthy can also be good for blood pressure. And so when you eat certain things like oatmeal or oat brand, you have to be careful.
If you're dealing with the whole grain, then yes it can have some beneficial effects. And by whole grain, I mean all three parts. You want that outer layer of the bran because that's loaded with fiber. Then you have that endosperm and then you have that inner layer, the germ which has all kinds of vitamins.
Now, if you're talking about oatmeal that is processed and loaded with sugar and it's been stripped of a lot of that fiber, then no. That's not going to have very many heart-healthy benefits or blood pressure benefits because when it is stripped... Even when it says it's enriched, when it's enriched they may put some of the vitamins back in but you're not getting all of the fiber.
And fiber is the key to being heart healthy and blood pressure healthy. When you're eating oatmeal, you want to make sure that you're eating something that's like an oat bran or something that is a whole grain. When you do that and you have that fiber then the fiber has been associated with potentially lowering blood pressure.
Now you know, with this there are a lot of anecdotal studies. We don't necessarily have any huge, randomized controlled trials. But what some studies do suggest is that eating this fiber can help to increase your nitric oxide, which can help to dilate blood vessels and decrease blood pressure. We also know that eating this fiber can help to bulk your diet, which can make you get full faster, which is healthy. And it can help to decrease your weight, and decrease that BMI.
We also know that having a healthy BMI or body mass index can be associated with lowering blood pressure. In fact, for every two kilograms or between four to five pounds that you lose if you are overweight, then that can lower your blood pressure by 5 to 10 points (5 to 10 millimeters mercury). So that can be associated with having these whole grains, oats, or oatmeal in your diet.
So bottom line, if you're eating oats that are whole, okay, or something like oat bran that is a whole grain then it has certain fibers that can be associated with lowering cholesterol, unclogging arteries, and potentially lowering the blood pressure. Make sure you consult with your physician and your nutritionist.
16. Can High Blood Pressure Cause Ringing In The Ears?
Yes. And I do have many patients who have had that ringing in the ears. So when the blood pressure is elevated, we know that blood pressure is the force that the blood exerts against the blood vessels, right? And so if you have high blood pressure and it is high in the blood vessels in your brain, then you can get a pounding, literally, that's pressure on the arteries in your brains, even near your ears. And it can cause a pounding in the ears associated with a headache as well.
It can cause a ringing in the ears. So can high blood pressure be associated with a ringing in the ears? Yes, but here's what you don't want to do. You don't want to wait for symptoms before you decide whether or not you have high blood pressure. Because remember hypertension is a silent killer. Make sure you're seeing your physician regularly and checking your blood pressure to know.
17. Do Energy Drinks Cause High Blood Pressure?
People have so much to do all the time that they love a good energy drink. You see them advertised, you see people scooting around drinking those drinks. Here's the deal. Energy drinks are loaded with caffeine. Now I will say there's not really enough data out, enough randomized controlled trials out on caffeine to give an outright answer to the question is caffeine good, or is caffeine bad? But there are a lot of studies that have been done on caffeine.
And so with energy drinks, do they cause high blood pressure? It's possible. Now we do believe just in general that if adults have less than 400 milligrams of caffeine a day then it's not likely to have many detrimental effects. And for children, they need less. Something like 2.5 milligrams per kilogram. But if you have energy drinks and you're drinking a lot, especially if you're getting up to 400, 800 milligrams of caffeine per day, then certainly it can be associated with high blood pressure.
And here's how it works. Caffeine is a stimulant. It's literally a drug. In fact, it's the most commonly used drug in the world. Isn't that something? I find that to be interesting. But what caffeine does is that it blocks adenosine receptors. And adenosine receptors can be found in the brain, in the heart, and in the kidneys. And when adenosine receptors are met with adenosine they make you calm and cool, right? They kinda make you a little sleepy in the brain.
If adenosine is on adenosine receptors in the heart they slow the heart rate down. But imagine if caffeine is blocking those adenosine receptors, in the heart specifically, then instead of your heart rate being slow and cool, it's going to speed up.
So caffeine can cause you to have a fast heart rate. And in some people, it can cause jitteriness or anxiety, and guess what? In some people, it can elevate their blood pressure.
So especially if you're already at risk for high blood pressure, or if you have hypertension you definitely want to consult with your physician. But having caffeine, especially in excess of 400 milligrams a day can, in some cases, exacerbate high blood pressure.
18. Can High Blood Pressure Cause Seizures?
The short answer is yes, it's possible. When you're dealing with high blood pressure in the vessels, yes, that affects the blood vessels in the brain. And if that blood pressure is very high, pushing against the blood vessels in the brain, guess what? It can actually cause those blood vessels to burst. You can get a hemorrhagic stroke from very high blood pressure.
If this happens, then certainly, you can have irritation in the brain, you can actually have swelling in the brain getting pushed a certain way in the brain causing all kinds of abnormal firing. And ultimately it could lead to a seizure.
Again, you don't sit around and wait for neurological deficits or for seizures to find out whether or not your blood pressure is managed. You go see your doctor, you manage that blood pressure. But can high blood pressure potentially cause a seizure? Yes.
19. Does High Blood Pressure Cause Blurred Vision?
When your blood pressure is high, it can cause pressure on these tiny blood vessels in the back of your eyes or in your retina. When this happens, sometimes these tiny blood vessels can burst from the pressure and they can bleed. And this can cause hypertensive retinopathy. And if you have this hypertensive retinopathy, and certainly if it's something that's recurrent or long going, you can even have a detachment of the retina. And so yes, high blood pressure can cause blurry vision.
20. Can A Tooth Infection Cause High Blood Pressure?
That's a really interesting question because indirectly there are mechanisms where I can see a tooth infection causing high blood pressure. Number one, pain. If you've ever had a tooth infection and certainly the way my patients describe it to me, that hurts. And it hurts quite a bit, especially when you're trying to eat foods that you like and you're sitting up here with a decayin' tooth, it causes pain. Guess what? Pain causes stress. Stress causes stress hormones to surge. Stress hormones cause blood vessels to tighten or vasoconstriction and this can cause high blood pressure. So yes, having a tooth infection can lead to high blood pressure. Certainly, if you're having a lot of pain involved.
21. Is Celery Good For High Blood Pressure?
There are many anecdotal studies about celery to suggest that it is a good way to lower blood pressure naturally. However, there's no huge, randomized controlled trial where I can give you a definitive answer of "take this much celery and it will lower your blood pressure by this much." I don't have that evidence.
But I can say this, celery has coumarins which can help to increase vascular flow. There have been studies to suggest that it has diuretic properties like a water pill which can potentially help to lower blood pressure naturally. Celery also has vitamin D, vitamin C, it has vitamin K and it is a low sodium vegetable, which is good for blood pressure.
Also, it is a bulking vegetable, meaning that if you eat celery that helps to fill you up and it can keep you from eating some unhealthy foods. So celery can be good for lowering your body mass index which of course can help to lower blood pressure. So overall, is celery something that can help you to lower blood pressure naturally? Yes. Can I tell you definitively how much celery? And exactly what it will do? No. Make sure you consult with your physician.
Conclusion
Remember high blood pressure is the silent killer. And so you must consult with your physician. You must get your blood pressure checked. Just because you're walking around, having no symptoms, feeling great, feeling footloose and fancy-free, that does not mean that you do not have the diagnosis. Make sure you find out if you have hypertension, this silent killer so that you can get it controlled.
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