Download Issue   |   Print Article

High Blood Pressure: 7 Causes You Might Be Missing *ONLINE ONLY*

May 2025

By Suzy Cohen, R.Ph.

Most people focus on the usual triggers, like salt or aging, but there’s more to the story. Understanding the full range of causes, especially the ones your doctor may overlook, can make all the difference.

Let’s start with the 6 most obvious:

1. Aging naturally stiffens blood vessels, making it harder for blood to flow freely. That resistance raises pressure over time.

2. Excess body weight, especially around the midsection, strains the heart and disrupts hormonal balance. It also contributes to insulin resistance, a major cardiovascular risk factor.

3. A sedentary lifestyle lowers circulation and oxygen delivery, contributing to vascular stiffness. Even light, consistent movement improves endothelial function and helps regulate pressure.

4. High sodium intake causes fluid retention, which increases blood volume—and therefore, pressure. Unfortunately, sodium lurks in everything from soups to salad dressings, not just your salt shaker.

5. Chronic stress drives up cortisol and adrenaline levels. These stress hormones constrict blood vessels and keep your nervous system in a constant state of "high alert."

6. Sleep apnea, especially obstructive sleep apnea, disrupts your oxygen supply throughout the night. This condition leads to surges in blood pressure and raises the risk of arrhythmias and stroke.

Now here’s something your physician may not have mentioned—what I call the “drug mugger” effect. Let’s make it number seven on the list. This happens when medications you take for unrelated issues quietly deplete the nutrients that help regulate blood pressure.

For example, proton pump inhibitors (PPIs) like omeprazole (Prilosec) or esomeprazole (Nexium) can lower your magnesium, potassium, and calcium levels over time. These minerals are critical for vascular tone and proper nerve signaling. Without them, your blood vessels may tighten up and resist blood flow. So taking a PPI long-term can inadvertently lead to hypertension via the “drug mugger” effect.

These drug-nutrient interactions are often missed in routine checkups, yet they can quietly undermine your progress. As a pharmacist, I’ve seen hundreds of cases where restoring nutrient balance made a significant difference - even when medications alone weren’t enough.

Magnesium deficiency, in particular, has been linked to increased vascular resistance and endothelial dysfunction. I wrote an entire book on Amazon called Drug Muggers to help people identify which medications might be robbing them of essential nutrients. If you’re on a PPI, talk to your practitioner about checking your magnesium levels and supplementing wisely.

Understanding the real root of your high blood pressure, whether it’s a lifestyle issue, a sleep problem, or a hidden nutrient depletion, puts the power back in your hands.

Want the full list of lesser-known causes? I’ve created a longer, more comprehensive version of this article, and I’ll email it to you when you sign up for my Tuesday newsletter at suzycohen.com.

This information is not intended to treat, cure, or diagnose your condition. Always consult your physician for all medical matters. Visit www.SuzyCohen.com. ©2025 Suzy Cohen, R.Ph. Distributed by Dear Pharmacist, Inc.