Quick – what causes high blood pressure? The first culprits that pop into your mind are likely to be eating too much salt, being stressed out all the time and alcohol abuse. And you would be right. 

But there are also less obvious causes of high blood pressure, a condition that affects about one in three, or 78 million, adults in the U.S.

“The best data demonstrates that hypertension is almost unavoidable as we age,” said Clyde Yancy, MD, chief of the Division of Cardiology and the Magerstadt Professor at Northwestern University Feinberg School of Medicine. “Once we reach age 55, we have a 90% chance of becoming hypertensive.”

Yet that inevitability doesn’t mean we can’t do something about it. Step one is to modify your lifestyle: lose weight, exercise, and eat a wholesome diet, explains Dr. Yancy. Another thing you can do: Get to know these less well-known blood pressure factors.

1. Feeling lonely

Spending time with friends has been linked to better health and well-being, but the flip side of that — feeling lonesome — takes a toll not only on your confidence, happiness and stress levels, but also on your blood pressure.

So says a five-year study at the University of Chicago, which, for the first time, showed a direct correlation between loneliness and high blood pressure among people 50 years old and older. Blood pressure increase was first observed two years into the study, and continued to increase until four years later.

“Conversely, when you’re with close friends and have social supports you can depend on, you tend to feel more relaxed,” says Irene S. Levine, Ph.D., professor of psychiatry at the NYU School of Medicine. “Set aside time for friendships, but recognize that not all of them last forever. That’s why it’s important to cultivate new friendships, too,” she says.

2-3. Hot tubs and saunas

Ahhh… that heat feels good, especially when it’s cold outside or your muscles and joints ache. But beware of hot tubs and saunas if you already have high blood pressure, says the American Heart Association.

Since the heat from hot tubs and saunas causes blood vessels to open up (similar to what happens during normal activities, like a brisk walk), the AHA says that if your doctor has told you to avoid moderate exercise, you should use caution when considering hot tubs and saunas. Saunas are particularly problematic, since the temperature is difficult to control, he says. “If you do use a hot tub, set the temperature to about 90 degrees Fahrenheit, and be careful you don’t overheat.”

4. Medications

Prescription and over-the-counter medications are designed to enhance your health, right? Yes, but certain drugs could be putting your blood pressure at risk, finds a study published in the Archives of Internal Medicine.

According to the Mayo Clinic, people who take acetaminophen (Tylenol) daily are more likely to develop high blood pressure than those who don’t take it. Also, certain pain and anti-inflammatory medications can raise your blood pressure, including ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve). And if you take an antidepressant, check your blood pressure regularly — some have been shown to raise blood pressure.

See Also: This one simple move could lower your blood pressure by 10%

5. Herbal supplements

Certain herbal supplements, like ginseng, licorice and ephedra (ma huang), may have the same effect. Always remember to check with your doctor or pharmacist if you’re concerned about your blood pressure. 

6. Thyroid Problems

A study published in the Journal of Hypertension reported a correlation between hypothyroidism (when the thyroid gland doesn’t produce enough thyroid hormone) and high blood pressure. When compared with volunteers, patients with the condition had significantly higher blood pressure readings. Conversely, hyperthyroidism (when there’s too much hormone produced) can also result in higher-than-normal blood pressure readings.

And then there’s a condition known as hyperparathyroidism, one type of which may be accountable for a high reading as well. This parathyroid condition affects hormone regulation and can result in too much calcium in the blood which has been associated with elevated blood pressure, says the Mayo Clinic.

7. Sleep apnea

This common disorder, which often goes undiagnosed, leads to snoring, restless nights — and, possibly, elevated blood pressure. That’s because when your breathing is interrupted, the oxygen level in your body falls. Your brain then sends signals through your nervous system to increase the flow of oxygen to the heart and brain, thereby tightening up your blood vessels. Frequent drops in your blood oxygen level, along with reduced quality of sleep, can also trigger the release of stress hormones, which raise your heart rate and increase your risk for high blood pressure.

See Also: If you have high blood pressure, watch out for these 8 symptoms