High blood pressure, also called hypertension, plagues three out of four Americans over the age of 60. It’s often called the ‘silent killer’ because high blood pressure usually has no symptoms. Heart disease, sexual dysfunction, stroke, kidney failure and aneurysms can all be caused by elevated blood pressure.

The American Heart Association recommends a normal blood pressure reading of 120/80 mm Hg. While we know that too much salt in our diet, or stress in our lives, can contribute to high blood pressure, there are some surprising things that can send blood pressure soaring.

1. Sleep apnea. According to AARP, this sleep disorder, in which a person’s breathing is interrupted throughout the night, can raise blood pressure. Excess weight is one of the biggest risk factors for sleep apnea and age is another, says Dr. Donald Lloyd-Jones, president of the American Heart Association. The continuous interruption in sleep patterns interferes with sleep quality which Lloyd-Jones says is very hard on the vascular system. That stress and strain drive up blood pressure, not only during the night but also during the day.
2. Air pollution. One study led by researchers at the University of Michigan concluded that even short-term exposure to air pollution can boost blood pressure in healthy adults. Another study, also from the University of Michigan, found that filtering the air can conversely lower blood pressure.
3. Black licorice. Real black licorice contains a compound called glycyrrhizin, which causes the body to hold on to lots of salt and water, which drive blood pressure skyward. Not all black licorice contains glycyrrhizin, check the label.  
4. Alcohol. While a little wine may be heart-healthy, Lloyd-Jones says that both short-term and long-term drinking can raise blood pressure. He explains that while initially alcohol relaxes the blood vessels, they constrict after the liver metabolizes it. Blood pressure can remain high days after drinking too much booze and if drinking becomes habitual, the numbers will continue to rise.
5. Medications. Over-the-counter painkillers may not only increase your risk for heart attack and stroke, drugs like ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve) can raise blood pressure and even lower the efficacy of the medications that lower BP, says the American College of Cardiology. The ACC adds that many common decongestants, cough and cold medications, weight-loss stimulants, high-sodium antacids, and even herbal remedies should be used with caution if you have high blood pressure. According to the Mayo Clinic, even aspirin can raise your BP, so check your numbers frequently to help identify triggers.
6. Added sugar. Our bodies release insulin when we eat food to help clear the resulting glucose from the blood to get into the cells where it can be used for energy, says AARP. “But insulin, itself, tends to drive up blood pressure in many people,” says Lloyd-Jones. “So, if you are eating a lot of added sugar or simple starches, you’re having these more intense and longer bursts of insulin, which will raise blood pressure.”