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Food Products That May Cause an Increase in Blood Pressure


Purpose of Review

To review latest reports of the food products which might increase blood pressure and therefore might participate in the pathogenesis of hypertension.

Recent Findings

Results of clinical study suggest that consumption of high-sodium food leads to transient increase in plasma sodium concentration. This is accompanied by blood pressure increase. Results of both clinical and experimental studies suggest direct vasculotoxic effects of sodium. Increased plasma sodium concentration could mediate its effects on blood pressure by changes in endothelial cell stiffness and glycocalyx integrity. Energy drinks are non-alcoholic beverages with increasing popularity. Clinical, interventional, randomized, placebo controlled, and cross-sectional studies showed that energy drinks may increase arterial blood pressure. Blood pressure increase after exposure for the energy drinks is mainly related to the caffeine content in these drinks. Many case reports were published concerning the clinically significant increase in blood pressure caused by the consumption of liquorice root or food products containing liquorice, such as candies, tea, Pontefract cookies, and chewing gum. Liquorice contains a precursor of glycyrrhetic acid. Glycyrrhetic acid reduces the activity of the 11β-hydroxysteroid dehydrogenase type 2 (11ß-HSD2) isoenzyme, which leads to activation of the mineralocorticoid receptor by cortisol in the distal convoluted tubule resulting in hypertension, hypokalemia, and metabolic alkalosis. The relationship between chronic alcohol intake and blood pressure is well established on the basis of a diverse body of evidence including animal experiments, epidemiological studies, mendelian randomization studies, and interventional studies. Results of recent studies suggested that binge drinking (i.e., episodic consumption of a very high amount of alcohol beverages) has pronounced hypertensinogenic effects. Recently, it was documented that also low doses of alcohol may increase the risk of cardiovascular complications. Therefore, the amount of alcohol consumption that is safe is zero.


High-salt food products, energy drinks, food products containing liquorice, and alcoholic beverages have hypertensinogenic properties. Patients with hypertension and other cardiovascular diseases should avoid even accidental consumption of these food products.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.

    World Health Organization. Guideline: sodium intake for adults and children. Geneva, Switzerland: World Health Organization; 2012.

  2. 2.

    Murtaugh MA, Beasley JM, Appel LJ, Guenther PM, McFadden M, Greene T, et al. Relationship of sodium intake and blood pressure varies with energy intake: secondary analysis of the DASH (Dietary Approaches to Stop Hypertension)-sodium trial. Hypertension. 2018;71:858–65.

  3. 3.

    He FJ, MacGregor GA. Role of salt intake in prevention of cardiovascular disease: controversies and challenge. Nat Rev Cardiol. 2018;15:371–7.

  4. 4.

    Strazzullo P. Reducing sodium and increasing potassium intake. BMJ. 2013;346:f2195.

  5. 5.

    He FJ, MacGregor GA. Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. J Hum Hypertens. 2002;16:761–70.

  6. 6.

    Jaworowska A, Blackham T, Stevenson L, Davies IG. Determination of salt content in hot takeaway meals in the United Kingdom. Appetite. 2012;59:517–22.

  7. 7.

    Dunford E, Webster J, Woodward M, Czernichow S, Yuan WL, Jenner K, et al. The variability of reported salt levels in fast foods across six countries: opportunities for salt reduction. CMAJ. 2012;184:1023–8.

  8. 8.

    •• Suckling RJ, He FJ, Markandu ND, MacGregor GA. Dietary salt influences postprandial plasma sodium concentration and systolic blood pressure. Kidney Int. 2012;81:407–11 Clinical study demonstrated that consumption of salty food product leads to plasma sodium concentration and blood pressure increase lasted for 3 hours.

  9. 9.

    Friedman SM, McIndoe RA, Tanaka M. The relation of blood sodium concentration to blood pressure in the rat. J Hypertens. 1990;8:61–6.

  10. 10.

    •• Suckling RJ, Swift PA, He FJ, Markandu ND, MacGregor GA. Altering plasma sodium concentration rapidly changes blood pressure during haemodialysis. Nephrol Dial Transplant. 2013;28:2181–6 Clinical study demonstrated that blood pressure increase after consumption of salty food product is related directly to plasma sodium concentration increase but not to extracellular volume increase.

  11. 11.

    Dickinson KM, Clifton PM, Keogh JB. Endothelial function is impaired after a high-salt meal in healthy subjects. Am J Clin Nutr. 2011;93:500–5.

  12. 12.

    •• Oberleithner H, Riethmuller C, Schillers H, et al. Plasma sodium stiffens vascular endothelium and reduces nitric oxide release. Proc Natl Acad Sci U S A. 2007;104:16281–6 Experimental study shown in cultured human endothelial cells that raising sodium bath concentration from 135 to 145 mmol/l, lead to increase endothelial cell stiffness and to reduction of nitric oxide synthase (eNOS) activity.

  13. 13.

    Oberleithner H, Kusche-Vihrog K, Schillers H. Endothelial cells as vascular salt sensors. Kidney Int. 2010;77:490–4.

  14. 14.

    Li J, White J, Guo L, Zhao X, Wang J, Smart EJ, et al. Salt inactivates endothelial nitric oxide synthase in endothelial cells. J Nutr. 2009;139:447–51.

  15. 15.

    Fels J, Jeggle P, Liashkovich I, Peters W, Oberleithner H. Nanomechanics of vascular endothelium. Cell Tissue Res. 2014;355:727–37.

  16. 16.

    Oberleithner H. Vascular endothelium: a vulnerable transit zone for merciless sodium. Nephrol Dial Transplant. 2014;29:240–6.

  17. 17.

    •• Oberleithner H, Peters W, Kusche-Vihrog K, Korte S, Schillers H, Kliche K, et al. Salt overload damages the glycocalyx sodium barrier of vascular endothelium. Pflugers Arch. 2011;462:519–28 Experimental study documented that increase of sodium concentration leads to damage of the endothelial glycocalyx.

  18. 18.

    Breda JJ, Whiting HS, Encarnacao R, Norberg S, Jones R, Reinap M, et al. Energy drink consumption in Europe: a review of the risks, adverse health effects, and policy options to respond. Front Public Health. 2014;134:1–5.

  19. 19.

    Nowak D, Jasionowski A. Analysis of the consumptions of caffeinated energy drinks among Polish adolescents. Int J Environ Res Public Health. 2015;12:7910–21.

  20. 20.

    Malinauskas BM, Aeby VG, Overton RF, Carpenter-Aeby T, Barber-Heidal K. A survey of energy drink consumption patterns among college students. Nutr J. 2007;6:35–41.

  21. 21.

    O’Brien MC, McCoy TP, Rhodes SD, Wagoner A, Wolfson M. Caffeinated coctails: energy drink consumption, high-risk drinking, and alcohol-related consequences among college students. Acad Emerg Med. 2008;15:453–60.

  22. 22.

    Gallucci AR, Martin RJ, Morgan GB. The consumption of energy drinks among a sample of college students and college student athletes. J Community Health. 2016;41:109–18.

  23. 23.

    Grasser EK, Miles-Chan JL, Charrière N, Loonam CR, Dulloo AG, Montani JP. Energy drinks and their impact on the cardiovascular system: potential mechanisms. Adv Nutr. 2016;7:950–60.

  24. 24.

    Bigard AX. Risks of energy drinks in youths. Arch Pediatr. 2010;17:1625–31.

  25. 25.

    Seifert SM, Schaechter JL, Hershorin ER, Lipshultz SE. Health effects of energy drinks on children, adolescents, and young adults. Pediatrics. 2011;127:511–28.

  26. 26.

    Finnegan D. The health effects of stimulant drinks. Nutr Bull. 2003;28:147–55.

  27. 27.

    Gunja N, Brown J. Energy drinks: health risk and toxicity. Med J Aust. 2012;196:46–9.

  28. 28.

    Temple JL. Caffeine use in children: what we know, what we have left to learn, and why we should worry. Neurosci Biobehav Rev. 2009;33:793–806.

  29. 29.

    Szotowska M, Bartmańska M, Wyskida K, Bąba M, Tarski M, Adamczak M, et al. The influence of so called “energy drinks” on the blood pressure and the pulse rate in young, healthy adults. Arterial Hypertens. 2013;17:169–74.

  30. 30.

    Grasser EK, Yepuri G, Dulloo AG, Montani JP. Cardio- and cerebrovascular responses to the energy drink Red Bull in young adults: a randomized cross-over study. Eur J Nutr. 2014;53:1561–71.

  31. 31.

    Higgins J, Yarlagadda S, Yang B. Cardiovascular complications of energy drinks. Beverages. 2015;1:104–26.

  32. 32.

    Svatikova A, Covassin N, Somers KR, Somers KV, Soucek F, Kara T, et al. A randomized trial of cardiovascular responses to energy drink consumption in healthy adults. JAMA. 2015;314:2079–82.

  33. 33.

    •• Shah SA, Chu BW, Lacey CS, Riddock IC, Lee M, Dargush AE. Impact of acute energy drink consumption on blood pressure parameters: A meta-analysis. Ann Pharmacother. 2016;50:808–15 A metaanalysis of 15 clinical, interventional, randomized, placebo controlled studies documented that energy drinks consumption resulted in blood pressure increase.

  34. 34.

    • Franks AM, Schmidt JM, McCain KR, Fraer M. Comparison of the effects of energy drink versus caffeine supplementation on indices of 24-hour ambulatory blood pressure. Ann Pharmacother. 2012;46:192–9 Interventional, clinical study demonstrated that repeated intakes of an energy drinks 4 times over 24 h increased blood pressure measured by 24 hours ambulatory blood pressure monitoring (ABPM) when compared with a water drink with equivalent amounts of caffeine.

  35. 35.

    Nazari S, Rameshrad M, Hosseinzadeh H. Toxicological effects of glycyrrhiza glabra (licorice): a review. Phytother Res. 2017;31:1635–50.

  36. 36.

    Sontia B, Mooney J, Gaudet L, Touyz RM. Pseudohyperaldosteronism, liquorice, and hypertension. J Clin Hypertens (Greenwich). 2008;10:153–7.

  37. 37.

    Bisogni V, Rossi GP, Calò LA. Apparent mineralcorticoid excess syndrome, an often forgotten or unrecognized cause of hypokalemia and hypertension: case report and appraisal of the pathophysiology. Blood Press. 2014;23:189–92.

  38. 38.

    Schröder T, Hubold C, Muck P, Lehnert H, Haas CS. A hypertensive emergency with acute visual impairment due to excessive liquorice consumption. Neth J Med. 2015;73:82–5.

  39. 39.

    Allcock E, Cowdery J. Hypertension induced by liquorice tea. BMJ Case Rep. 2015;2015:bcr2015209926.

  40. 40.

    Russo S, Mastropasqua M, Mosetti MA, Persegani C, Paggi A. Low doses of liquorice can induce hypertension encephalopathy. Am J Nephrol. 2000;20:145–8.

  41. 41.

    Tassinari D, Bergamaschi R, Corsini I, Landini S, Romanin B, Ballarini E, et al. Posterior reversible encephalopathy syndrome associated with licorice consumption: a case report in a 10-year-old boy. Pediatr Neurol. 2015;52:457–9.

  42. 42.

    Flores-Robles BJ, Sandoval AR, Dardon JD, Blas CA. Lethal liquorice lollies (liquorice abuse causing pseudohyperaldosteronism). BMJ Case Rep. 2013;2013:bcr2013201007.

  43. 43.

    Foster CA, Church KS, Poddar M, Van Uum SH, Spaic T. Licorice-induced hypertension: a case of pseudohyperaldosteronism due to jelly bean ingestion. Postgrad Med. 2017;129:329–31.

  44. 44.

    Gallacher SD, Tsokolas G, Dimitropoulos I. Liquorice-induced apparent mineralocorticoid excess presenting in the emergency department. Clin Med (Lond). 2017;17:43–5.

  45. 45.

    •• Sigurjónsdóttir HA, Franzson L, Manhem K, Ragnarsson J, Sigurdsson G, Wallerstedt S. Liquorice-induced rise in blood pressure: a linear dose-response relationship. J Hum Hypertens. 2001;15:549–52 Interventional, clinical study demonstrated that liquorice induced blood pressure increase.

  46. 46.

    Sigurjonsdottir HA, Manhem K, Axelson M, Wallerstedt S. Subjects with essential hypertension are more sensitive to the inhibition of 11 beta-HSD by liquorice. J Hum Hypertens. 2003;17:125–31.

  47. 47.

    Martínez-González MA, Gea A, Ruiz-Canela M. The mediterranean diet and cardiovascular health. Circ Res. 2019;124:779–98.

  48. 48.

    Temple NJ, Guercio V, Tavani A. The mediterranean diet and cardiovascular disease: gaps in the evidence and research challenges. Cardiol Rev. 2019;27:127–30.

  49. 49.

    Lieber CS. Hepatic and other medical disorders of alcoholism: from pathogenesis to treatment. J Stud Alcohol. 1998;59:9–25.

  50. 50.

    •• GBD 2016 Alcohol and Drug Use Collaborators. The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiatry. 2018;5:987–1012 Analysis of epidemiological studies on individual and population-level alcohol consumption and epidemiological studies on the risk of alcohol intake.

  51. 51.

    Puddey IB, Mori TA, Barden AE, Beilin LJ. Alcohol and hypertension-new insights and lingering controversies. Curr Hypertens Rep. 2019;21:79.

  52. 52.

    Marchi KC, Muniz JJ, Tirapelli CR. Hypertension and chronic ethanol consumption: what do we know after a century of study? World J Cardiol. 2014;6:283–94.

  53. 53.

    Klatsky AL, Friedman GD, Siegelaub AB, Gérard MJ. Alcohol consumption and blood pressure Kaiser-Permanente Multiphasic Health Examination data. N Engl J Med. 1977;296:1194–200.

  54. 54.

    Sesso HD, Cook NR, Buring JE, Manson JE, Gaziano JM. Alcohol consumption and the risk of hypertension in women and men. Hypertension. 2008;51:1080–7.

  55. 55.

    Fan AZ, Li Y, Elam-Evans LD, Balluz L. Drinking pattern and blood pressure among non-hypertensive current drinkers: findings from 1999-2004 National Health and Nutrition Examination Survey. Clin Epidemiol. 2013;5:21–7.

  56. 56.

    Holmes MV, Dale CE, Zuccolo L, et al. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. BMJ. 2014;349:g4164.

  57. 57.

    Chen L, Smith GD, Harbord RM, Lewis SJ. Alcohol intake and blood pressure: a systematic review implementing a Mendelian randomization approach. PLoS Med. 2008;5:e52.

  58. 58.

    Roerecke M, Kaczorowski J, Tobe SW, Gmel G, Hasan OSM, Rehm J. The effect of a reduction in alcohol consumption on blood pressure: a systematic review and meta-analysis. Lancet Public Health. 2017;2:e108–20.

  59. 59.

    Phillips SA, Osborn K, Hwang CL, Sabbahi A, Piano MR. Ethanol induced oxidative stress in the vasculature: friend or foe. Curr Hypertens Rev. 2019;15:1–10.

  60. 60.

    •• Mori TA, Burke V, Beilin LJ, Puddey IB. Randomized controlled intervention of the effects of alcohol on blood pressure in premenopausal women. Hypertension. 2015;66:517–23 Interventional, clinical study demonstrated that alcohol consumption induced blood pressure increase.

  61. 61.

    Potter JF, Watson RD, Skan W, Beevers DG. The pressor and metabolic effects of alcohol in normotensive subjects. Hypertension. 1986;8:625–31.

  62. 62.

    Seppa K, Sillanaukee P. Binge drinking and ambulatory blood pressure. Hypertension. 1999;33:79–82.

  63. 63.

    Rosito GA, Fuchs FD, Duncan BB. Dose-dependent biphasic effect of ethanol on 24-h blood pressure in normotensive subjects. Am J Hypertens. 1999;12:236–40.

  64. 64.

    •• Hayibor LA, Zhang J, Duncan A. Association of binge drinking in adolescence and early adulthood with high blood pressure: findings from the National Longitudinal Study of Adolescent to Adult Health (1994–2008). J Epidemiol Community Health. 2019;73:652–9 Prospective study documented that binge drinking may increase the risk of hypertension.

  65. 65.

    • Wellman RJ, Vaughn JA, Sylvestre MP, O'Loughlin EK, Dugas EN, O'Loughlin JL. Relationships between current and past binge drinking and systolic blood pressure in young adults. J Adolesc Health. 2016;58:352–7 A cross-sectional study documented that binge drinking is associated with higher systolic blood pressure.

  66. 66.

    • Piano MR, Burke L, Kang M, Phillips SA. Effects of repeated binge drinking on blood pressure levels and other cardiovascular health metrics in young adults: National Health and Nutrition Examination Survey, 2011–2014. J Am Heart Assoc. 2018;7:e008733 Epidemiological study documented that binge drinking in adolescents and young adult were associated with higher blood pressure.

  67. 67.

    Ohira T, Tanigawa T, Tabata M, Imano H, Kitamura A, Kiyama M, et al. Effects of habitual alcohol intake on ambulatory blood pressure, heart rate, and its variability among Japanese men. Hypertension. 2009;53:13–9.

  68. 68.

    Oda N, Kajikawa M, Maruhashi T, Iwamoto Y, Kishimoto S, Matsui S, et al. Endothelial function is impaired in relation to alcohol intake even in the case of light alcohol consumption in Asian men; Flow-mediated Dilation Japan (FMD-J) Study. Int J Cardiol. 2017;230:523–8 Clinical study suggest that flow mediated dilation is impaired in relation to alcohol consumption.

  69. 69.

    Ward NC, Puddey IB, Hodgson JM, Beilin LJ, Croft KD. Urinary 20-hydroxyeicosatetraenoic acid excretion is associated with oxidative stress in hypertensive subjects. Free Radic Biol Med. 2005;38:1032–6.

  70. 70.

    Barden AE, Croft KD, Beilin LJ, Phillips M, Ledowski T, Puddey IB. Acute effects of red wine on cytochrome P450 eicosanoids and blood pressure in men. J Hypertens. 2013;31:2195–202.

  71. 71.

    Barden A, Zilkens RR, Croft K, Mori T, Burke V, Beilin LJ, et al. A reduction in alcohol consumption is associated with reduced plasma F2-isoprostanes and urinary 20-HETE excretion in men. Free Radic Biol Med. 2007;42:1730–5.

  72. 72.

    Husain K, Ansari RA, Ferder L. Alcohol-induced hypertension: mechanism and prevention. World J Cardiol. 2014;6:245–52.

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Correspondence to Marcin Adamczak.

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Adamczak, M., Wiecek, A. Food Products That May Cause an Increase in Blood Pressure. Curr Hypertens Rep 22, 2 (2020).

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  • Salt and hypertension
  • Cardiovascular disease
  • Diet and hypertension
  • Blood pressure
  • Salt intake
  • Alcohol and hypertension