1. Sugar-Sweetened Beverages
Sugar-sweetened beverages (SSBs) contain "added" sugars, syrups, or other calorie-containing sweeteners.1 These added sugars are introduced during processing to enhance the drink's taste and shelf life, and while they may be tasty, they are a source of "empty calories."
Common examples of SSBs include:

Regular soda
Sports or energy drinks
Lemonades
Sweetened coffees and teas
Non-100% fruit juice
Research has found that drinking sugar-sweetened beverages leads to a small but invariable rise in blood pressure, especially systolic blood pressure.

For example, a 2024 meta-analysis pooled data from 35 studies on the relationship between SSB intake and blood pressure.2 Compiled results revealed that for every additional 250 gram (g) serving of an SSB—around 8.5 ounces (oz)—systolic blood pressure increased by an average of 0.24 millimeters of mercury (mmHg). While the increase in blood pressure reported above is small, the concern lies with habitual SSB consumption.

Excessive intake of added sugars, particularly sugary drinks, is linked not only to higher blood pressure, but also to weight gain, chronic inflammation, and diabetes—all of which increase your odds of having a heart attack or stroke.

How Many Sugary Drinks Can I Safely Consume?
It's best to avoid SSBs and stick to smarter alternatives like plain or flavored-infused sparkling water and hot or iced unsweetened tea.

If you indulge in the occasional SSB, the American Heart Association (AHA) advises restricting added sugar intake to no more than 6% of daily calories. This is equivalent to approximately 6 teaspoons of sugar for adult females and 9 teaspoons for adult males—a close match to the sugar in a single 12 oz. can of Coca-Cola.

2. Caffeine
Research indicates that acute or short-term caffeine intake can potentially cause a mild, temporary, and reversible spike in blood pressure, though often only by a few mmHg.
The good news is that for most people, any small, transient increase in BP with caffeine intake does not appear to have a long-term impact on blood vessel and heart health. In fact, moderate caffeine consumption may even provide heart-protective effects.8

A major exception to keep in mind is if you have severe hypertension, defined as BP that is 160/100 mmHg or higher. In a 2023 study in the Journal of the American Heart Association (JAHA), individuals with severe hypertension had a increased risk of dying from cardiovascular disease (e.g., heart attack and stroke) when drinking two or more cups of coffees per day.

How Much Caffeine Can I Safely Consume?
While the FDA recommends a daily caffeine limit of 400 milligrams (mg) for healthy adults (around four 8-ounce cups of coffee), if you have hypertension, you will want to restrict your caffeine intake to below 400 mg.

Talk to your healthcare provider about what your specific daily caffeine cap should be.

3. Alcohol
When too much alcohol is consumed, it can have a "biphasic" effect on blood pressure—temporarily lowering it, only to increase it hours later.

This finding is supported by a 2020 Cochrane systematic review that analyzed data from 32 randomized, placebo-controlled trials involving over 760 participants, some with or without hypertension.12 The study investigators compared the acute impact of different doses of alcohol on blood pressure.

The doses of alcohol were defined in grams, with 14 grams being equivalent to one standard drink:

12-ounce beer (5% alcohol)
8-ounce malt liquor (7% alcohol)
5-ounce glass of wine (12% alcohol)
1.5 ounces of 80-proof liquor
High‐dose alcohol consumption was defined as more than 30 g of alcohol for males and more than 20 g of alcohol for females.

After six hours of consuming a high dose of alcohol, blood pressure decreased. However, more than 13 hours after consumption, blood pressure increased—systolic BP by 3.7 mmHg and diastolic BP by 2.4 mmHg.

The concern here is that the later increase in blood pressure, while small, could end up being sustained over time in those who consume alcohol chronically.

How Much Alcohol Can I Safely Consume?
According to the AHA, it's best to avoid alcohol if you have hypertension. If you do choose to drink, males should stick to no more than two drinks per day and females to no more than one drink per day.

Due to potential medication interactions with alcohol, including reduced effectiveness of certain anti-hypertensive drugs, please discuss what a safe amount of alcohol is for you with your provider.

4. Grapefruit Juice

Grapefruit juice (and the fruit itself) interacts with more than 85 medications, with around half of these interactions potentially leading to dangerous side effects.
Certain calcium channel blockers—a type of anti-hypertensive drug—are well-established interactants with grapefruit juice. Examples of such medications include:
Harvard Health Publishing. Grapefruit and medication: a cautionary note.


Procardia, Adalat (nifedipine)
Plendil (felodipine)
The interaction between grapefruit juice and the above-mentioned blood pressure medications occurs because compounds found within grapefruit juice block the action of a vital protein in the intestines called the CYP3A4 enzyme.

As a result of this enzyme blockage, the medication's breakdown is slowed, leading to a dangerous elevation of the drug's levels in a person's bloodstream, which may cause low blood pressure (hypotension).

Can I Safely Consume Grapefruit Juice?
Always ask your healthcare provider if grapefruit juice interacts with your blood pressure (or other) medication. If you aren't supposed to drink grapefruit juice, be aware that certain fruit juices may contain or be flavored with grapefruit juice, so read the drink's nutritional label before consuming it.