Twisted two-dimensional structures open new possibilities in band structure engineering. At magic twist angles, flat bands emerge, which give a new drive to the field of strongly correlated physics. In twisted double bilayer graphene dual gating allows changing the Fermi level and hence the electron density and also allows tuning the interlayer potential, giving further control over band gaps. Here, we demonstrate that by applying hydrostatic pressure, an additional control of the band structure becomes possible due to the change of tunnel couplings between the layers. We find that the flat bands and the gaps separating them can be drastically changed by pressures up to 2 GPa, in good agreement with our theoretical simulations. Furthermore, our measurements suggest that in finite magnetic field due to pressure a topologically non-trivial band gap opens at the charge neutrality point at zero displacement field.