Can Anxiety Cause High Blood Pressure?

Anxiety and your blood pressure

Lately, maybe you’ve been feeling jumpy and anxious and wondering what all that worry could be doing to your blood pressure. Can anxiety cause high blood pressure?

It’s kind of a chicken and egg scenario: Anxiety may lead to high blood pressure. But a diagnosis of high blood pressure—and its implications—may also trigger feelings of anxiety.

Untreated high blood pressure can set the stage for heart attack, stroke and other complications by damaging blood vessels throughout your body. A blood pressure of less than 120/80 mm Hg is considered normal.

Systolic blood pressure, the upper number in a blood pressure measurement, refers to how much pressure your blood is exerting against your artery walls when your heart beats. Diastolic blood pressure, the lower number, refers to how much pressure your blood is exerting against your artery walls when your heart is at rest between beats.

(If your blood pressure is 180/120 mm Hg or higher and you have chest pain, back pain, numbness or weakness, or a change in vision, you may be experiencing a blood pressure emergency.)

Anxiety disorders are different from temporary stress—like the kind that kicks in before a big job interview or in the wake of a major life decision.

Anxiety disorders such as generalized anxiety disorder, panic disorder, and various phobias are characterized by near-constant worry and often physical symptoms that interfere with daily life. About 40 million people in the U.S. will have an anxiety disorder in any given year, according to the Anxiety and Depression Association of America.

Can anxiety cause high blood pressure?

In-the-moment anxiety affects blood pressure in the same way stress does, explains Vijay Nambi, MD, associate professor of medicine at Baylor College of Medicine in Houston. It kick-starts your sympathetic nervous system, which releases the stress hormones adrenaline and cortisol that can increase heart rate and blood pressure.

A prime example of this: white coat hypertension. That’s when your blood pressure readings at your doctor’s office are higher than normal, likely because you are anxious about the visit.

Sometimes this reaction can be helpful and serve as a warning against impending doom. But when anxiety is chronic, it can lead to a higher risk for heart attack, stroke, and kidney disease, Dr. Nambi explains. For one, anxiety affects your ability to engage in a healthy lifestyle, like getting enough sleep, exercise, and healthy food.

“When we are anxious, we tend to overeat or overindulge,” he says. “Your sleep hygiene is lost, and your blood pressure will go up.” An unhealthy diet, lack of exercise, and sleep loss can increase blood pressure. Anxiety may also get in the way of taking your blood pressure medications, he notes.

There are other theories about how anxiety directly affects blood pressure. For example, anxiety may increase levels of angiotensin II, which in turn can raise blood pressure, according to research published in Neuropsychiatric Disease and Treatment. Certain blood pressure-lowering drugs block angiotensin II. Over the long term, anxiety may also more easily activate the sympathetic nervous system.

Depression and anxiety may travel together, says Salim Virani, MD, professor of medicine at Baylor College of Medicine. “We know depression and Type D personality is more significantly associated with future risk of heart disease,” Dr. Virani says. Type D people are distressed and tend to see the glass as half empty. By contrast, optimistic personality types may have a lower risk of heart disease or stroke, he says.

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Treating anxiety and high blood pressure

“If you are anxious because of something that is explainable such as job loss, it is a normal response, but if these feelings persist or if there is no reason for them, start by seeking help from your primary care physician,” Dr. Nambi suggests.

You can treat anxiety with talk therapy, medication, and cognitive behavioral therapy (CBT), a type of  therapy that works to change how you react and respond to triggers.

Engaging in mindfulness meditation may also help reduce anxiety, and these benefits can be seen after your first session, according to research presented at the 2018 annual meeting of the American Physiological Society. The results were even more pronounced one week after the meditation session. Study participants also showed less mechanical stress on their arteries an hour after the session. (Mechanical stress on the arteries can set the stage for heart attack and strokes.) “Treatment will allow you to have a better outlook toward life and take better care of yourself,” adds Dr. Virani.

Treating and preventing high blood pressure is also important, says Guy L. Mintz, MD, director of Cardiovascular Health & Lipidology at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, New York.

This includes:

• monitoring your blood pressure at home
• exercising for 150 minutes each week
• eating a heart-healthy diet with no added salt
• maintaining an ideal weight

“Hypertension is referred to as the silent killer because it has no symptoms,” Dr. Mintz says. “Hypertension is a major risk factor for heart attack and stroke and needs to be addressed early and effectively.”

The last word

Anxiety can cause blood pressure to rise. Over time, that can increase the risk for more serious consequences of high blood pressure, including heart attack and stroke. High blood pressure can also cause anxiety when you worry about these complications. Getting help for anxiety and high blood pressure is the best way to take back your health.

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