Can Anxiety Cause High Blood Pressure?

When you think of stress, two things may come to mind: anxiety and blood pressure. But how do anxiety and high blood pressure relate to stress? Do these two things relate to each other? Research suggests that there may be an association between anxiety and blood pressure, but before we talk about how anxiety and blood pressure are related, it makes sense to look at them both individually.

What is anxiety?

One of the great tragedies of anxiety is its stigma. Most emotional and mental health issues have some stigma attached to them, and the reason for the stigma changes based on the disorder. In the case of anxiety, the stigma comes from the misconception that since everyone experiences anxiety, people just need to get over it.

This stigma comes from a misunderstanding. Anxiety can be a normal, natural, and healthy emotion when it occurs in accordance with the gravity of the situation. Some people, however, may feel anxious all the time, or they may have a disproportionately high level of anxiety in certain situations. People who fit this description may have an anxiety disorder. Both anxiety and anxiety disorders may be related to blood pressure in different ways. 

Chronic stress

There's also such a thing as "chronic stress". Chronic stress occurs when you have feelings of anxiety for prolonged periods of time, not because you have an anxiety disorder, but because you live under prolonged stressful circumstances. Chronic stress affects the body in ways similar to anxiety disorders. Further, chronic stress can cause anxiety disorders and related conditions.

What is blood pressure?

The nutrients that you take in through your diet and the oxygen that you take in when you breathe are required to keep your body functioning properly. These chemicals, as well as other important substances, are carried through your body by way of your blood. The blood also moves around waste products, so that your body can filter the blood and get rid of chemicals that you don't need. Your blood moves through veins and arteries in your body when your heart beats.

Blood pressure is a measure of the pressure on the walls of your heart and the walls of your veins and arteries. You can also look at it as a measure of how hard your heart needs to work to do its job. If a person’s blood pressure is too low, their heart may have to work harder than it should to move the blood around. If their blood pressure spikes, their heart will still have to work harder than it should. High blood pressure may also damage blood vessels and stretch out the veins and arteries in the body, potentially leading to serious short- and long-term challenges, like cardiovascular disease.

Mental and environmental factors

There are a number of things that can impact your blood pressure. Psychosocial factors like stress can affect blood pressure levels. Another potential contributor to high blood pressure is your diet. One of the things that your blood carries around your body is dissolved fats, so if you eat too much of the wrong kind, it can negatively impact your health by raising your blood pressure. The amount of body fat that you have can also contribute to high blood pressure, partly because if your body is larger, your heart needs to pump harder to circulate your blood effectively.

When you get a blood pressure reading from your doctor or at a pharmacy, you'll see two numbers reported as a ratio. One number is the pressure on your veins and arteries while your heart is contracting. The other number is the pressure on your veins and arteries while your heart is relaxed. Ideally, this number is around 120 over 80, but some variation is okay.

The stress response

Whether you're experiencing feelings of anxiety because of an anxious situation or because of an anxiety disorder, you're experiencing stress.

Stress isn't just an emotion. It's a physiological process called the stress response. The stress response evolved in our ancient ancestors to help prepare our bodies to either run away from a threat or to fight it. In modern society, we're not stressed about running from predators as often as we're stressed about paying the bills, but this is still how our body responds.

To get your blood to where it needs to be to prepare your body for a challenging situation, a couple of things happen. Your breath rate increases, and your heart rate increases. Your body also redirects your blood away from your internal organs and toward your muscles and skin, which increases your blood pressure. Once the stressful situation passes, your blood pressure returns to a normal level. 

How the body and mind are connected

Whenever there is a link between your emotional state and your physical state, it's because of messenger molecules in your body. These are called hormones and neurotransmitters. In particular, the neurotransmitter called adrenaline and the hormone called cortisol. When we are faced with a perceived threat or an otherwise stressful situation, these hormones trigger the fight-or-flight response. Most of the symptoms of the stress response, particularly those listed above, are the result of adrenaline. However, cortisol also plays a role.

How anxiety and dietary factors affect blood pressure

As we discussed above, blood pressure is largely due to dietary factors, including the amount of dissolved fat in your blood. Dissolved sugar can also affect blood pressure. This is important for people with generally bad diets, but it is also important for people experiencing feelings of anxiety, whether because of chronic stress or because of anxiety disorders.

Cortisol changes the way that your body uses energy. It can also change the kinds of energy that your body demands. A lot of the time, when we talk about "cravings," we're using them as an excuse for eating food that we shouldn't. However, sometimes when we crave food, it is because our body requires a nutrient found in that food. Cortisol, for example, makes us crave energy-rich foods like those high in fats and sugars. As mentioned above, foods that are high in fats and sugars contribute to higher blood pressure. So "stress eating" isn't just an excuse, but a biological urge that you may feel when you're worried because your body is trying to prepare you for the worst.

Cortisol doesn't only make you crave dietary energy; it also changes what your body does with that energy. Some of that energy will be consumed in the work that your body does. However, because you're probably not running from or physically fighting your problem like your body expects, much of this energy will be stored as body fat. This means a number of things for your blood pressure. For one thing, fat that your body is trying to store is the fat that can dangerously raise your blood pressure. You may hear it called "bad cholesterol." This fat can also be left behind in the bends and behind the valves in your blood vessels, leading to constricted spaces and higher blood pressure still. 

If you feel stressed because of a late morning, you might snag an extra donut at work, but after an hour or two, your body won't know the difference. If you feel stressed because you have chronic stress or an anxiety disorder, you may continually make poor dietary choices that take a huge toll on your overall health. In this way, the amount of anxiety that you feel and the reason that you feel it can impact your blood pressure reading.

Anxiety and blood pressure: The vicious cycle

Another problem, particularly for people with anxiety disorders, has to do with "the vicious circle" that can be created by the link between anxiety and high blood pressure. Some people with anxiety may worry about whatever is going on in their lives. If nothing is going wrong, their anxious minds may try to find something wrong. A huge source of potential problems from which to draw is a person's health. Concerns about physical health conditions related to anxiety and high blood pressure—such as heart disease—can be compounded by symptoms like rapid pulse rate, sweating, etc.  

If a person has an anxiety disorder, they may feel anxiety about their anxiety disorder. If they have an anxiety disorder, they may very well have high blood pressure as well. If they have high blood pressure, they likely feel anxious about their high blood pressure, too.

In some cases, anxiety and hypertension can cause symptoms that may feel like a medical emergency, including chest pain, dizziness, and rapid breathing. If you’re experiencing symptoms of one or both conditions, consider seeking professional help. A medical or mental health care professional can provide expert care and help you understand the connections between anxiety and high blood pressure. Unmanaged anxiety can significantly impact both mental and physical health. In an article titled “Association between anxiety and hypertension: a systematic review and meta-analysis of epidemiological studies”, researchers conclude that early detection of anxiety can be vital to the management of high blood pressure. 

What to do next

Treatment options for anxiety can include therapy, medication, and lifestyle changes. A therapist can help you identify negative thinking patterns that trigger feelings of worry or nervousness. There are several potential modalities a therapist may use, depending on the sources of your anxiety. For example, if you’re living with a phobia, they may administer exposure therapy, during which they will gradually expose you to the experience or object of your fear. 

Drugs used in depression treatment (e.g., selective serotonin reuptake inhibitors; serotonin and noradrenaline reuptake inhibitors) are the most commonly prescribed for anxiety symptoms. Certain types of sedative medication, like benzodiazepines, may be used for short-term anxiety relief. Beta blockers may be particularly effective for individuals experiencing hypertension and anxiety. According to the American Heart Association, beta blockers can lower blood pressure by slowing an individual’s heart rate. This mechanism helps explain why beta blockers can be beneficial for people who live with the physical effects of anxiety, like rapid pulse rate. 

If you frequently feel anxious, healthy lifestyle changes can make managing stress easier. Try to get enough sleep, exercise regularly, and maintain a balanced diet. If you have occasional feelings of anxiety, you can lower your symptoms of anxiety and your blood pressure by engaging in mindfulness techniques like meditation or diaphragmatic breathing. 

Sometimes, people with anxiety are hesitant to make an in-person appointment for therapy. They may have social anxiety, for instance, that makes it hard to talk to people they don’t know. Online therapy could present a better option. Many people feel more at ease discussing their problems in an internet-based setting. Plus, online therapy can be reached from anywhere you have an internet connection, so you don’t even need to leave your home to receive treatment. 

Current research in the field of mental health points to the effectiveness of online therapy. For instance, a recent systematic review and meta-analysis found that internet-delivered cognitive behavioral therapy (ICBT) was just as effective as face-to-face CBT in the treatment of anxiety disorders.