The link between anxiety and high blood pressure

Stress and anxiety can have a profound effect on many areas of our physical health. One of the ways our physical health can be impacted by our mental health is blood pressure.

This article explores the relationship between anxiety and blood pressure, offering insights and practical advice for managing anxiety-related blood pressure spikes.

What is blood pressure?

Blood pressure is a vital sign of everyone’s general health. It measures the force of circulating blood on the walls of our blood vessels. It's an important part of the cardiovascular system, ensuring that oxygen and nutrients are efficiently delivered throughout the body.

Blood pressure readings, expressed in millimetres of mercury (mmHg), comprise two numbers:

1. The systolic pressure (the higher number) indicates the force as the heart contracts and pumps blood
2. The diastolic pressure (the lower number) represents the pressure when the heart relaxes between beats

According to the NHS, the ideal blood pressure level is between 90/60mmHg and 120/80mmHg.

Can anxiety cause high blood pressure?

The link between anxiety and increases in blood pressure is well-documented. Anxiety triggers the body's ‘fight, flight or freeze’ response, a primal reaction that prepares us to either confront, flee or become immobile in the face of a perceived threat. This involuntary response involves the release of adrenaline and cortisol, stress hormones that have immediate effects on the cardiovascular system, including an increase in heart rate and the narrowing of blood vessels. These physiological changes can lead to a spike in blood pressure.

The link between anxiety and blood pressure has been explored in many relevant studies, as outlined in this meta-analysis in the Neuropsychiatrist Disease and Treatment journal.

These spikes are generally short-lived, with blood pressure levels returning to normal as the anxiety subsides. For this reason, it doesn’t seem as though anxiety can cause long-term or chronic issues with blood pressure.

Can high blood pressure cause anxiety?

The relationship between high blood pressure (also known as hypertension) and anxiety can work both ways. Just as anxiety can lead to temporary increases in blood pressure, the experience of living with high blood pressure can also contribute to the symptoms of anxiety. This connection can happen for several reasons:

• Awareness and concern over health status: people who’ve been diagnosed with hypertension may experience anxiety due to concerns about their health and the potential for serious complications as a result of their hypertension, such as heart disease or a stroke. This concern can become a source of chronic stress and anxiety, especially if their blood pressure is difficult to control. If this worry continues, it could lead to an anxiety disorder called health anxiety
• Physical symptoms of hypertension: without a medical examination, high blood pressure can sometimes go unnoticed, even in people who are affected by it. However, some people may experience other symptoms of high blood pressure, such as headaches, shortness of breath or nosebleeds. This could, in turn, lead to an increase in anxiety, particularly if these symptoms are interpreted as a sign of a serious health issue
• Medication side effects: some blood pressure medications can have side effects that mimic symptoms of anxiety, such as increased heart rate or nervousness. This can be confusing and concerning, exacerbating feelings of anxiety
• Lifestyle impact: the lifestyle changes and medical treatments that are needed to manage high blood pressure, such as dietary restrictions, exercise, and regular medical check-ups, can be significant sources of stress and anxiety, especially if these changes are difficult to commit to or maintain

How much can anxiety raise blood pressure?

The extent to which anxiety can elevate blood pressure can vary significantly. How much of an influence it can have depends on factors such as your baseline blood pressure, general physical health, and the severity of your anxiety.

During episodes of acute anxiety or panic attacks, it's not uncommon for systolic blood pressure to increase by 20 to 30 mmHg or more. These spikes are typically temporary, but they highlight the significant impact that our emotional states can have on physical health.

How to bring anxiety-related blood pressure down quickly

To manage anxiety-induced blood pressure spikes, you can use a number of immediate interventions and long-term strategies. Ultimately, these strategies are focused on reducing your overall levels of anxiety. In turn, this should lead to less frequent episodes of elevated blood pressure.

Here are some practical tips for quickly lowering blood pressure during moments of anxiety:

• Deep breathing techniques: deep, controlled breathing helps us to counteract the stress response we’re experiencing, leading to a lowering of blood pressure. Breathing techniques such as diaphragmatic breathing, where you focus on filling your diaphragm rather than your chest with air, can be particularly effective.
• Distract yourself: when we’re experiencing anxious thoughts, this is usually because we’re ruminating about things in the past, or overthinking an upcoming event or scenario. Grounding techniques, like taking a walk outside or engaging in positive self-talk can help draw you out of anxious thoughts and bring you back to the here and now
• Progressive muscle relaxation (PMR): PMR involves tensing and then relaxing different muscle groups in a calm and relaxed manner, away from the distractions of the world around us. The PMR technique not only helps alleviate physical tension but also diverts focus away from anxiety-inducing thoughts, helping to reduce blood pressure
• Mindfulness and meditation: practices such as mindfulness meditation can foster a state of calm awareness, helping to reduce anxiety and its physiological effects. Even short sessions can be beneficial in managing stress and blood pressure levels
• Limit stimulants: reducing intake of caffeine and alcohol, both of which can exacerbate anxiety and elevate blood pressure, can provide immediate and long-term health benefits
• Accept anxiety: when anxiety kicks in, just being aware of what’s going on, and acknowledging we’ll be OK, can help us to take ownership of how we’re feeling and not let it control us. This can really help to reduce feelings of anxiety

Long-term strategies for managing anxiety and blood pressure

While the above tips offer ways to quickly lower blood pressure during anxiety spikes, adopting long-term strategies is essential for reducing the overall impact of anxiety on blood pressure:

1. Regular exercise: incorporating regular physical activity into your routine can significantly reduce anxiety levels and improve cardiovascular health
2. Healthy diet: a diet that’s rich in fruits, vegetables, whole grains and lean proteins can support both mental and physical health, contributing to lower blood pressure and reduced anxiety
3. Adequate sleep: ensuring sufficient, quality sleep is crucial for managing positive wellbeing and maintaining healthy blood pressure
4. Get professional help: today, many effective treatments are available for people whose anxiety is seriously affecting their ability to live their life. Consulting with healthcare professionals or therapists can offer personalised strategies for managing anxiety. Talking therapies such as cognitive behavioural therapy (CBT), for example, are considered a gold standard treatment for people who are looking to effectively manage their anxiety – which, in turn, will positively impact your blood pressure

If you’re worried about your anxiety and the impact it might be having on your physical health, you should consider reaching out for professional support. Ask your GP what your next steps could be, or get in touch with a private provider of anxiety treatment like Priory.