Anxiety And Blood Pressure

What is Anxiety?

According to the American Psychological Association, anxiety is defined as a feeling of worry that causes us to experience “worried thoughts” and “tension”.1 Unfortunately, anxiety is a part of everyday life and everyone experiences it at some point. Anxiety can come in many forms and affect us in a variety of ways. People who suffer from ‘everyday stressors’ such as job interviews, watching their favourite sports team, or taking an exam may suffer symptoms of anxiety before and during stressful events. In some cases, an individual may suffer from an anxiety disorder and therefore suffer from more severe and long-lasting symptoms. According to statistics, around 284 million people experience some form of anxiety disorder globally. Listed below are some of the most common anxiety disorders.2

  • Generalised anxiety disorder
  • Panic disorder
  • Obsessive-compulsive disorder (OCD)
  • Social Phobia
  • Post-traumatic stress disorder (PTSD)
  • Health Anxiety

Symptoms

It should be noted that anxiety is a broad term, and therefore the symptoms of anxiety can be extremely wide-ranging. For example, the symptoms someone experiences due to an ‘everyday stressor’ will likely differ greatly from those experienced by an obsessive-compulsive disorder patient. Below are some of the symptoms considered most common in anxiety patients.

  • Nervousness
  • Restlessness/shaking
  • Nausea/stomach feels like it’s churning 
  • Headaches
  • Increased breathing and heart rate
  • Trouble sleeping
  • Sweating
  • Dizziness
  • Muscle aches and pains
  • Irritability

The Link Between Anxiety and Blood Pressure

The term blood pressure simply refers to the pressure of the blood that circulates in an individual’s body. Anxiety and blood pressure seemingly go hand in hand. Encountering a stressful and anxiety-inducing situation can cause a spike in blood pressure and being diagnosed with high blood pressure can cause an individual to feel anxious about their health.

How Does Anxiety Affect My Blood Pressure?

Experiencing anxiety can have a direct influence on our blood pressure. When we are placed in any kind of stressful situation, our body goes into what is known as ‘fight or flight’ mode. In other words, the body undergoes physiological changes as a result of either fighting or fleeing from a stressor. One of these changes is an increase in the release of the stress hormones noradrenaline, adrenaline, dopamine, and cortisol (stress hormones) into the bloodstream. When these hormones are released into the bloodstream, they force our heart to beat at a faster rate and our blood vessels (veins and arteries) to begin to narrow. As a result of both, we experience an increase in blood pressure.

Anxiety and High Blood Pressure (Hypertension)

Hypertension is the medical term used to define consistent high blood pressure. An individual is diagnosed with hypertension when their blood pressure reading is over 140/90 mmHg. When we become anxious due to a stressor, a sudden and sharp increase in blood pressure normally occurs. Occasionally, this may result in a much higher blood pressure reading than normal. Fortunately, the latest research indicates that anxiety does not cause hypertension.3 However, frequently experiencing spikes in blood pressure as a result of anxiety has been shown to cause damage to the kidneys, blood vessels and the heart.4

Anxiety and Low Blood Pressure (Hypotension)

The medical term hypotension is used to describe consistently low blood pressure. An individual is diagnosed with hypotension when their blood pressure reading is below 90/60 mmHg. While the link between low blood pressure and anxiety appears much less direct, scientists have hypothesized that bouts of high anxiety can lead to low blood pressure later on. After experiencing stressful events we can become extremely fatigued, which in turn can lead to a decrease in our blood pressure levels.

Treatment

As anxiety is an extremely broad term, there is a wide array of treatments available for those diagnosed with ‘anxiety’. The type of treatment prescribed to individuals depends greatly on the type of anxiety they have and the severity of their symptoms. The following is a summary of the various ways anxiety may be treated.

Changes in lifestyle

In some cases, an individual’s stress may be caused solely by their lifestyle. Therefore, for some individuals, a few simple lifestyle changes may be all it takes to reduce their stress levels. The following are some of the key lifestyle factors that can affect stress levels.

Physical activity

A large amount of research and literature has been published discussing the benefits of exercise for our mental health.5 Performing exercises such as walking, cycling, yoga, swimming and weightlifting can be highly beneficial for stressed individuals. When we exercise, our body produces higher amounts of endorphins, the hormones responsible for happiness, which helps to improve our mood and reduce stress levels.

Diet

Our diet can actually have a large influence on our mental health, including how stressed we are. Harvard University reports that a healthy diet not only helps improve our mental health but also equips us with the energy required to deal with stressful events.6 The best way to maintain a healthy diet is to consume five portions of fruit and vegetables every day, eat whole grains instead of white foods, and reduce the amount of saturated fat, salt, and sugar you consume.

Sleep

Sleep can play a vital role in helping us manage our stress levels. The American Psychological Association reports that those who achieve a greater night's sleep are much less likely to become overly stressed when compared to those who do not regularly get a good night sleep.7 Sleeping helps us to recharge at night, improves our decision making as well as reducing the amount of cortisol in our bloodstream, the hormone responsible for stress.  As a consequence, people who achieve a greater amount of sleep are not only less likely to become stressed but also have a better ability to remain calm under stressful circumstances. 

Stress management

Scientific studies have found that those who regularly practice stress management and relaxation techniques are much less likely to become stressed.8 Of course, different people require different methods, so don’t be disheartened if you try something and it doesn’t work for you. Below are some tips and techniques you could try to help manage your stress.

  • Planning your weeks
  • Take on manageable amounts of work
  • Make time for social activities and family
  • Breathing techniques
  • Imagery
  • Listening to relaxing music
  • Warm baths
  • Progressive muscular relaxation

Psychotherapy

In most cases, those who visit their healthcare provider with symptoms of anxiety will likely be prescribed some form of psychotherapy before being prescribed any kind of medication. Below are some of the most effective and common methods of psychotherapy.

Cognitive behavioural therapy (CBT)

Research has found CBT to be an effective method for treating anxiety disorders.9 Those prescribed CBT are likely to meet with a psychologist for an hour a week for 3-4 months. During these sessions, patients will learn how to cope with their anxious thoughts by altering the way they perceive them.

Guided self-help

Studies have also indicated that guided self-help can be effective in reducing an individual’s anxiety.10 Guided self-help patients are often given a booklet (physical or online copies are available) to work through. The booklet aims to teach anxiety patients ways in which they can help manage their anxiety.

Progressive muscular relaxation (PMR)

PMR is a form of psychotherapy in which patients tense and relax each muscle group in a specific order, helping relieve muscular tension and reduce anxiety. Those who are prescribed PMR will likely be taught how to correctly perform it by a trained professional.

Medications

If psychotherapy proves to be ineffective at managing a patient’s anxiety, they will likely be prescribed some form of medication. Different medications can have very different side effects and treatment lengths, ensure you have discussed this with your GP before starting treatment. Below are some of the medications prescribed to those diagnosed with an anxiety disorder.

Benzodiazepines Benzodiazepines, such as diazepam, are a type of sedative that is prescribed for short-term use in individuals who are going through a short but highly stressful situation. Benzodiazepines can become addictive and therefore should be taken for no longer than a month. Some of the side effects include the following

  • Feeling drowsy and tired
  • Headaches
  • Shaking
  • Regularly feeling dizzy
  • Low sex drive

Selective serotonin reuptake inhibitors (SSRIs) Most patients will likely be offered SSRIs before any other medication. SSRIs, such as escitalopram, sertraline and paroxetine are a form of antidepressant prescribed to patients experiencing long-term anxiety. SSRIs can take a few weeks to begin to work and come with a wide range of the following side effects.

  • Headaches
  • Sweating
  • Feeling dizzy and blurred vision
  • Changes in mood/ easily agitated
  • Nausea and vomiting
  • Low sex drive
  • Reduced appetite
  • Loss of weight

Serotonin and noradrenaline reuptake inhibitors (SNRIs) SNRIs are normally prescribed to patients when SSRIs prove to be ineffective. SNRIs, such as duloxetine and venlafaxine, are another form of antidepressants that aim to increase the amount of the ‘happy hormones’ (serotonin and noradrenaline) in our brains. Those prescribed with SNRIs may experience the following side effects.

  • Increased blood pressure
  • Nausea and vomiting
  • Headaches
  • Feeling drowsy and tired
  • Difficulty sleeping
  • Sweating
  • Constipation

Pregabalin In the event that both SSRIs and SNRIs prove ineffective in reducing a patient’s anxiety, pregabalin will likely be prescribed. Despite being originally designed to treat epilepsy, research has found pregabalin to help the severity of a patient's anxiety symptoms.11 Whilst pregabalin is much less likely to cause nausea and vomiting and have an effect on a patient’s sex drive, it does come with the following side effects.

  • Feeling tired and drowsy
  • Larger appetite
  • Weight gain
  • Regularly feeling dizzy
  • Headaches
  • Blurry vision

When to Seek Medical Advice

As detailed above, there is a wide range of effective treatments available for those who suffer from anxiety. If you relate to or experience any of the following, contact your healthcare provider for an appointment.

  • Unable to cope with stress
  • Experience suicidal thoughts
  • Thought about harming yourself
  • Home based remedies haven’t worked

Getting professional help for stress is vital for not only your psychological health but also your physiological health. Research has found that reducing our stress levels can help reduce the risk of further complications such as heart attacks, heart disease and strokes.

Summary

There is a clear link between anxiety levels and blood pressure. Psychological conditions are often overlooked by patients as there is no physical damage done to the body. However, if you do experience severe symptoms of anxiety, be sure to visit your healthcare provider. Treatment can be highly beneficial in the management of anxiety and can also help reduce the risk of further complications.

References

  1. ‘Anxiety’. American Psychological Association, https://www.apa.org/topics/anxiety
  2. Dattani, Saloni, et al. ‘Mental Health’. Our World in Data, Aug. 2021. ourworldindata.org, https://ourworldindata.org/mental-health
  3. ‘Can Anxiety Cause High Blood Pressure?’ Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/anxiety/faq-20058549
  4. ‘High Blood Pressure & Kidney Disease | NIDDK’. National Institute of Diabetes and Digestive and Kidney Diseases, https://www.niddk.nih.gov/health-information/kidney-disease/high-blood-pressure
  5. Stults-Kolehmainen MA, Sinha R. The effects of stress on physical activity and exercise. Sports Med. 2014 Jan;44(1):81-121.
  6. Boston, 677 Huntington Avenue and Ma 02115 +1495‑1000. ‘Stress and Health’. The Nutrition Source, 5 Oct. 2020, https://www.hsph.harvard.edu/nutritionsource/stress-and-health/
  7. ‘Stress and Sleep’. Https://Www.Apa.Org, https://www.apa.org/news/press/releases/stress/2013/sleep
  8. Toussaint L, Nguyen QA, Roettger C, Dixon K, Offenbächer M, Kohls N, Hirsch J, Sirois F. Effectiveness of Progressive Muscle Relaxation, Deep Breathing, and Guided Imagery in Promoting Psychological and Physiological States of Relaxation. Evid Based Complement Alternat Med. 2021 Jul 2;2021:5924040.
  9. Kaczkurkin AN, Foa EB. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence. Dialogues Clin Neurosci. 2015 Sep;17(3):337-46. 
  10. Falbe-Hansen L, Le Huray C, Phull B, Shakespeare C, Wheatley J. Using guided self-help to treat common mental health problems: The Westminster Primary Care Psychology Service. London J Prim Care (Abingdon). 2009;2(1):61-4.
  11. Baldwin DS, Ajel K, Masdrakis VG, Nowak M, Rafiq R. Pregabalin for the treatment of generalized anxiety disorder: an update. Neuropsychiatr Dis Treat. 2013;9:883-92.
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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George Evans

MSc, Sport Science, University of Lincoln

George is a freelance writer with three years of writing experience and first class honours in Sport Science (BSc).

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