What is Blood Pressure?
Blood pressure is a measure of the force exerted onto the walls of your artery as your heart pumps blood throughout the body. Overall, the state of an individual’s artery and heart health, heart rate, and blood volume influence the level of pressure.
Blood pressure naturally changes throughout the day. For example, climbing 5 flights of stairs elevates your blood pressure as your heart works quicker to pump more blood to supply more oxygen to your body.
Another example is stress: under a stressful situation, a surge in the primary stress hormone called cortisol narrows your blood vessels and raises your heart rate, thus elevating your blood pressure. For a healthy individual, blood pressure returns to normal as your body stabilises.
To understand the dynamic changes in blood pressure, knowing how to read blood pressure is helpful. There are two types of pressure: systolic and diastolic pressure, measured in millimetres of mercury (mmHg), a standardised measurement for pressure. Blood pressure is read as systolic over diastolic pressure, such as 120/80mmHg.
Systolic pressure measures the pressure in your arteries when your heart beats. A normal, healthy heartbeats in a “lub-dub - (pause) - lub-dub” fashion. Systolic pressure is measured at the “lub-dub” stage when blood is pumped through your body.
Diastolic pressure measures the pressure in your arteries when your heart is at its resting state. This pressure is measured at the “(pause)” stage in the “lub-dub - (pause) - lub-dub.”
An ideal, normal blood pressure range is between 90/60 and 120/80mmHg.
About High Blood Pressure
High blood pressure, also known as hypertension, is when you record a consistent blood pressure that is higher than 130/80 mmHg. Blood pressure is divided into 5 broad categories based on a person’s recorded blood pressure:
| Blood Pressure Categories | Measurement Levels |
| Low Blood Pressure | below 90/60 mmHg |
| Normal | up to 120/80 mmHg |
| Elevated | 120~129 / less than 80 mmHg |
| High Blood Pressure(Stage 1 Hypertension) | 130~139 / 80~89 mmHg |
| High Blood Pressure(Stage 2 Hypertension) | 140~180 / 90~120 mmHg |
| Hypertensive Crisis | above 180/120 mmHg |
Hypertension can be caused by blood vessel deterioration, medication, medical conditions, and diseases. Hypertension strains your heart and blood vessels responsible for delivering oxygen and nutrients to the body’s organs. Prolonged hypertension can damage your heart and blood vessels and consequently weaken your organs as they struggle to receive an adequate supply of oxygen and nutrients.
Risk factors for developing hypertension are:
- Age
- Race/ Ethnicity
- Sex
- Family History
- High Cholesterol Levels
- Diabetes
- Physical Inactivity
- Overconsumption/ use of alcohol and tobacco
- Diet with high levels of salt and fat
- Stress
Prolonged hypertension can increase the risk of cardiovascular diseases, such as coronary heart disease, stroke, peripheral arterial disease, aortic disease, and vascular dementia.
Approximately 1 in 4 adults in England and 1 in 2 in the U.S. live with hypertension, according to their respective national health surveys1,2.
Hypertension presents challenges as it often does not express notable symptoms that you can see or feel. The “quiet” nature of hypertension is the primary reason why you should make use of the free NHS health checks available to prevent the serious complications mentioned above.
About Low Blood Pressure
Low blood pressure, known as hypotension, is when you record a blood pressure reading below 90/60 mmHg. Usually, low blood pressure is considered a health complication if it causes symptoms such as dizziness, nausea, fatigue, and fainting. Severe hypotension where your body is not receiving enough oxygen can lead to a life-threatening condition called shock. Hypotension has several causes such as blood loss, dehydration, severe infection, and others.
The role of Mental Health in Blood Pressure
Studies signify a strong association between hypertension and mental health state and mental disorders 3,4. With mental disorders increasing the risk of developing hypertension, it is important to include early screening for hypertension when diagnosed with a mental disorder.
Depression
Depression is a diagnosed, common, and treatable mental health condition that negatively affects your emotions, thoughts, and behaviours. Common symptoms of depression include but are not limited to prolonged sadness, loss of interest in once enjoyable activities, fatigue, lack of motivation, and others.
Depression may contribute to your blood pressure deviating from healthy, normal levels. Similar to anxiety and stress, depression contributes to the increased production of cortisol, a primary stress hormone that puts your body in a constant state of alert.
Your heart responds by elevating the heart rate, where a constant state of alert, may overburden your heart and blood vessels leading to hypertension. On the other hand, some studies reported that depression led to a decrease in blood pressure and antidepressant medication increased blood pressure 5.
One key point to remember is that depression has been shown to affect blood pressure away from health.
Stress
Stress is your physical and mental to an external event or cause. While stress is commonly discussed negatively, it produces positive effects as well.
Two hormones, adrenaline and cortisol, are released during a situation that causes stress, such as an unexpected deadline at work, a car that suddenly merges into your lane, or a severe trauma such as losing a loved one. Both hormones attempt to assist you to avoid or escape from a stressful situation in a fight or flight response for self-preservation and protection.
Adrenaline elevates your heart rate and blood pressure and increases energy production.
Cortisol increases glucose (or sugar) production in your bloodstream, enhancing brain and repair activity in your body. These surges in hormones will naturally return to normal once the stressors are removed.
However, long-term and repeated exposure to stress leads to the constant presence of these hormones that will overburden and seriously disrupt normal bodily functions. Long-term and repeated increases in heart rate and blood pressure can cause damage to your blood vessels and overburden your heart, which consequently will increase your risk of cardiovascular diseases.
Therefore, it is important to seek help to alleviate stress and treatment options for depression: first, to maintain mental wellbeing and, second, to restore your body’s functions to a normal, healthy level.
Treatment for High Blood Pressure and Mental Health
Mindfulness
Mindfulness, also commonly referred to as meditation, is a way to train your mind to direct your attention and emotional state. Mindfulness focuses on restoring your mind to a state of calm and control, especially during a stressful situation. Studies have shown that mindfulness-based therapy is an effective treatment for reducing stress, anxiety, and depression7.
Deep Breathing
Like mindfulness, deep breathing helps you restore calm to your body during a stressful situation. Breathing deeply sends a signal to your brain to calm and relax, helping your body to decrease your heart rate, blood pressure, and rapid breathing due to stress.
Additionally, similar to how mindfulness restores calm, deep breathing helps you attain physical and mental awareness, drawing your attention away from what is causing stress.
Healthy Diet
A healthy and balanced diet not only benefits your body but your mental health as well. Eating regularly, staying hydrated, nutrient-rich foods, and regulating salt, unhealthy fat, and sugar can maintain and improve your heart health and provide you with the nutrients you need for mood regulation. Furthermore, eating well with others as a form of social engagement and support can produce additional mental health benefits and prevent the risk of mental health problems and disorders7.
Physical Activity
A moderate, 30 minutes of exercise every day can have significant benefits for your mental and physical health 8. Exercise increases blood circulation to your brain, affecting areas responsible for physical reactivity to stress, mood regulation, and motivation. Again, physical exercise is a form of distraction, resulting in increased awareness and attention to how your body is responding.
Summary & Conclusion
In conclusion, while hypertension does not cause mental illness and vice versa, they can become a risk factor for one another. Mental disorders, such as anxiety disorder and major depressive disorder, have strong associations with changes in blood pressure. Therefore, it is strongly advised to consult your doctor about your heart health when diagnosed with a mental illness. Do remember that depression, stress, and hypertension are treatable and preventable. The key is early diagnosis and maintaining a healthy lifestyle to prevent physical and mental health complications.
References
- CDC. Facts About Hypertension | cdc.gov. Centres for Disease Control and Prevention [Internet]. 2021 [cited 2022 Mar 14]. Available from: https://www.cdc.gov/bloodpressure/facts.htm.
- Hypertension prevalence estimates in England, 2017 [Internet]. Assets.publishing.service.gov.uk. 2020 [cited 14 March 2022]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/873605/Summary_of_hypertension_prevalence_estimates_in_England__1_.pdf
- Hamer M, Batty G, Stamatakis E, Kivimaki M. The combined influence of hypertension and common mental disorder on all-cause and cardiovascular disease mortality. Journal of Hypertension. 2010;28(12):2401-2406.
- Stein DJ, Aguilar-Gaxiola S, Alonso J, Bruffaerts R, Jonge P de, Liu Z, et al. Associations between mental disorders and subsequent onset of hypertension. General Hospital Psychiatry [Internet]. 2014 [cited 2022 Mar 14]; 36(2):142–9. Available from: https://www.sciencedirect.com/science/article/pii/S0163834313003149.
- Licht CMM, Geus EJC de, Seldenrijk A, Hout HPJ van, Zitman FG, Dyck R van, et al. Depression Is Associated With Decreased Blood Pressure, but Antidepressant Use Increases the Risk for Hypertension. Hypertension [Internet]. 2009 [cited 2022 Mar 14]; 53(4):631–8. Available from: https://www.ahajournals.org/doi/10.1161/hypertensionaha.108.126698.
- Khoury B, Lecomte T, Fortin G, Masse M, Therien P, Bouchard V, et al. Mindfulness-based therapy: A comprehensive meta-analysis. Clinical Psychology Review [Internet]. 2013 [cited 2022 Mar 14]; 33(6):763–71. Available from: https://www.sciencedirect.com/science/article/pii/S0272735813000731.
- Diet and mental health. Mental Health Foundation [Internet]. 2015 [cited 2022 Mar 14]. Available from: https://www.mentalhealth.org.uk/a-to-z/d/diet-and-mental-health.
- Sharma A, Madaan V, Petty FD. Exercise for Mental Health. Prim Care Companion J Clin Psychiatry [Internet]. 2006 [cited 2022 Mar 14]; 8(2):106. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470658/.
