Can anxiety cause your blood pressure to go up

Can Anxiety Cause High Blood Pressure?

According to the Anxiety & Depression Association of America (ADAA), anxiety disorders affect more than 40 million adults every year in the United States. Anxiety can cause a wide range of physical symptoms, including an increase in blood pressure levels.

Although anxiety isn’t linked to chronic high blood pressure, both short-term and chronic anxiety may cause your blood pressure to spike.

In this article, we’ll explore the link between anxiety and high blood pressure and treatment options for both.

Fortunately, anxiety doesn’t cause chronic high blood pressure. However, it can lead to a short-term increase in blood pressure.

When you begin to feel anxious because of a stressful situation, your body enters fight-or-flight mode. This happens due to the activation of your sympathetic nervous system. During fight-or-flight mode, your adrenaline and cortisol levels rise, both of which can lead to an increase in blood pressure.

Although stress and anxiety can cause high blood pressure, it’s only temporary, and levels generally return to normal once you’ve calmed down again.

High blood pressure, or hypertension, is a chronic condition that occurs when blood pressure levels are elevated. Chronic high blood pressure can be quite dangerous and can cause significant damage to the body, especially the brain, heart, kidneys, and eyes.

Hypertension is classified into two categories:

Primary hypertension. This type of hypertension develops in the absence of a specific trigger and is the most common type of hypertension. Primary hypertension is often thought to develop due to genetic, environmental, or lifestyle causes.
Secondary hypertension. The cause of this type of hypertension is generally known and is often another underlying condition. Secondary hypertension is often caused by conditions that affect the kidneys, heart, or thyroid.

Interestingly, anxiety can also cause a type of high blood pressure commonly called white coat hypertension. This type happens when your blood pressure is typically normal but spikes in a medical setting, such as a doctor’s office, due to medical anxiety.

Anxiety is a natural response to a perceived threat and is something that all of us experience from time to time. When you feel anxious and your fight-or-flight response is activated, you may experience:

nervousness
restlessness
panic or dread
rapid heart rate
sweating
difficulty breathing
chest pain
hyperventilation
shaking or trembling
muscle twitches
chills or hot flashes
numbness or tingling
weakness or fatigue
nausea or vomiting
diarrhea
poor concentration
depersonalization or derealization

In some people, chronic anxiety is due to an underlying anxiety disorder rather than just environmental causes. Anxiety disorders include:

generalized anxiety
panic disorder
specific phobias

obsessive-compulsive disorder (OCD)
post-traumatic stress disorder (PTSD)

Just like anxiety can cause temporary high blood pressure, high blood pressure can sometimes cause anxiety.

For example, some symptoms of high blood pressure mimic those caused by anxiety, such as:

shortness of breath
dizziness
chest pain
changes in vision

Experiencing these symptoms or any other symptoms of high blood pressure can lead to an increase in anxiety.

In addition, having a chronic condition like high blood pressure can cause depression and anxiety. In fact, the National Institute of Mental Health (NIMH) states that people who have chronic illnesses are more likely to experience mental health conditions, such as anxiety.

One 2018 study found that up to 51 percent of people with pulmonary arterial hypertension may have anxiety and panic disorders, with many of these individuals going untreated for these conditiƒwas ons.

If you have frequent episodes of high blood pressure that are caused by anxiety, treating the underlying anxiety disorder can help bring your blood pressure back down to healthier levels.

Treatment options that may help include:

Psychotherapy

Cognitive behavioral therapy (CBT) is the gold standard treatment for most anxiety disorders. CBT techniques can help address and change problematic thoughts, feelings, and behaviors that contribute to anxiety.

Research has shown that CBT can be as effective as medication in treating anxiety disorders.

Other treatment approaches can also be considered, depending on the type and severity of the anxiety disorder. For example, exposure therapy is effective for treating specific phobias, while trauma-focused therapy and interactive therapy such as Eye Movement Desensitization and Reprocessing (EMDR) can be helpful for conditions like PTSD.

Medications

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medications for anxiety disorders. SSRIs work by increase the uptake of serotonin in the brain, which can reduce the symptoms of anxiety.

According to the research, SSRIs are most effective when combined with psychotherapy.

In some cases, benzodiazepines may be prescribed to provide short-term relief of anxiety symptoms. However, they’re highly addictive and are generally prescribed for short-term use only.

Other

While psychotherapy and medications are effective methods for treating anxiety disorders, lifestyle changes are also important.

Make sure that you are getting enough sleep, eating a balanced diet, and moving your body physically. Relaxation techniques such as meditation, yoga, and massage can also help.

Things you can do to feel less anxious

Whether you have an anxiety disorder or not, everyone can benefit from reducing their daily anxiety levels. Here are some changes that you can make in your daily life to lower your anxiety levels:

Get enough sleep. Sleep is very important for overall health, and getting enough sleep can make a huge difference in daily anxiety levels. Most people need 7 to 9 hours of sleep each night, so make sure to aim for this.
Eat a balanced diet. Eating nutritious foods can help support both your physical and mental well-being. Aim to fill your plate with whole foods, such as fruits, vegetables, whole grains, and lean proteins, whenever possible.
Move your body. Moving your body is important, whether that involves weight training at the gym or taking a walk around the block. Daily exercise and movement can help increase your endorphins and lower stress levels.
Practice mindfulness. Mindfulness is the practice of bringing your awareness to the present moment, which is incredibly important when you have anxiety. Meditation is a great mindfulness practice to reduce daily stress and anxiety.

Medications used to treat anxiety can help reduce overall anxiety levels, which can reduce blood pressure spikes. However, some anxiety treatment options may also cause an increase in blood pressure levels.

One meta-analysis from 2017 investigated the impact of SSRIs and serotonin and noradrenaline reuptake inhibitors (SNRIs) on blood pressure levels. Data from over 13,000 participants was analyzed, and the researchers found that while SSRIs didn’t have any significant impact on blood pressure, SNRIs caused a slight increase in blood pressure levels.

If you have high blood pressure and have recently started taking medication for anxiety, keep track of any changes in your blood pressure levels. This can help your doctor determine if adjustments need to be made to any of your medications.

Treatment for high blood pressure generally involves making a handful of dietary and lifestyle changes. This includes increasing physical activity, maintaining a healthy weight, limiting sodium, and increasing intake of whole foods.

If dietary and lifestyle changes aren’t enough to lower your blood pressure naturally, certain medications may be prescribed, such as:

beta-blockers (which are also prescribed to reduce symptoms of anxiety)
diuretics
ACE inhibitors
angiotensin II receptor blockers
calcium channel blockers
alpha-2 agonists

Generally, if you have high blood pressure and it’s causing an increase in your anxiety, treating the high blood pressure can help to reduce your anxiety symptoms.

Although anxiety can’t cause chronic hypertension, there’s a definite connection between anxiety and blood pressure. Anxiety leads to a natural increase in blood pressure due to the fight-or-flight response, and high blood pressure can sometimes also lead to an increase in anxiety.

If you’re experiencing symptoms of anxiety or high blood pressure that are impacting your daily life, talk with your doctor about which treatments may work for you.

Can Anxiety Cause High Blood Pressure?

Although anxiety isn’t linked to chronic high blood pressure, both short-term and chronic anxiety may cause your blood pressure to spike.

In this article, we’ll explore the link between anxiety and high blood pressure and treatment options for both.

Fortunately, anxiety doesn’t cause chronic high blood pressure. However, it can lead to a short-term increase in blood pressure.

Although stress and anxiety can cause high blood pressure, it’s only temporary, and levels generally return to normal once you’ve calmed down again.

Hypertension is classified into two categories:

Primary hypertension. This type of hypertension develops in the absence of a specific trigger and is the most common type of hypertension. Primary hypertension is often thought to develop due to genetic, environmental, or lifestyle causes.

Secondary hypertension. The cause of this type of hypertension is generally known and is often another underlying condition. Secondary hypertension is often caused by conditions that affect the kidneys, heart, or thyroid.

nervousness
restlessness
panic or dread
rapid heart rate
sweating
difficulty breathing
chest pain
hyperventilation
shaking or trembling
muscle twitches
chills or hot flashes
numbness or tingling
weakness or fatigue
nausea or vomiting
diarrhea
poor concentration
depersonalization or derealization

In some people, chronic anxiety is due to an underlying anxiety disorder rather than just environmental causes. Anxiety disorders include:

generalized anxiety
panic disorder
specific phobias
obsessive-compulsive disorder (OCD)
post-traumatic stress disorder (PTSD)

Just like anxiety can cause temporary high blood pressure, high blood pressure can sometimes cause anxiety.

For example, some symptoms of high blood pressure mimic those caused by anxiety, such as:

shortness of breath
dizziness
chest pain
changes in vision

Experiencing these symptoms or any other symptoms of high blood pressure can lead to an increase in anxiety.

If you have frequent episodes of high blood pressure that are caused by anxiety, treating the underlying anxiety disorder can help bring your blood pressure back down to healthier levels.

Treatment options that may help include:

Psychotherapy

Research has shown that CBT can be as effective as medication in treating anxiety disorders.

Medications

According to the research, SSRIs are most effective when combined with psychotherapy.

In some cases, benzodiazepines may be prescribed to provide short-term relief of anxiety symptoms. However, they’re highly addictive and are generally prescribed for short-term use only.

Other

While psychotherapy and medications are effective methods for treating anxiety disorders, lifestyle changes are also important.

Make sure that you are getting enough sleep, eating a balanced diet, and moving your body physically. Relaxation techniques such as meditation, yoga, and massage can also help.

Things you can do to feel less anxious

Whether you have an anxiety disorder or not, everyone can benefit from reducing their daily anxiety levels. Here are some changes that you can make in your daily life to lower your anxiety levels:

Get enough sleep. Sleep is very important for overall health, and getting enough sleep can make a huge difference in daily anxiety levels. Most people need 7 to 9 hours of sleep each night, so make sure to aim for this.
Eat a balanced diet. Eating nutritious foods can help support both your physical and mental well-being. Aim to fill your plate with whole foods, such as fruits, vegetables, whole grains, and lean proteins, whenever possible.
Move your body. Moving your body is important, whether that involves weight training at the gym or taking a walk around the block. Daily exercise and movement can help increase your endorphins and lower stress levels.
Practice mindfulness. Mindfulness is the practice of bringing your awareness to the present moment, which is incredibly important when you have anxiety. Meditation is a great mindfulness practice to reduce daily stress and anxiety.

If dietary and lifestyle changes aren’t enough to lower your blood pressure naturally, certain medications may be prescribed, such as:

beta-blockers (which are also prescribed to reduce symptoms of anxiety)
diuretics
ACE inhibitors
angiotensin II receptor blockers
calcium channel blockers
alpha-2 agonists

Generally, if you have high blood pressure and it’s causing an increase in your anxiety, treating the high blood pressure can help to reduce your anxiety symptoms.

If you’re experiencing symptoms of anxiety or high blood pressure that are impacting your daily life, talk with your doctor about which treatments may work for you.

Stress and arterial hypertension

Stress is the eternal companion of our life. It arises as a result of excessive nervous and mental stress, despondency, lack of positive prospects or a state of uncertainty. Stress is multifaceted in its manifestations. It plays an important role in the occurrence of not only disorders of human mental activity, but also a number of diseases.

Indeed, mental stress causes an increase in the release of hormones that increase vascular tone, increase cardiac output, accelerate heart contractions and, as a result, lead to an increase in blood pressure.

Stress is a factor provoking the development of arterial hypertension.

How can you tell if stress is having a negative effect on you? There are many signs, and they are all different in their manifestations.

All alarms can be divided into four categories:

Physical - dizziness, clenched jaws, headaches, indigestion, tense muscles, impaired sleep, palpitations, tinnitus, slouching posture, sweating of the palms, fatigue, exhaustion, trembling, weight gain or loss.

Psychological - worries and fears, difficulty in making decisions, forgetfulness, pessimism, devastation.

Emotional - a manifestation of anger, aggression, tearfulness, a feeling of powerlessness, frequent mood changes, irritability, a feeling of loneliness, negative thinking, nervousness, longing.

Behavioral - alcohol, drugs, overeating, changing jobs and even places of residence, if this is possible.

Stress management is a useful skill that every modern person needs. It is very important to learn how to cope with stress yourself and protect yourself from its consequences, including such as arterial hypertension.

How to overcome stress:

Use your time wisely (decide on the main tasks, and then assign a time for each of them and fix them, for example, in your notebook. After that, you can plan the rest of the tasks and assign time for them in between the main tasks).
Avoid negative assumptions (eg “everything always goes wrong with me”, “I can’t do this”, etc.) and tune in to a positive outcome (eg “I can do this”, “I can do it” etc.).
Analyze the causes of your anxiety. After you understand what the true cause is, think about how to minimize or completely eliminate the existing irritant.
Avoid bad habits, they only exacerbate the presence of problems.
Take rest breaks. Breaks should be taken not only during work, but also on weekends. In particular, make sure you get good sleep.
Maintain positive relationships with other people.
Go in for sports. At the preparation stage, you should undergo a medical examination, which will allow you to answer the following questions: What kind of sport is optimal for you? What is the maximum allowable load? Physical activity should be dosed. Sports should be done 3-4 times a week. The recommended duration of one workout is 30-60 minutes. The load should be increased gradually.
Take proportionate responsibility. Don't take on things you can't handle.
Set realistic goals in life.

How to learn to relax.

Muscle relaxation. Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally "walk" through your body. Pay attention to areas of stress. Relax your muscles. Slowly turn your head to the sides one or two times. Roll your shoulders back and forth. Then breathe deeply again. You should feel relaxed.

Psychological relaxation. This is also a very important moment of relaxation. Learn to imagine yourself in pleasant places: whether it is a quiet forest, a calm sea or mountains. This allows you to relax.

Relaxing music. Find quiet calm instrumental music in the store or on the Internet. Currently, there is such music on the market, specially created for this purpose.

The role of anxiety disorders in hypertension and the possibility of their correction | #03/07

In recent years, more and more evidence has been accumulating that anxiety and some other psychopathological conditions are independent risk factors for the development of arterial hypertension (AH) and should be considered in conjunction with recognized risk factors [7]. These pathologies increase morbidity and mortality from hypertension and coronary heart disease (CHD) [2]. Anxiety disorder should be detected and treated in a timely manner, as it worsens the prognosis of somatic pathology [1]. The importance of anxiety disorder in cardiology is confirmed by the results of a prospective 32-year study conducted in the United States by the Centers for Disease Control and Prevention [7], which showed that with increased anxiety, the probability of fatal myocardial infarction increases by 1.9times, sudden death - 4.5 times. At the same time, social epidemiological studies using objective methods conducted at the State Research Center for Preventive Medicine showed that the population experienced an increase in the level of psychological stress. It was found that about 70% of the country's population lives in conditions of chronic high- and medium-level psychosocial stress [3].

In this regard, special attention is paid to the study of the role of anxiety in the development of hypertension, one of the main risk factors for coronary artery disease. It is known that hypertension is one of the most common cardiovascular diseases affecting, in particular, 25–35% of the Russian population. Assumptions that affective disorders, most often anxiety and depression, occupy an important place in the development and course of hypertension, were expressed at the beginning of the last century. Currently, work on the study of the relationship between hypertension and affective disorders is carried out in two directions.

On the one hand, the results of large studies have been published demonstrating the relationship between symptoms of anxiety or depression and the development of hypertension, on the other hand, hypertension is considered as a psychosomatic disease, in the treatment of which psychotropic drugs play a very important role [4].

According to the literature, the prevalence of neurotic and somatoform disorders with anxiety symptoms in patients with hypertension can reach 51.3% [2, 5]. However, the number of studies is limited, and there are no clear recommendations for the management of such patients. It is known that comorbid anxiety-depressive disorders, like hypertension, in themselves lead to a significant decrease in working capacity, while they aggravate the course of a somatic disease, contribute to the formation of a hypochondriacal type of internal disease [7]. In this regard, it seems very interesting and important to determine the possibility of the effect of complex therapy with antihypertensive drugs and a “daytime” anxiolytic on the course of hypertension in patients with anxiety.

Anxiolytic therapy significantly improves the quality of life of patients with cardiovascular diseases, contributes to their better compensation in the process of somatotropic therapy, and further adaptation to the disease. Tranquilizers are the most adequate, effective and safe drugs for the relief of adaptation disorders in cardiac patients [2, 3]. However, patients often avoid taking benzodiazepines, fearing the development of addiction symptoms, unpleasant side effects in the form of lethargy, muscle weakness, and impaired attention. Elderly patients often fear the development of coordination disorders in them due to the fear of falling, the appearance of instability.

Taking into account the noted problems, in recent years there has been an increasing need for drugs with a tranquilizing effect of the non-benzodiazepine series. These drugs include Tenoten.

The drug Tenoten is an ultra-low dose (ULD) to the brain-specific protein S100. The mechanisms of action of anti-S100 SMD in anxiety states are probably associated with a modification of the functional activity of the endogenous S100 protein and its ligands. As a result, its GABA-mimetic effect is realized, restoration of GABAergic neurotransmission. The clinical effect in this case is manifested by facilitating falling asleep, reducing behavioral manifestations of anxiety, improving memory, and reducing asthenia.

The aim of the study was to evaluate the efficacy and tolerability of combined treatment with antihypertensive drugs and the anti-anxiety drug Tenoten in patients with hypertension. The duration of the study is 4 weeks.

The study involved 60 patients with hypertension aged 61.41 ± 6.91 years (from 38 to 77 years). Patients were divided randomly into two groups (main and control) of 30 people. There were 18 men and 12 women in the main group, 19 in the comparison group. men and 11 women.

AH in the main group with a moderate course (II degree) was observed in 60% of patients, with a severe course (III degree) - in 40%; in the comparison group, there were 66.6% of patients with a moderate course, and 33.4% with a severe course. The average duration of AH disease was 10.61 ± 4.1 years (from 3 to 20 years).

Of great importance in the course of hypertension is a family history, lifestyle, risk factors and comorbidities.

Persons with symptomatic hypertension and complicated forms of hypertension were excluded from the study.

In the comparison group, patients received only antihypertensive therapy - ACE inhibitors, β-blockers, diuretics (Enap, Hypothiazid, Acridilol, Arifon). Patients of the main group received combined treatment with antihypertensive drugs in combination with Tenoten, which was prescribed according to the scheme: 6 tablets per day for the first 2 weeks, and then 1 tablet 3 times a day.

Treatment was prescribed for a month. Monitoring in dynamics was carried out at the beginning of the study, after 2 and 4 weeks of therapy.

The personal anxiety scale (J. Teylor) was used to assess the mental status, which is designed to measure the level of anxiety (adapted by T. A. Nemchininov).

The questionnaire consists of 50 statements. Evaluation of the results of the study is carried out by counting the number of responses of the subject, indicating anxiety; the total score is:

40-50 points - an indicator of a very high level of anxiety;

20-40 points - high level of anxiety;

15-20 points - average level of anxiety with a tendency to high;

5-15 points - average level of anxiety with a tendency to low;

0-5 points - low level of anxiety.

A study of the mental status of patients in both groups revealed anxiety symptoms of varying severity in a significant proportion of patients. The number of patients with an initial high level of anxiety was 40% in the main group and 43% in the comparison group. The number of patients with an initial average level of anxiety with a tendency to high was 60% in the main group and 56.6% in the comparison group.

Research results

By the end of the study, the high level of anxiety decreased in the main group by 39.39% and reached the average level of anxiety with a tendency to low, and in the comparison group, the level of anxiety decreased only by 3.6%.

In patients of the main group who took Tenoten, a clear decrease in the level of anxiety was noted already after 2 weeks and by the end of the month it reached significance in comparison with the group of patients who received standard antihypertensive therapy. The relief of affective disorders was accompanied by a decrease in complaints of anxiety, feelings of helplessness, self-doubt, a sense of threatening danger, poor sleep ( tab. 1 ).

The demonstrated differences in the dynamics of anxiety indicators in the studied groups of patients confirmed the possibility of effective correction of these disorders in patients with AH with Tenoten. However, it was extremely interesting to assess whether this therapy and the severity of associated anxiety disorders affect the effectiveness of antihypertensive therapy in general.

A decrease in the values of maximum systolic and diastolic pressure occurred in both studied groups. By the end of the month of treatment, the decrease in blood pressure (BP) reached a statistically significant significance. In the main group of patients who additionally took Tenoten, systolic blood pressure (BP) decreased by 24.28% - almost to the age norm, in the comparison group there was a decrease by 16.48%, i.e. there was some excess of normal values. The decrease in diastolic pressure by the end of the 4th week in the main group (by 17.7%) and in the comparison group (by 5.9%) was also significant ( tab. 2 , 3 ).

The addition of Tenoten to the complex therapy in patients with high and moderate levels of anxiety made it possible to achieve a much more pronounced improvement in blood pressure. Against the background of therapy with Tenoten, a more rapid effect of antihypertensive drugs is observed - after 2 weeks of combined administration of the drug in patients of the main group, blood pressure decreased to the target level, in contrast to the comparison group, where it remained above the target.

Conclusion

The results of our study show that all patients with hypertension have anxiety symptoms of varying severity, which aggravate the course of the disease, contributing to higher levels of both systolic and diastolic blood pressure. The inclusion of the modern "daytime" anxiolytic Tenoten in the complex therapy of patients with hypertension increases the effectiveness of the treatment, reduces the level of anxiety, which contributes to a more rapid onset of the hypotensive effect. Tenoten is well tolerated by patients, does not cause orthostatic hypotension and any other undesirable side effects.

Literature

Avedisova AS Anxiety disorders // Yu. A. Aleksandrovsky. Mental disorders in general medical practice and their treatment. M.: GEOTAR-MED, 2004. S. 66–73.
Kopina O. S., Suslova S. F., Zaikin E. R. Population studies of psychosocial stress as a risk factor for cardiovascular diseases// Cardiology. 1996. No. 36 (3). pp. 53–56.
Sudakov KV Emotional stress and arterial hypertension. M.: VNIIMI, 1976.
Chazov EI Ischemic heart disease and the possibility of improving the effectiveness of its treatment// Clinical trials of drugs in Russia. 2001. No. 1. S. 2–4.
Kawachi I., Sparrow D., Vokonas P. S., Wess S. T. Symptoms of anxiety and risk of coronary heart disease. The Normative Aging Study. circulation. 1994; 90, 5: 2225–2229.
Lavie C., Milani R. Prevalence of anxiety in coronary patients with improvement following cardiac rehabilitation and exercise training. Am J Cardiol. 2004; 93:336–339.
Sonas B. S., Franks P., Ingram D. D. Are symptoms of anxiety and depression risk factor for hyprtension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study.
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