Does stress and anxiety cause high blood pressure

The Link Between Anxiety and High Blood Pressure

We’ve all experienced anxiety from time to time. Our heart rate increases and we feel tense, on edge or even fearful. Many people are able to cope appropriately to reduce their anxiety. However, some people experience anxiety on a daily basis. This can have serious health consequences because anxiety can affect your blood pressure.

How Stress and Anxiety Can Build Over Time

Constant, chronic stress can lead to an increased risk of heart attack and stroke. Long-term stress may increase cortisol production, which can raise both your blood pressure and body weight, two factors that influence a person’s risk of heart disease. According to the American Heart Association, chronic stress can also cause chronic anxiety and depression.

Understanding Anxiety

Anxiety affects many of us. In fact, an estimated 31% of American adults will have an anxiety disorder at some point in their lives, according to the National Institutes of Health. You may feel anxious when making a big decision, leading up to a deadline or even visiting your doctor if you are worried about a health condition. However, if feelings of anxiety are intense and linger, you may be one of 25 million Americans who live with an anxiety disorder.

Symptoms of anxiety can include restlessness, muscle tension, difficulty controlling feelings, irrational worries, trembling and shaking.

People who live with untreated anxiety may feel trapped, isolated or paralyzed with fear. Anxiety can limit your ability to interact with others, complete day-to-day tasks and face your fears.

Similarly, people with anxiety disorders are at an elevated risk of cardiovascular disease. Thankfully, with treatment, you can gain control of your anxiety. If you’re concerned about anxiety, talk with your primary care provider, who can recommend strategies that might include:

  • Psychotherapy or talk therapy. Certain types of therapy, including cognitive behavioral therapy and cognitive therapy, can teach individuals how to change their thinking or identify unhelpful ways of thinking. A psychotherapist or licensed clinical social worker may guide patients through exposure therapy to face their fears.
  • Certain medications include beta blockers, antidepressants and anti-anxiety medications. These treatments may help control anxiety and its related symptoms, but medications alone cannot cure anxiety-related disorders.

In addition to psychotherapy and medication, some people find relief from anxiety with lifestyle changes that include exercise. Even a short walk outside can give you a sense of control and a change of scenery. Exercise can improve your mood by releasing endorphins, distract you from concerns or worries, and reduce tension in your muscles. For some, exercise can work as well as medication to reduce symptoms of anxiety or depression, according to the Anxiety & Depression Association of America. Exercise can also help your brain better cope with stress, which has the potential to improve your mental health.

Understanding High Blood Pressure

High blood pressure, or hypertension, is when blood pushes against the artery walls at a higher rate than normal. Long term, high blood pressure greatly increases the chance of experiencing a serious cardiac event, such as a heart attack and/or stroke. High blood pressure is one of the most common diseases worldwide and may affect as many as half of the adults in the United States, according to the Centers for Disease Control and Prevention.

Unlike other chronic conditions, high blood pressure doesn’t cause noticeable symptoms or warning signs. High blood pressure can only be uncovered through a blood pressure measurement done at your doctor’s office, a clinic, pharmacy or at home. If you or a loved one are at risk for high blood pressure, learn how to do an at-home blood pressure check. Talk with your physician about how often and when to do these checks.

High Blood Pressure and Anxiety: How Are They Related?

When you experience anxiety, it can lead to brief periods of high blood pressure. Some studies show an overlap between people with anxiety and people who have high blood pressure. People with chronic anxiety may have an increased risk of high blood pressure when compared to people without anxiety, and people with high blood pressure have a higher risk of anxiety than people without high blood pressure.

It’s vital for people with high blood pressure to discuss stress and anxiety with their health care provider. While the association between anxiety and hypertension isn’t explicitly clear, both conditions have similar treatment approaches. In other words, taking steps to reduce high blood pressure can also help reduce anxiety.

Both high blood pressure and anxiety require regular follow-up and monitoring individually and under the care of your health care provider. Both high blood pressure and anxiety may be treated with medications appropriate for each condition.

Tackling Your Risk of Anxiety and High Blood Pressure

By proactively taking control of your blood pressure, you can lower your risk of heart attack or stroke. You may also be able to reduce your stress and treat anxiety in the following ways:

  • Reduce stress. Does your day include time for self-care or doing something that is solely beneficial for you? Reducing stress can look different for everyone, but it may include spending time around people who love and support you, moving your body to improve your mood, reading or meditating.
  • Address anxiety. If you live with anxious thoughts and feelings, find a psychologist or therapist to address stress, anxiety and depression. These specialists help an individual reframe their thoughts and help develop coping strategies to manage day-to-day life circumstances that cause anxiety or depression.
  • Exercise. Engaging in physical activity can improve your mood, prevent weight gain, manage high blood pressure and more. Plan to exercise most days of the week for the most benefits. Exercise can be as simple as a daily 15- to 30-minute walk, following an at-home aerobics video, participating in an exercise or dance class, biking, jogging, or simple calisthenics. Still not sure how to fit it in? Consider multitasking—doing laundry, cleaning, gardening or raking—as your movement.
  • Quit smoking. Smoking increases your risk of heart attack and stroke and can raise your blood pressure.
  • Sleep. Did you know sleep helps keep blood vessels healthy? Not getting enough sleep can lead to an increased risk of heart disease, high blood pressure and stroke. A lack of sleep also can contribute to depression and feelings of frustration or stress.
  • Eat a healthy diet. The foods we eat impact high blood pressure. Consider the DASH eating plan, or Dietary Approaches to Stop Hypertension. This diet includes choosing vegetables, fruits, and whole grains; low-fat dairy and lean poultry and fish; and limiting foods high in saturated fats, oils and sugar-sweetened beverages and foods.

If you live with stress and anxiety, talk with your primary care provider about the impact of anxiety on your overall health and high blood pressure.

More to Read

  • How Exercise Can Boost Your Mood
  • Expert Tips on How to Sleep Better
  • Break the Cycle of Seasonal Affective Disorder (SAD)
  • Managing Stress When You Have Heart Disease

Do you live with stress and anxiety or high blood pressure?
The University of Maryland Medical System has experts who can help. Talk to a primary care provider near you.

Find a Provider

Medically reviewed by Nika Bitsko, CRNP.

  • Category: Health Awareness, Heart Conditions, Stress Management, Vascular Disease
  • Tag: Concerning Symptoms, Health Awareness, Heart Conditions, Heart Disease

Can anxiety cause high blood pressure?

Anxiety and high blood pressure can be symptoms of each other. Anxiety may lead to high blood pressure, and high blood pressure can trigger feelings of anxiety.

The American Psychological Association (APA) defines anxiety as feelings of worry or tension. It can cause certain physical symptoms, including increased heart rate and sweating. The APA also notes that anxiety may increase a person’s blood pressure.

Additionally, having long-term high blood pressure, or hypertension, can cause people to feel anxious about their health and future. Severe hypertension can also cause a person to experience anxiety.

Keep reading to learn more about the link between anxiety and high blood pressure, as well as how to treat both conditions.

Anxiety is the body’s natural response to stress. A person may feel anxious before a test or when waiting for important news.

It occurs when the body releases stress hormones. These hormones trigger an increase in heart rate and a narrowing of the blood vessels. Both of these changes can cause a person’s blood pressure to rise.

A 2015 review indicates that people with intense anxiety have a higher risk of hypertension than those with lower levels of anxiety. Researchers conclude that early detection and treatment of anxiety are particularly important in people with hypertension.

Anxiety-induced increases in blood pressure are usually temporary and subside once the anxiety lessens. Regularly having high levels of anxiety, however, can cause damage to the heart, kidneys, and blood vessels in the same way that long-term hypertension can.

In the long term, anxiety-related hormone changes may cause increased fat deposits, particularly around the abdomen. Anxiety can also prompt behavior changes in people, such as stress eating, which may indirectly contribute to hypertension.

Additionally, some medications for anxiety can increase blood pressure. Research from 2017 found that serotonin and noradrenaline reuptake inhibitors (SNRIs), which people use to treat anxiety disorders, can increase blood pressure.

Anxiety is a response to stress. Stress causes the release of hormones, such as epinephrine and cortisol. These hormones induce the “fight-or-flight” response, which prepares the body to flee or confront the perceived threat.

Fight-or-flight hormones can cause a person to experience an increase in:

  • heart rate
  • blood pressure
  • muscular strength

Once a person has dealt with their stress, their body systems should return to normal. However, a person who has long-term stress can develop health problems, such as:

  • diarrhea
  • stomach pain
  • weight gain
  • weakened immune system
  • depression
  • lack of sleep
  • fatigue
  • inability to make decisions
  • memory issues
  • increase in fats in the blood

Having high blood pressure may trigger feelings of anxiety in some people. A person with hypertension may worry about their health and their future.

Additionally, the symptoms of hypertension can cause panic or anxiety. Symptoms of hypertension include:

  • vision changes
  • headaches
  • irregular heart rhythm
  • buzzing in the ears

Severe hypertension can also cause a person to experience anxiety. If a person experiences extreme anxiety alongside symptoms such as headache or shortness of breath, they should seek medical attention immediately.

It can be difficult to distinguish between anxiety and changes in blood pressure. Hypertension does not usually cause symptoms. This means it is important for a person to have a doctor check their blood pressure regularly.

There is currently no evidence to suggest that anxiety lowers a person’s blood pressure. However, having low blood pressure may cause a person to become anxious or worried.

Symptoms of low blood pressure can be similar to those of anxiety. Symptoms of both low blood pressure and anxiety include:

  • dizziness
  • lightheadedness
  • nausea
  • fainting
  • difficulty concentrating

Learn more about fluctuating blood pressure here.

A person with low blood pressure may experience symptoms similar to those of anxiety. If a person is unsure whether their symptoms are due to anxiety or low blood pressure, they should speak with a doctor.

Additionally, people who have severe or recurrent symptoms of either should see their doctor. A doctor will be able to diagnose the underlying cause of the symptoms and can prescribe any necessary treatments.

There are several treatment options for anxiety. A person may require a combination of these treatments.


Several medicines can relieve the symptoms of anxiety. Different types of medication will work for different people. Options include:

  • buspirone, an anti-anxiety drug
  • certain antidepressants
  • benzodiazepines, which are a type of sedative medication for short-term anxiety relief
  • beta-blockers, which help a person’s heart beat more slowly and gently


Working with a psychotherapist can help people manage their anxiety symptoms.

Cognitive behavioral therapy (CBT) is one of the most effective forms of psychotherapy for anxiety. CBT teaches people to change their thinking patterns to help them reduce anxious thoughts and worries.

During CBT, a person learns techniques to manage their anxiety and gradually expose themselves to situations that trigger it. This helps the person become less fearful and anxious in these situations.

Lifestyle changes

A person can make lifestyle changes to help reduce feelings of anxiety. The National Alliance on Mental Illness (NAMI) suggests the following to help with anxiety:

  • exercising regularly
  • practicing mindfulness
  • eating a balanced diet
  • avoiding alcohol and drugs
  • getting consistent, high-quality sleep
  • learning a new skill
  • trying to reduce negative thoughts, countering them with positive ones
  • setting goals and rewards
  • creating or maintaining a support system

Read about natural remedies for anxiety here.

A person who has hypertension may be given a treatment plan by their doctor. This can involve lifestyle changes, medications, or both.

Lifestyle changes

A person can make various lifestyle changes to lower their blood pressure, including:

  • avoiding or limiting alcohol
  • reducing salt intake
  • eating a heart-healthy diet that is rich in fruit, vegetables, and whole grains
  • exercising regularly
  • quitting smoking, if appropriate
  • maintaining a moderate weight
  • managing stress
  • getting good-quality sleep

Learn about 15 natural ways to lower blood pressure here.


There are several types of medication for treating high blood pressure. These include:

  • angiotensin converting enzyme (ACE) inhibitors, which prevent blood vessels from narrowing as much
  • angiotensin II receptor blockers (ARBs) to stop blood vessels from narrowing
  • calcium channel blockers, which allow blood vessels to relax
  • diuretics, which remove excess water and sodium from the body
  • beta-blockers

The type of medication that a person needs will depend on several factors, including their general health and the severity of their hypertension. Some people may need more than one type of medication to keep their blood pressure under control.

People who think they may have anxiety, hypertension, or both, should speak with a doctor. Those who have severe symptoms should seek immediate care, as this can indicate a medical emergency.

Symptoms to look out for include:

  • fatigue
  • nausea
  • vomiting
  • confusion
  • chest pain
  • muscle tremors
  • shortness of breath
  • back pain
  • numbness or weakness
  • difficulty speaking

Both hypertension and anxiety are highly treatable conditions. A person with anxiety will not necessarily develop hypertension.

However, seeking help as early as possible can improve the outcome for people with either condition and reduce the risk of complications.

There is a link between anxiety and high blood pressure. A person with anxiety may develop hypertension, especially if they regularly experience intense anxiety.

Other people may develop anxiety as a result of high blood pressure. Treatment for one condition can often improve the other.

A person who suspects they have one or both conditions should see a doctor for diagnosis and treatment.

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 tension. 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.

Pressure and stress /

  • What is stress?
  • Pressure increase in response to stress as an adaptation
  • Increased blood pressure due to chronic stress or adaptation failure
  • How to correctly assess the level of your pressure during stress?

What is stress?

According to the classical definition, stress in medicine is usually called a non-specific reaction of the body that occurs as a response to the action of various physical factors and strong emotions (stressors) that threaten to disrupt the stable state of the body, and leading to characteristic changes in the nervous and endocrine systems.

It is widely believed that stress is always bad for a person. But in fact, stress performs the most important protective and adaptive function, launches processes that allow you to survive a stressful situation with the least losses, to emerge victorious from it. The only real danger is repetitive, chronic stress [1].

This difference is clearly visible if we consider the effect of stress on blood pressure as an example.

Increasing pressure in response to stress as an adaptation

Consider the classic situation where a person needs to publicly present and then discuss a project with colleagues.

The feeling of excitement and emotional tension grows, the body reacts to this by releasing many hormones. Adrenaline, norepinephrine and cortisol lead to an increase in heart rate, increased pressure, increased blood flow, and an increase in blood glucose levels. Such changes lead to an improvement in the blood supply to the brain, it absorbs an increased amount of glucose and oxygen from the blood, increases concentration, concentration, increases the speed of reaction, which means that a person becomes maximally collected and ready to answer any question [2]. At the same time, in a healthy person, the pressure will be within acceptable limits, not higher than 140/90.

After some time, the discussion of the project ends, the stress factor disappears and the body returns to its original state. In a few hours, the heart rate decreases, blood pressure normalizes [3]. Thus, with the help of stress, the body successfully adapted to the situation, and then returned to a stable state (homeostasis).

Such a short-term increase in pressure can be harmful only if a person suffers from hypertension or other chronic diseases.

Increased blood pressure due to chronic stress or failure of adaptation

Suppose that the same person has a "black" streak in his life. First, the child messed up at school, and had to go to the director, then an icicle fell on the car and broke through the roof, and then the neighbors also flooded the apartment. Because of this, the next day he was late for work, having received a scolding from his superiors. A day later, his previously approved project was curtailed due to lack of funding, and he was transferred to remote work due to the pandemic, depriving him of the opportunity to see his beloved colleagues live.

Such a series of stressful effects did not allow the body to fully recover, which led to a chronic increase in the level of cortisol, corticosterone and mineralocorticoid hormones in the blood, and these hormones, in turn, contributed to maintaining high blood pressure for a long time [5, 7]. As a result, there was a breakdown in adaptation, the body began to consider constantly elevated pressure as the norm, and baroceptors responsible for regulating pressure and various body systems responsible for homeostasis adapted to this level [4]. A step was taken towards the development of hypertension.

It is these people who often turn to therapists with complaints such as “jumping pressure from nerves” or “constant headache at work”. After all, any additional stress factor will cause a further increase in the already elevated level of blood pressure, leading to the development of unpleasant symptoms and the risk of a hypertensive crisis [9].

How to correctly assess the level of your pressure during stress?

It is best to measure pressure with an accurate automatic blood pressure monitor in a sitting position, after resting for 10-15 minutes.

During a stressful event and 2-4 hours after it, elevated blood pressure may be recorded [9]. However, if a person does not experience severe discomfort, and the numbers do not exceed 140-150 units of systolic (“upper”) pressure and 100 units of diastolic (“lower”) pressure, then this condition can be attributed to the normal variant during adaptation to stress.

If the pressure remains high for more than 6 hours, symptoms such as headache, dizziness, tinnitus, blurred vision, nausea are observed, it makes sense to call an ambulance or see a doctor. Also, the reason for going to the doctor can be constantly high blood pressure for several days or the appearance of similar symptoms during any emotional experiences [8].

The best way to control your condition is with the help of an observation diary, briefly describing what exactly led to the increase in pressure, to what level it rose and what were the symptoms. Such a diary will greatly help the specialist to choose and prescribe the right treatment. It is most convenient to keep such a diary when the tonometer has a memory function and remembers the results of the last measurements.

1. Bobkov A.I., Reshetnyak D.V., Nikushkin E.V. On compensated and decompensated hormonal and biochemical disorders in clinical stress. Klin. lab. diag. – 2009. No. 9, pp. 42–43
2. Buijs, R. M., & Van Eden, C. G. (2000). The integration of stress by the hypothalamus, amygdala and prefrontal cortex: balance between the autonomic nervous system and the neuroendocrine system. Cognition, Emotion and
3. Autonomic Responses: The Integrative Role of the Prefrontal Cortex and Limbic Structures, 117–132.
4. Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). The impact of stress on body function: A review. EXCLI journal, 16, 1057–1072.
5. McEwen B.S. (2006). Protective and damaging effects of stress mediators: central role of the brain. Dialogues in clinical neuroscience, 8(4), 367–381.
6. Ostroumova, O. D., & Kochetkov, A. I. (2018). Worksite hypertension as a model of stress-induced arterial hypertension. Terapevticheskii arkhiv, 90(9), 123–132.
7. Strizhakov, L. A., Babanov, S. A., Lebedeva, M. V., Moiseev, S. V., & Fomin, V. V. (2018). Arterial hypertension at the workplace: risk factors and the population value. Terapevticheskii archiv, 90(9), 138–143.
8. Antonov, E. V., Markel', A. L., & Yakobson, G. S. (2011). Aldosterone and stress-dependent arterial hypertension. Bulletin of experimental biology and medicine, 152(2), 188–191.
9. Akagi, S., Matsubara, H., Nakamura, K., & Ito, H. (2018). Modern treatment to reduce pulmonary arterial pressure in pulmonary arterial hypertension.

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