Do Stress and Anxiety Cause High Blood Pressure?

You’re under a brutal deadline at work. You’re in the midst of an argument with your spouse. Your dog escapes from your yard, and you’re afraid he’ll be hit by a car as you try desperately to catch him.

In all of these examples, you may start to feel the physical symptoms of stress and anxiety — your pulse quickens and your mood takes a turn for the worse as your body begins to feel frayed. And common wisdom suggests that stress and anxiety send your blood pressure skyrocketing, too.

But what’s the real relationship between stress, anxiety and blood pressure? Do you need to worry about how short-term stress impacts your body, or is it only prolonged stress that’s problematic?

“Anxiety and stress themselves don’t necessarily elevate blood pressure in the long term,” says preventive cardiologist Luke Laffin, MD, “but they often have an impact on lifestyle factors, which can absolutely contribute to elevations in blood pressure.”

How stress and anxiety impact blood pressure

Dr. Laffin confirms that there is indeed a relationship between stress, anxiety, high blood pressure and the risk of other heart-related health issues — but it might not be what you think.

“While stress and anxiety can definitely cause elevated blood pressure, they don’t necessarily cause sustained elevations in blood pressure,” he says.

To understand this, it’s important to know about the two categories of stress we experience: acute stress and chronic stress. While both can cause your blood pressure to go up, they have different long-term effects.

Acute stress and blood pressure

Acute stress is temporary stress caused by a specific event, like the ones mentioned above. Bouts of anxiety, like having a panic attack, can also cause acute stress that raises your blood pressure.

“If we’re in a stressful situation, the normal physiologic response is to increase blood pressure,” Dr. Laffin explains. “Acute stress can increase your heart rate and rev up your sympathetic nervous system, which, in turn, raises your blood pressure.”

In these cases, your symptoms dissipate once your stressor is gone. You complete your deadline, you make up with your spouse, you catch your dog, you come down from your panic attack — and soon, your blood pressure returns to normal, too.

It’s normal to experience changes in blood pressure throughout the day, and your body is typically skilled at managing them. “The body can handle acute changes in blood pressure pretty well,” Dr. Laffin says. “What we’re really worried about is chronically elevated blood pressure.”

Chronic stress and blood pressure

Researchers don’t know as much about the ways chronic stress affects blood pressure, Dr. Laffin notes. But what they do know is that stress can impact your lifestyle habits and increase your risk of health concerns.

“Stress can manifest as unhealthy lifestyle habits that can ultimately impact your cardiovascular risk,” Dr. Laffin explains. When you’re chronically stressed, you may:

• Sleep less or more poorly.
• Not exercise as much.
• Make unhealthy dietary choices.
• Smoke, drink or abuse drugs.

All of these habits can lead to higher blood pressure and increase your risk of stroke or other heart issues.

When does acute stress become chronic stress?

Because we all handle stress in different ways, it can be hard to see the signs of acute stress turning into chronic stress. Stressors that last for weeks on end turn into chronic stressors that need to be addressed for the sake of your heart health (not to mention your mental health!)

“If a couple of weeks turn into a couple of months, and a couple of months turn into a couple of years, it can be very difficult to turn those patterns around,” Dr. Laffin warns. “It also becomes harder to get rid of some extra belly fat, which ends up rising blood pressure, blood sugar, blood cholesterol and more.”

How can you lower stress, anxiety and blood pressure?

We all have to deal with a certain amount of stress and anxiety, and the way we do so impacts our health.

“It really can come down to how someone perceives stress,” Dr. Laffin says. “Two people can be in the exact same situation, but it can be much more stressful to one than the other. Some people just deal better with stress and have healthier coping strategies or support systems.”

He shares some of the ways you can lower your stress levels and get a handle on your anxiety, which can, in turn, lower your blood pressure.

1. Work it out: “Regular exercise is a great way to make people feel better, decrease stress levels and help them adapt to stressful situations,” Dr. Laffin says. The positive effects on your heart health are also important for your blood pressure.
2. Get enough high-quality sleep: Focus on both the quantity and the quality of your sleep, aiming for six to eight hours of uninterrupted sleep per night. “For stable blood pressures, you need to get about six to eight hours of uninterrupted sleep at night.”
3. Remove stressors, when you can: To reduce your stress, it’s critical to try to remove some of the things that cause it. Of course, that’s easier said than done when your main stressor is your job or a family member. In these cases, additional steps, like therapy, may help you deal with your stress.
4. Maintain a heart-healthy diet: Foods high in salt and fat can increase your blood pressure even before you add stress and anxiety to the mix. To keep blood pressure down, try to scale way back on those foods while adding in heart-healthy, antioxidant-rich foods.
5. Try meditation: Various forms of meditation can help you cope with both acute and chronic stress. And one study showed that mindfulness meditation programs may improve anxiety, too.

Medications to manage stress and anxiety

“Managing hypertension (stress) is really 70% lifestyle and 30% medications,” Dr. Laffin says.

To start, expect your doctor to ask questions about your lifestyle and habits, including your sleep. “I always talk to patients about the impact of sleep on heart health, and how stress impacts sleep,” he adds.

You may also need to rely on medication to bring down your anxiety. But just like the ability to handle stress, what medication will work best varies from person to person and requires consultation with your healthcare provider.

“If stress and anxiety are leading to a lot of blood pressure elevation, we can try medications called beta-blockers,” Dr. Laffin says. “They’re not the first line of treatment for blood pressure in most people, but they can be helpful for people with significant stress and anxiety because they decrease your sympathetic nervous system activity and slow down your heart rate in stressful situations.”

Other medications for bringing down blood pressure include calcium channel blockers and angiotensin receptor blockers. But it’s not all about medication. Remember: There’s no cure-all medication that will ensure a healthy heart, so it’s up to you to embrace a lifestyle that will help keep your ticker in tip-top shape.

To hear more from Dr. Laffin on this topic, listen to the Health Essentials Podcast episode “Combating High Blood Pressure.” New episodes of the Health Essentials Podcast publish every Wednesday.