Can Anxiety Cause High Blood Pressure?

Anxiety is a natural response to stress or perceived danger and is often associated with fear and worry. If you’re feeling anxious, you may experience physical symptoms, such as sweating, shaking, nausea, or muscle tenseness. These symptoms may become excessive or persistent if you have a generalized anxiety disorder (GAD), and may affect blood pressure, just as chronic high blood pressure or hypertension may in some circumstances cause feelings of anxiety. 

We all experience anxiety on occasion, but if you have been diagnosed with GAD, particularly if accompanied by high blood pressure, you’ll want to seek care. A healthcare provider can offer strategies and ways to manage your blood pressure and your anxiety. This article discusses the connection between anxiety disorder and high blood pressure and what a diagnosis and treatment look like for both conditions.

The Connection Between Anxiety Disorder and High Blood Pressure

When you’re faced with a stressful situation—a public speaking engagement, an unexpected call, a panicked crowd, or even a high-pressure work environment—your fight-or-flight response can be triggered.

According to Michael Wheaton, PhD, assistant professor of psychology at Barnard College, this may cause your heart rate to speed up, your body to sweat, and your blood pressure to rise temporarily.

"Your body is increasing your heart rate and physiological arousal to be able to manage a potentially dangerous situation, and as a natural consequence, your blood pressure increases during this time," says Wheaton. "Typically, your blood pressure returns to the normal range as the anxiety passes."

If you have an anxiety disorder, these spikes can occur more frequently and lead to various physical symptoms, such as irritability, muscle tension, fatigue, and/or difficulty sleeping, as well as high blood pressure.

The relationship between anxiety and hypertension is complex. Although anxiety can lead to short-term increases in blood pressure, it can, but generally doesn't increase the risk for essential hypertension.

Hypertension is often asymptomatic, although sometime significantly elevated blood pressure can result in physical symptoms related to anxiety. Having a chronic health condition such as hypertension can increase your risk for an anxiety disorder. In addition, certain unhealthy lifestyle behaviors can contribute to both conditions.

Complications of Anxiety and High Blood Pressure

Unmanaged stress or anxiety can have a negative effect on your cognitive functioning, your immune system, gastrointestinal (GI) system, and your cardiovascular system. Unfortunately, some people use unhealthy coping mechanisms to deal with their chronic stress or anxiety and engage in the following behaviors:

• Smoking
• Poor sleep habits
• Avoiding exercise
• Poor diet
• Drinking alcohol to excess

These can have a negative impact on overall health and well-being and can contribute to hypertension, poor heart health, and severe health complications.

Diagnosis of Anxiety and High Blood Pressure

Anxiety can be challenging to monitor. Excessive monitoring can have paradoxical negative consequences, according to Dr. Wheaton, as the process of noticing changes in your body's functioning might cause anxiety in some individuals. This could then cause more anxious arousal in an escalating cycle, and these escalatory cycles of arousal and anxiety can culminate in panic attacks as experienced by individuals with panic disorder. 

Often the best thing you can do is look at the underlying causes of your stress and anxiety to best manage them. Questions to ask yourself:

• Do you feel uncomfortable at work?
• Do you get anxious around certain people?
• Do certain activities, like driving, making certain phone calls, or going to crowded events make you uncomfortable and stressed?

Treatment of Anxiety and High Blood Pressure

If you want to address your anxiety and blood pressure, some practitioners offer a treatment that involves biofeedback, in which physiological monitoring of your bodily arousal is made observable to you so that you can learn to be aware of physical changes that might occur with anxiety and elevated blood pressure. “The idea is that with practice, you could learn to control your bodily response, easing tension and slowing your heart rate down to enter a more relaxed state," Dr. Wheaton says.

Psychotherapy and certain medications are the mainstay of management for anxiety disorders. Antihypertensive medications may be required to manage high blood pressure. In addition to biofeedback, other mind-body approaches such as mindfulness, yoga, breathing techniques and exercise may be a helpful adjunct for both anxiety and hypertension.

Unless you’re visiting your healthcare provider's office frequently or using your own at-home blood pressure monitor, it’s hard to know if your blood pressure is elevated.  We do know, however, how to recognize the signs and feelings of stress and anxiety—and you can take action to protect your health by implementing healthy habits and simple stress management techniques.

• Exercise regularly: This can be as simple as taking a walk, practicing yoga, or spending time in the gym.
• Eat a healthy diet: Try to lower your intake of foods high in saturated fats and incorporate more fruits and vegetables into your daily meals.
• Get quality sleep: If this means starting your night routine earlier or setting your phone outside of your room, make sure you get plenty of sleep.
• Try deep breathing: Find a quiet place free of distractions, such as your bedroom, couch, or even outside. 
• Relax your muscles: Dr. Wheaton recommends progressive muscle relaxation (PMR), an anxiety-reducing technique in which you alternate between tensing and releasing muscles throughout the body. 
• Practice mindfulness meditation: This can be used anywhere, at any time. Slow down your thoughts, calm your breath, and focus on your body in the present moment. 
• Visit a therapist: Mental health professionals can help you develop coping strategies or recommend a more comprehensive treatment plan. 

If you’ve been diagnosed with high blood pressure or an anxiety disorder, look for ways to better manage the stress in your life. This may require adjustments to your behavior, lifestyle, or work/life obligations. Do what you can to minimize stress and anxiety. If you can’t or if stress management techniques aren’t working, let your doctor know. 

“Meeting with a treatment provider could be helpful to differentiate anxiety-related bodily arousal (which typically involves temporary benign increases in blood pressure) and more serious medical concerns such as hypertension,” Dr. Wheaton says.

Stress is inevitable, but it shouldn’t be a part of your every day. If you have hypertension or if you're feeling stressed on a regular basis, it’s time to slow down, evaluate your behaviors, habits, and stressors, and make some necessary changes so you can better care for your overall health and well-being. Know that there are tools, resources, and services out there to help you manage high levels of stress and anxiety.