Why Do Anxiety and High Blood Pressure Go Hand-In-Hand?

Fortunately, here's more than a dozen no-pills options that can fix both.

Posted Feb 15, 2018

(c) pressmaster/fotosearch
Source: (c) pressmaster/fotosearch

As a psychologist who trains therapists around the country in new ways to combat anxiety, I have become interested in the relationship between anxiety and high blood pressure.  

Which causes which?  And can treatments for one help with the other?  Here’s the latest that I've found in my search for answers.

Does anxiety cause high blood pressure? 

The answer seems to be complex: No, and yes.

Sheldon Steps, M.D. from Mayo Clinic writes on the Mayoclinic blog that,  “Anxiety doesn't cause long-term high blood pressure (hypertension). But episodes of anxiety can cause dramatic, temporary spikes in your blood pressure.  If those temporary spikes occur frequently, such as every day, they can cause damage to your blood vessels, heart and kidneys, as can chronic high blood pressure. …"

That is, while anxiety does not cause a chronic rise in blood pressure, anxiety can create temporary blood pressure spikes.  If spikes occur often and/or repeatedly, they cause the same damage to your blood vessels, heart and kidneys as chronic high blood pressure would.  So even though anxiety may not cause chronic high blood pressure, it can cause similar health problems. 

Dr. Sheps adds a warning about a second way in which anxiety can damage blood pressure health.  Because of their sedating side-effects, physicians may prescribe anti-depressants to lower anxiety.  Unfortunately, these drugs, known as serotonin and norepinephrine re-uptake inhibitors (SNRIs), can increase your blood pressure.

Yet another concern rises if you take into account a third variable, that ever-important phenomenon of sleep or lack thereof.  Dr. Sheps' article refers to Dr. Robert Rosenberg, Medical Director in Northern Arizona of The Sleep Disorders Centers of Prescott Valley and Flagstaff to explain that anxiety can cause you to lie awake worrying or to sleep fitfully with anxiety always in the background.  If so, your body’s stress reaction is being activated while you lie in bed, that is, during the very hours that your body is supposed to be recuperating from your daytime activities, feelings and thoughts.  Stress reactions throughout the night cause your body to release  cortisol and adrenaline, two chemicals that raise blood pressure.  Hypertension, here we come. 

The bottom line: if you are experiencing too much anxiety, for health reasons as well as because anxiety feels so unpleasant, best to do something to reduce it. 

(c) bds /fotosearch
Source: (c) bds /fotosearch

Does high blood pressure cause anxiety?

Probably not directly. 

At the same time, fear of what high blood pressure is doing to your body definitely can cause anxiety. 

High blood pressure does not create immediately visible or painful symptoms.  That's why most people are unaware when their blood pressure has become too high unless their medical professionals have discovered it in a health checkup.  The difficulty is that high blood pressure can lead to potentially fatal consequences.  Want atherosclerosis (hardening of the arteries), a stroke, or a heart attack?

If not, best to lower that blood pressure.

Can treatments for one hurt the other?

As I wrote above, one category of medications for anxiety (anti-depressant medications like SNRI’s) can increase blood pressure. At the same time, the benzodiazepines (Valium, etc) which used to be the mainstay of anxiety medications are highly additive.  Becoming addicted then creates anxiety about the addiction. So overall, beware.

As to blood pressure treatments, several medical websites list anxiety as one of the possible side effects of some of these medications.  An online search may be helpful if you want more information on this concern.

Can treatments for one help the other?

Here’s where there is good news.

Non-drug treatments for high blood pressure tend to be the same treatments that lower anxiety.  So the following list of high blood pressure treatments is pretty much the same list as what you can do to lower excessive anxiety. 

Here’s the list:

  1. Yoga.  There is much research now on yoga as a treatment for lowering anxiety. Research also indicates that yoga effectively lowers hypertension if it incorporates all three elements of poses, meditation and breathing.
  2. Exercise. A review article summarizing research on the impacts of exercise on hypertension and another on the impacts of exercise on anxiety conclude that three factors are important for effective results: frequency (the best is daily), intensity (best at least some of the time to pump it up), and time (30-60 minutes).
  3. Sex
  4. Sunshine, outdoor scenes and natural environments
  5. Acupuncture
  6. Massage
  7. Biofeedback
  8. Limits on alcohol
  9. End worry habits.  Use thought substitution, that is, replace worry thoughts with visualizing a positive scene.  Needn’t be a solution to your problem.  Just visualize any situation in which you see yourself feeling relaxed, e.g. playing with children, floating in the water at the beach, lying in the sunshine, sitting in a garden with colorful flowers in full bloom, etc.
  10. Sleep.  Beware though of taking pills for sleep. Too many potential negative side effects. Consider instead using 2Breathe, a device that puts you to sleep by easing you into sleep-inducing breathing patterns.
  11. Meditate: Putt your mind into alpha rhythms for 15-20 minutes a day.
  12. Use a float tank: Restful floating seems to reduce, at least temporarily, anxiety and also lowers blood pressure.  More studies are needed to establish whether on-going use of flotation treatments removes these difficulties more long-term.
  13. Problem-solve.  The single best stress-reducer is to find solutions to the dilemmas you are facing.

What if you can’t get yourself to use any of the options on this list consistently enough to help?

Some of my clients report that they believe that yoga or meditation might help them, and yet doing these activities consistently enough feels too far out of their comfort zone or too time-consuming. Similarly, none of the above list of "natural" treatments may seem to suffice.

In these cases, I suggest that my clients try the new medical device called Resperate. Resparate is an FDA-cleared and American Heart Association recommended medical device for non-drug treatment of hypertension—and also for stress.

How does Resperate work?  The device guides your breathing into a relaxing rhythm similar to that induced by yoga or meditation. In multiple research studies, 15 minutes a day of restfully breathing in synch with the device’s gentle bell tones lowered blood pressure and also lowered stress/anxiety levels.

The bottom line: both high blood pressure and excessive anxiety can be alleviated, and without risking side effects from medications. 

Medications can fix many problems.  They save lives. 

At the same time, when alternative treatments that do not risk the potential negative side effects of medications are options, seems to me that these are worth a try. As you can see from the title of my book on treatments for anxiety, depression and other kinds of emotional distress—Prescriptions Without Pills—my mission is to be sure that my readers have information about treatments that do not require taking drugs.

If you can say goodbye to both high blood pressure and anxiety by availing yourself of one or several of the no-pills options in the list above, what's your reaction? 

You get just one life.  Take care of yourself.