What effect does uncontrolled anxiety have on blood pressure?

From the Guidelines

Uncontrolled anxiety can significantly raise blood pressure through its effects on the body's stress response system, potentially leading to sustained high blood pressure (hypertension) over time, as suggested by the 2020 international society of hypertension global hypertension practice guidelines 1. When experiencing anxiety, the body releases stress hormones like adrenaline and cortisol, which trigger the "fight-or-flight" response, causing blood vessels to constrict and heart rate to increase. This physiological reaction directly elevates blood pressure in the short term. Some key points to consider in managing anxiety and its impact on blood pressure include:

• Reducing stress and inducing mindfulness, as recommended by the 2020 international society of hypertension global hypertension practice guidelines 1
• Engaging in regular physical activity, such as moderate intensity aerobic exercise or strength training, to help reduce blood pressure
• Practicing relaxation techniques, such as deep breathing, meditation, or yoga, to help manage anxiety and reduce blood pressure
• Getting adequate sleep and maintaining a healthy diet, rich in whole grains, fruits, vegetables, and lean proteins, to help regulate blood pressure
• Avoiding or limiting consumption of high salt foods, sugary drinks, and saturated fats, which can contribute to high blood pressure In cases of severe anxiety, medications like selective serotonin reuptake inhibitors (SSRIs) or benzodiazepines may be prescribed alongside therapy, as noted in the prevention, detection, evaluation, and management of high blood pressure in adults: synopsis of the 2017 american college of cardiology/american heart association hypertension guideline 1. Addressing anxiety not only improves mental health but also helps protect cardiovascular health by reducing the physical stress response that drives blood pressure elevation. It is essential to work with a healthcare provider to develop a comprehensive plan to manage anxiety and high blood pressure, including lifestyle modifications, medication, and regular monitoring of blood pressure.

From the Research

Uncontrolled Anxiety and Blood Pressure

• Uncontrolled anxiety can lead to repeated blood pressure elevations, which may eventually result in hypertension 2, 3, 4.
• The relationship between anxiety and hypertension is bidirectional, with individuals with hypertension being more likely to have anxiety and those with anxiety being more likely to have hypertension 4.
• Anxiety disorders, including generalized anxiety, posttraumatic stress disorder, panic disorder, and obsessive compulsive disorder, have been linked to an increased risk of hypertension 4.

Mechanisms Underlying the Relationship

• Psychosocial stressors associated with anxiety disorders can raise autonomic arousal via the hypothalamic-pituitary axis, increasing circulating catecholamines and leading to an increased risk of hypertension 4.
• Anxiety can also lead to a pro-inflammatory state, which may contribute to the development of coronary heart disease 4.
• Blood pressure variability and reduced baroreflex sensitivity in response to autonomic dysfunction may also play a role in the relationship between anxiety and hypertension 3.

Treatment Implications

• Selective serotonin reuptake inhibitors (SSRIs) may be a safe option for treating anxiety in individuals with hypertension, as they have limited effects on autonomic system activity and a lower impact on blood pressure 5, 6.
• Other antidepressant drugs, such as serotonin-norepinephrine reuptake inhibitors and tricyclic antidepressants, may have a greater risk of hypertension or orthostatic hypotension, and should be used with caution in individuals with cardiovascular comorbidities 6.