Can Anxiety Cause High Blood Pressure?

For that you need clinical studies, and obviously scientists are not going to conduct experiments that would induce stress, anxiety or anger to the point of hurting someone’s health, Contrada noted. He said he has seen research that assessed whether reducing stress, anxiety or depression also reduced the chances of a heart problem worsening, but he considers those results inconclusive.

“There are some promising studies that show that sometimes, psychotherapy or mindfulness can reduce stress and thereby reduce the odds of a heart problem,” Contrada said. “But in aggregate, when all the studies are taken together and analyzed statistically, it’s not a strong relationship.”

Stress and anxiety look different in different people

“Everybody gets anxious more or less, depending upon what’s going on around them,” Contrada said. But for some people, anxiety is a “more chronic, stable characteristic.”

Other people roll with the punches, and their blood pressure might become temporarily elevated and not to dangerous levels, Bakris said. Those individuals are managing stress, which is temporary and dissipates once the stressful circumstance is resolved. But people who are characteristically anxious across various situations and over time might have what’s called trait anxiety, Contrada said, as opposed to a time-limited state of feeling anxious.

“If you were to take 100 people, same age, same background, and expose them to the same level of anxiety, you would get a bell-shaped curve in terms of blood pressures,” Bakris said. “And the reason for that is how people handle anxiety and stress.”

The fallout from stress and anxiety

People experiencing stress and anxiety might respond in other ways that can raise blood pressure. Anxiety, anger and depression can contribute to heart problems indirectly when they bring on certain behaviors, Contrada said. Stress can cause overeating, for example, and obesity is a clear risk factor for heart problems. Conversely, excess weight might increase the levels of stress hormones. So “it’s kind of chicken-and-egg, because being overweight also can contribute to stress,” he said. Same with smoking or excessive alcohol use, which may be related to stress in some people.

“When you add up these interactions with specific behaviors, then it does become part of a set of lifestyle factors that warrant people’s attention,” Contrada said. “So I wouldn’t dismiss it. It’s just that it’s not as simple as some of the theories led us to believe” about the relationship between stress and high blood pressure.

Having anxiety about high blood pressure

Your lifetime risk of getting high blood pressure at some point is 90 percent after reaching middle age, studies show. Yet anxiety surrounding measuring blood pressure itself might make any single result artificially high. If you were anxious at the time your blood pressure was taken and the result was very high, Bakris suggested not taking it at face value.

“What you do is say, ‘OK, I must be very anxious. Let me sit down, take in deep breaths here and let’s start over,’ ” he said. “That should be a clue to the patient to not go to the emergency room but to go to a dark room.” After some deep breathing and relaxation, recheck the pressure and, if it hasn’t gone down, then consider going to the ER.

But if you have an elevated blood pressure of 180 over 120 and are suffering from other symptoms such as nausea, blurred vision, severe headache, confusion or dizziness, you could be having a hypertensive emergency and should call 911. And any consistently high blood pressure readings, even without other symptoms, should be discussed with your doctor.

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Anxiety, depression and anger are all risk factors

Heart problems are a risk factor for depression and anxiety, maybe to a greater extent than the reverse, Contrada said. So it becomes a negative cycle.

There’s also overlap or co-occurrence of different emotional states and conditions, Contrada said. Anxiety problems often co-occur with depression, which often co-occurs with anger problems, which often co-occur with having been exposed to trauma.

“A person who seems highly anxious may also be high on these other emotional dispositions,” Contrada said. “And so it’s hard to disentangle them and isolate which one may be the most important. But it also means there’s a pattern there that warrants attention, because things might be multiplying in a health-damaging way.”

Regardless of the link between anxiety and high blood pressure, Contrada suggests addressing anything that affects your quality of life.

“The starting point for many people would be: Anxiety is its own reason to do something about it,” he said.