The Link Between Anxiety and High Blood Pressure

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Anxiety and high blood pressure (hypertension) can occur together and even cause each other. High anxiety levels can lead to a spike in blood pressure, and getting a diagnosis of high blood pressure can lead to anxiety. However, some other medical conditions and medications can cause both high blood pressure and anxiety.

Read on to learn more about the link between hypertension and anxiety and the factors contributing to both conditions.

High Blood Pressure Can Lead to Anxiety

Finding out you have high blood pressure can cause anxiety, particularly if you are prone to having anxiety about health conditions.

That said, having anxiety about the condition is understandable. High blood pressure significantly increases your risk of serious health conditions, including heart attack, heart failure, stroke, kidney disease, and eye problems.

However, receiving a diagnosis of high blood pressure is the first step to getting treatment and reducing your risk for these outcomes. Studies have shown that heart (cardiovascular) events and death risk are substantially reduced when blood pressure levels greater than 140/90 Hg are treated.

There are many ways to lower your blood pressure. Healthcare providers can prescribe many different medications that are safe and effective at getting your blood pressure under control. Additionally, there are several healthy lifestyle changes you can make to help lower your blood pressure.

Anxiety Raises Blood Pressure

Blood pressure can be affected by both short-term (acute) and long-term (chronic) anxiety.

It's well known that acute anxiety can dramatically increase blood pressure levels. The rise happens because of the body's response to sudden stress, known as the "fight or flight response."

When we encounter a stressor, our bodies release hormones like cortisol and catecholamines. These hormones prepare our bodies to respond to a threat by diverting blood flow from the abdomen to increase blood flow to the muscles so that we can run away if necessary. As a result, our heart rate, blood pressure, and breathing rate all go up.

The effects of chronic anxiety on blood pressure are still debated. Studies have shown conflicting evidence of a relationship between anxiety and high blood pressure. However, more recent studies do suggest a possible link between the two conditions.

White Coat Effect

The "white coat effect" is when your blood pressure is higher than it normally is when it's being measured by a healthcare provider. The stress of being in a hospital or at a clinic is thought to contribute to the increase. A diagnosis of "white coat hypertension" can be confirmed with blood pressure monitoring at home.

Causes of Both Hypertension and Anxiety

Medical conditions and medications can cause both high blood pressure and anxiety, and certain lifestyle factors can also contribute to both conditions.

Medical Conditions

The following medical conditions can cause both high blood pressure and anxiety:

  • Primary aldosteronism: In this condition, the body makes too much of the hormone aldosterone.
  • Thyroid disorders: Having either an over or underactive thyroid can lead to high blood pressure.
  • Cushing's syndrome: In this disorder, excess cortisol leads to elevated blood pressure, anxiety, weight gain, and muscle weakness.
  • Pheochromocytoma: This rare tumor of the adrenal glands releases certain chemicals called catecholamines and can lead to intermittent very high blood pressure, headaches, anxiety, and sweating. Symptoms of pheochromocytoma can be confused with panic attacks.

When blood pressure is high because you have one of these conditions, it's known as secondary hypertension. Primary aldosteronism is a common cause of high blood pressure, whereas the other conditions listed are much less common causes of high blood pressure.

Medications

Several medications can cause high blood pressure and anxiety:

  • Corticosteroids
  • Stimulants such as Adderall (mixed amphetamine salts) and Ritalin (methylphenidate) used to treat attention-deficient hyperactivity disorder (ADHD) and narcolepsy
  • Asthma medications
  • Nasal decongestants like phenylephrine (Sudafed)

Some medications used to treat depression and anxiety, like MAO inhibitors and serotonin-norepinephrine reuptake inhibitors (SNRIs) can sometimes increase blood pressure.

Lifestyle

The following are lifestyle factors that can cause or contribute to high blood pressure or anxiety:

  • Alcohol use
  • Drugs like cocaine and methamphetamine
  • Caffeine
  • Living a sedentary lifestyle

Treatments

There are several well-proven treatments for both high blood pressure and anxiety. Your healthcare provider will work with you to make an individualized treatment plan to address your needs.

Lifestyle Changes

There are many proven lifestyle changes that can lower blood pressure. Making these modifications may also help manage mood and anxiety disorders.

  • Regular physical exercise has many benefits for your physical and mental health. The American Heart Association (AHA) recommends getting 150 minutes of moderate physical activity each week.
  • A nutritious diet has proven benefits for blood pressure and heart health. Eating a well-balanced diet may also help mood and anxiety disorders.
  • Poor sleep has been linked to high blood pressure, heart disease, and anxiety. Getting enough good quality sleep may help you manage these conditions.

Medication

In addition to lifestyle factors, you may need medication to get your blood pressure under control or to treat mood and anxiety disorders. Many different classes of medications are available to treat these conditions.

Some frequently used medications to lower blood pressure include:

  • ACE inhibitors and angiotensin receptor blockers
  • Calcium channel blockers
  • Diuretics

In some cases, beta-blockers, aldosterone antagonists, and vasodilators are used to lower blood pressure.

Talk therapy is often effective for treating anxiety, and many people also benefit from taking medication. For example, selective serotonin reuptake inhibitors (SSRIs) are a widely used class of medication for treating anxiety.

However, other medications for anxiety, like serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and tricyclic antidepressants, should be used cautiously in people with high blood pressure.

Summary

High blood pressure and anxiety can occur at the same time and one condition can contribute to the other. Diet, exercise, sleep, and other lifestyle changes can help manage both high blood pressure and anxiety. Some people need to take medications to help control their blood pressure and treat their anxiety.

A Word From Verywell

High blood pressure and anxiety are both treatable and there are many proven, safe treatments for each condition. Discuss them with your healthcare provider to find the one (or combination) that is right for you.

Frequently Asked Questions

  • Can anxiety cause hypertension?

    Anxiety increases stress hormone levels and catecholamines, both of which affect blood pressure. In the "fight or flight response" that happens when you encounter sudden stress, your body reacts by releasing catecholamines to prepare your body to fight or flee. The result can be a dramatic blood pressure increase.

  • Can anxiety cause low blood pressure?

    Anxiety is more often related to high blood pressure but it can sometimes cause a temporary drop in blood pressure. A classic example is a vasovagal response that is triggered by things like severe pain or the sight of blood. In these cases, low blood pressure is temporary and can cause symptoms like dizziness, nausea, and brief loss of consciousness.

  • Does anxiety cause chest pains?

    Panic attacks can cause chest pain accompanied by other symptoms like palpitations, trembling, shortness of breath, and fear of losing control.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Angela Ryan Lee, MD
Angela Ryan Lee, MD, is board-certified in cardiovascular diseases and internal medicine. She is a fellow of the American College of Cardiology and holds board certifications from the American Society of Nuclear Cardiology and the National Board of Echocardiography. She completed undergraduate studies at the University of Virginia with a B.S. in Biology, medical school at Jefferson Medical College, and internal medicine residency and cardiovascular diseases fellowship at the George Washington University Hospital. Her professional interests include preventive cardiology, medical journalism, and health policy.