How Anxiety and Blood Pressure Are Related

Hypertension (high blood pressure) and anxiety can often exist together. Among the nearly half of adults in the United States who have high blood pressure, about 40% also have anxiety—a rate that’s higher than in the general population.

In the short term, anxiety can temporarily increase blood pressure by activating your body’s fight-or-flight response. While experts aren’t sure that anxiety causes chronic (long-term) high blood pressure directly, studies suggest a possible link between them.

Anxiety may cause temporary increases in blood pressure by activating the sympathetic nervous system, the part of your nervous system responsible for your fight-or-flight response.

When you encounter a stressful situation that triggers anxiety, your body releases a hormone called adrenaline, which triggers your heart rate and blood pressure to rise. This temporary effect may last minutes to hours. Chronic or repeated stress may affect your blood pressure through the action of cortisol (sometimes called the stress hormone).

Research suggests long-term anxiety may also be linked to high blood pressure. One study found that participants with anxiety had a 55% higher chance of developing hypertension over time. Additional research has found that treating chronic anxiety can help lower high blood pressure.

These findings suggest the conditions are connected, but experts are still trying to understand whether one causes the other directly or if other common factors—such as age, smoking status, body weight, gut microbiome, or exposures—may influence both.

Anxiety and chronic stress may indirectly contribute to chronic hypertension in several ways. These include:

• Coping habits: Some strategies that people commonly use to cope with anxiety may worsen high blood pressure and other risk factors for heart disease. These strategies include smoking, eating less nutritious food, drinking alcohol, and being physically inactive.
• Shared mechanisms in the body: There is a possible biological link between anxiety and blood pressure. While research is mixed, some studies suggest potential mechanisms related to inflammation or changes to the microbiome (the typical bacterial environment in the gut).
• Medication: While anxiety treatment can lower blood pressure for some people, certain anxiety medications can raise blood pressure. These include serotonin and norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta (duloxetine) and Effexor (venlafaxine).

High blood pressure and anxiety have differences.

Anxiety can be excessive worry with fatigue, poor concentration, or disturbances in sleep. If you have symptoms such as palpitations (a pounding heartbeat), stomach upset or diarrhea, chest tightness or pain, and feelings of worry, stress, or doom, it’s more likely a panic attack.

High blood pressure does not typically cause any noticeable symptoms. However, severe cases of extremely high blood pressure may lead to symptoms resembling anxiety or panic, such as headache, vision changes, vomiting, confusion, shortness of breath, or chest discomfort or pain. These symptoms may signal a medical emergency called a hypertensive crisis.

If you’re unsure whether your symptoms are due to anxiety or high blood pressure, consider using an automated blood pressure cuff to check your blood pressure at home. If your blood pressure reading is very high, it’s important to seek emergency medical treatment.

Some lifestyle and treatment strategies can help keep anxiety and hypertension under control. These include:

• Get regular physical exercise: Movement could include a walk outside, a group exercise class, or a community sport. Combining exercise with spending time in nature or socializing may also boost your mental health.
• Consider your diet: Eating a balanced diet focused on fruits, vegetables, and whole grains is important for your mental and heart health. Try to avoid sugars and highly processed foods.
• Avoid substances: Replace smoking and excessive alcohol use with other stress-reducing habits.
• Manage your stress: Consider mindfulness, meditation, and breathing exercises to help ease stress as much as possible.
• Prioritize sleep: Aim for 7-9 hours of quality sleep per night.
• See a healthcare provider: If you want more support, talk with a healthcare provider about whether blood pressure-lowering medications or anti-anxiety medications would be a good option for you. Some people find that treating their anxiety lowers their blood pressure.

Besides its effects on blood pressure, anxiety can affect your body in other ways. Anxiety may also lead to:

• Difficulty sleeping
• Gastrointestinal problems, like nausea and diarrhea
• Headaches
• Fatigue
• Muscle tension and tremors

If you experience these anxiety-related symptoms, consider seeking help from a mental health professional, such as a counselor or therapist, in addition to your primary care provider.

Both anxiety and high blood pressure are common and treatable conditions.

If you have symptoms of anxiety that are affecting your life, it’s important to make an appointment with a healthcare provider. They may be able to refer you to a therapist for cognitive behavioral therapy (CBT) or prescribe medications that can help reduce anxiety.

If you have any severe symptoms related to hypertension or anxiety, seek emergency medical attention right away. These symptoms may include:

• Chest pain
• Shortness of breath
• Stroke symptoms, such as weakness or numbness on one side of your body or face, or difficulty speaking or walking
• Sudden, severe headache

Anxiety and stress can trigger the fight-or-flight response, raising blood pressure temporarily. Studies also suggest a link between having anxiety and developing high blood pressure in the future.

Getting regular physical exercise, lowering alcohol intake, and making other lifestyle changes can help manage both anxiety and high blood pressure. Medications are also effective.