Anxiety & High Blood Pressure

Tara Andresen
Mar 10, 2022

Anxiety, Stress & High Blood Pressure. A Naturopath Perspective

Stress generally makes many conditions worse but is not always the only cause for a condition. This is the case for high blood pressure or hypertension. However anxiety is significant factor in contributing to chronic elevation in blood pressure. As a Naturopath I often help people address the physical effects of anxiety on the body. Everything from muscle tension and gastrointestinal issues to headaches and hives. I have often wondered though about the long term impact of anxiety on cardiovascular health. Here is what I have found.

Research Studies on the Relationship Between Anxiety and Hypertension

A 2015 systematic review and meta-analysis in the Neuropsychiatric Disease and Treatment Journal investigated the association between anxiety and hypertension. They summarized the available data from cross-sectional and prospective studies. All of these studies were original peer-reviewed and included adults over 18 years of age. They found that anxiety and hypertension were significantly correlated in cross-sectional studies and they found a direct association in prospective studies.

How Does Anxiety Cause Chronic Hypertension?

All of these factors directly increased blood volume and blood pressure. So the overall effect of Angiotensin II is to increase blood pressure, body water and salt content.

Short term, these factors increase resistance to the flow of blood being pushed through the circulatory system but long term, this vascular resistance can result in chronic ongoing hypertension.

There is clearly a relationship between anxiety and hypertension that should be addressed as part of a treatment plan designed to decrease blood pressure.

To find out how natural medicine can effectively treat hypertension, contact Dr. Andresen at one of her Toronto Naturopathic Clinics and book your appointment today.

First, anxiety increases blood pressure in the short term. For example, people with anxiety can have night time increases in blood pressure as well as early morning increases in blood pressure.
Second, anxiety increases secretion of a protein hormone called Angiotensin II. Angiotensin has the following effects:
1. Constricts (narrows) blood vessels
2. Increases sensation of thirst and desire for salt
3. Stimulates the production of aldosterone which results in the body retaining sodium and excreting potassium
4. Increased water retention
  1. Third, people with long term anxiety tend to have physiological signs of more sensitive “sympathetic activation”. This means that the sympathetic nervous system (think fight or flight response) is more easily activated. Activation of the sympathetic nervous system reduces blood flow through the kidneys, increases water and sodium retention and elevates blood pressure. It also damages cells that line the artery walls which can lead to atherosclerosis (plaque formations that narrow the arteries and increase blood pressure). In addition, this heightened sympathetic nervous system response can lead to abnormal lipid metabolism which will result in increased LDL cholesterol (the bad cholesterol) and decreased HDL cholesterol (the good cholesterol).
  2. Fourth, something called the HPA axis (hypothalamo-pituitary-adrenal axis) which is our central response system releasing the stress hormone cortisol. With repeated exposure to stressors we habituate to the stressor with repeated and sustained HPA axis activation. This upregulation of cortisol causes water and sodium retention, leading to high blood pressure.
  3. Fifth, possible indirect relationship between anxiety and hypertension due to diet and lifestyle factors including increased eating, smoking and alcohol use along with less exercise.