The Connection Between Anxiety and Hypertension

By Arielle Mitton
Medically reviewed checkmarkMedically reviewed
December 4, 2021

Anxiety is a mental health condition that many people experience, and though it can be difficult to deal with, it’s not something to be ashamed of.

It can produce symptoms that are hard to control, including cardiovascular manifestations like palpitations and an increased heart rate.

However, it can also be managed with things like lifestyle changes, a good support system, talking to a therapist, and medication, if you and your provider feel like that’s right for you.

If you have chronic anxiety, you may be concerned about whether it can cause high blood pressure — or perhaps worsen existing hypertension.

What is Anxiety? 

The Merriam-Webster dictionary defines anxiety as “an abnormal and overwhelming sense of apprehension and fear often marked by physical signs.”

Everyone feels anxious at some point or another and we all experience anxiety differently.

But generally, you might feel afraid, nervous, concerned, or dreadful. 

When you’re in a dangerous situation, anxiety is actually a normal response.

Your brain tells your body to release chemicals that cause you to run, freeze, or react suddenly.

Your heart rate may increase or you might begin to sweat nervously. 

Some symptoms of anxiety are:

  • Persistent, excessive worry 
  • Feeling tense or on edge
  • Difficulty sleeping
  • Trouble concentrating
  • Irritability or restlessness
  • Muscle tension
  • Diarrhea
  • Numbness or tingling
  • Fatigue

Some people feel anxiety — this fight, freeze, or flight response — even when they’re physically safe.

Anxiety doesn’t just occur when a person is in physical danger; it’s also something that happens when there’s a perceived emotional threat.

You may worry excessively or feel a near-constant sense of fear about everyday concerns and situations.

When these experiences prevent someone from living their daily life with relative ease, a doctor might diagnose them with an anxiety disorder.

Most anxiety disorders cause chronic anxiety. Generalized Anxiety Disorder (GAD) is the most common anxiety disorder in the US

Other anxiety disorders include:

  • Obsessive compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Phobias
  • Panic disorders

What is Hypertension?

Hypertension is the medical term for high blood pressure.

This condition is extremely common, but many may not realize they have it. 

Blood pressure refers to the amount of force that the blood puts on the inner walls of your arteries, the tubular structures that carry blood around the body.

Healthy arteries don’t block the flow of blood, but when they reduce in size, or something restricts the flow of your blood, your blood pressure rises.

Chronic high blood pressure also puts pressure on other parts of your body, including your heart, causing it to work harder to move blood through your arteries.

This can cause long-term heart problems.

Other areas that can be damaged from hypertension, or high blood pressure, are your brain, eyes, and kidneys.

Blood pressure is evaluated with two measurements: your systolic blood pressure and your diastolic blood pressure.

Systolic blood pressure refers to the pressure inside your arteries as your heart is pumping blood.

Diastolic blood pressure refers to the blood pressure in between heart beats as your heart is resting.

When reading blood pressure, these two numbers are read as systolic blood pressure over diastolic blood pressure, such as 120/80.

Hypertension is diagnosed when systolic blood pressure and diastolic blood pressure levels reach 130+ and 80+ respectively.

A severe increase in blood pressure above 180/120 can lead to a hypertensive crisis, manifesting as a stroke, heart attack, or kidney failure

Symptoms of hypertension other than blood pressure levels include:

  • Pounding in the head or chest
  • Light-headedness or dizziness
  • Chest pain
  • Blurry vision or other vision problems
  • Headaches
  • Shortness of breath

Many people go their whole lives before realizing they are at risk for or have hypertension.

Even children can be at risk for high blood pressure if they are overweight, have hypertension in their family history, or if their mother smoked during pregnancy.

This is why it’s important to have your blood pressure checked with annual exams or if you experience any of these symptoms.

A common symptom of anxiety is a pounding heart, but should you be worried about the long term effects of this stress?

Can Anxiety Cause Hypertension?

Because anxiety can cause symptoms like a pounding heart, many believe that anxiety can result in blood pressure issues like hypertension. 

While some studies do show a link between anxiety and risk for high blood pressure, many others do not. 

A recent study of over 17,000 subjects in Norway found little evidence to support the suggestion that anxiety causes hypertension.

In fact, the study demonstrated that the opposite is actually true.

Findings showed that anxiety and depression was actually associated with lowered blood pressure.

So what does this mean?

Anxiety is a form of stress, and stress can cause temporary spikes in blood pressure.

This is because your body reacts to stress by increasing your heart rate and blood pressure during a fight-or-flight response, preparing you to face the danger you perceive.

A 2021 study demonstrates that the fewer resources you feel that you have to deal with the stressful situation, the more likely you are to have a greater blood pressure spike.

However, it’s unlikely that these temporary spikes in blood pressure when anxious will directly lead to high blood pressure issues later in life.

Pay attention, instead, to other factors that are proven to put you at risk for hypertension.

These include:

  • Weight: A critical review of literature emphasizes that increases in weight and BMI are linked to an increased risk for developing hypertension. Try to maintain your weight in the normal range through a healthy diet and exercise.
  • Genetics and Family History: A child of hypertensive parents often has a greater risk for developing high blood pressure.
  • Smoking: If you smoke, you are at a higher risk for developing hypertension.

Another important thing to know is that while anxiety itself might not lead to hypertension, some medications for anxiety have been linked to hypertension.

If you are started on a new medication for your anxiety, be sure to ask your doctor if it can increase your blood pressure if you have risk factors mentioned above.

Can Hypertension Cause Anxiety?

Many patients with hypertension often have diagnoses for anxiety or depression as well.

A 2018 study states that between 7.5% and 53% of hypertensive patients also have depression, and between 19% and 51% have anxiety and other panic disorders.

This doesn’t mean that hypertension causes chronic anxiety or depression, though.

However, natural concerns about health issues can cause heightened stress.

This might trigger anxiety in those predisposed. 

Having a good support network and healthy coping mechanisms for stress can help reduce your anxiety levels and prevent the added challenge of anxiety disorders.

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Treatment for Anxiety and Hypertension

Your doctor or health provider can recommend treatment for anxiety or hypertension.

Medications for both conditions rarely interact negatively, but be sure to speak with your doctor before taking multiple prescription drugs.

Anxiety Treatment

The main ways to manage anxiety are using medication, psychotherapy, or self-help. 

Medications work on the brain to stimulate or reduce the production of certain chemicals.

Most anxiety medications focus on the neurotransmitter, serotonin. 

Prescription drugs that work to increase serotonin are called selective serotonin reuptake inhibitors (SSRIs), or selective serotonin and norepinephrine inhibitors (SNRIs). 

Some of the most popular SSRIs include fluoxetine (Prozac), citalopram (Celexa), and sertraline (Zoloft).

Common SNRIs include desvenlafaxine (Pristiq), duloxetine (Cymbalta), levomilnacipran (Fetzima), and venlafaxine (Effexor XR).

Psychotherapy is another option, which is used either alone, alongside medication, or when medication is not an option.

This treatment includes making regular appointments with a psychotherapist or counsellor to explore your anxiety-inducing thoughts and experiences.

Some types of therapy include cognitive behavioral therapy (CBT), exposure therapy, and dialectical behavioral therapy (DBT).

There are also many ways that you can engage in self-help to uncover and help remove your own sources of stress and anxiety.

These can include:

  • Practicing mindfulness, accepting your thoughts and potential futures
  • Learning your biases, knowing what you might be assuming about the things around you
  • Recognizing that only you are able to change your own actions
  • Gradual exposure, learning that the perceived threat is not so scary with practice
  • Exercising regularly to keep your brain functioning at its best

Your mental health is important for your overall health, which means that even if you don’t experience anxiety regularly, you might benefit from learning some of these self-help tools.

Hypertension Treatment

Hypertension is often treated with medications that work to relax your blood vessels (and increase ease of blood flow), or remove extra sodium and water from your body.

Your doctor may also suggest certain lifestyle changes to control your blood pressure.

Prescription medications that work to remove extra sodium and water from your body are called diuretics.

Diuretics remove water by making you pee more frequently. 

Medications that relax blood vessels in various ways fall into three categories:

  • Angiotensin-converting enzyme (ACE) inhibitors: Including lisinopril, enalapril, and benazepril.
  • Angiotensin II receptor blockers (ARBs): Including azilsartan (Edarbi), candesartan (Atacand), and losartan (Cozaar). 
  • Calcium channel blockers: Including amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others), felodipine, isradipine, and nicardipine.

By relaxing the blood vessels, your heart can more easily pump blood through blood vessels and arteries, and thus reducing blood pressure.

When to See a Doctor

Learning stress management on your own can help with anxiety and blood pressure.

However, if you’ve been experiencing high blood pressure and anxiety for a prolonged period, you should speak with a doctor.

If you experience any of the following symptoms along with a blood pressure reading of over 180/120, seek emergency medical care:

  • Sudden loss of speech
  • Numbness, or weakness
  • Change in vision
  • Severe headache or chest pain

How K Health Can Help

Anxiety is a common condition all around the world. Uncontrolled hypertension is one of the top risk factors for cardiovascular disease mortality and people under 40 are less likely to recognize that they have hypertension.

You don’t have to keep wondering if you’re at risk.

Primary health care is key to understanding these problems and finding the right treatment. Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

Can anxiety cause low blood pressure?
Anxiety can cause temporary spikes in blood pressure, as we often feel during the fight or flight response, but does not cause chronic high or low blood pressure.
Can anxiety treatment affect blood pressure?
Some anxiety treatments can affect blood pressure. Certain prescription medications, specifically those that affect serotonin levels, are known to effect blood pressure. If you are taking medication for anxiety, speak with your doctor or health care provider before choosing to take additional blood pressure medications as a change in anxiety medications may help to lower your blood pressure
Is hypertension a common symptom of anxiety?
Anxiety can cause all sorts of symptoms, including a racing heart. However, hypertension is not a known symptom of anxiety. Not everyone with anxiety has hypertension. While anxiety can cause temporary spikes in blood pressure, hypertension is a separate condition that is not caused by anxiety.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.

Arielle Mitton

Dr. Mitton is a board certified internal medicine physician with over 6 years of experience in urgent care and additional training in geriatric medicine. She completed her trainings at Mount Sinai Hospital and UCLA. She is on the board of the Hyperemesis Research Foundation to help women suffering from hyperemesis gravidarum.