Anxiety and Blood Pressure

An anonymous user said,

I tend to freak out when I go to the doctor’s office and have my blood pressure taken. This means that they always comment on how high it is (last week I had the usual – for me – numbers of 127/92 with a pulse of 133. I’m not worried about my pulse because it’s usually in the 80s when I take it at home. The blood pressure, however, worries me. I want to know if anyone knows how to get over the fear of having blood pressure taken. I want to get over it, but my anxiety gets in the way.

It is normal for your blood pressure to fluctuate throughout the day. Everyone, regardless of health, will see changes in blood pressure based on their diet, amount of sleep, activity level, and stress. Anxiety definitely affects blood pressure but interestingly enough in addition to making it higher it can sometimes make it lower as well.

Can Anxiety Cause High Blood Pressure?

Anxiety will not lead to hypertension (long-term high blood pressure). Despite this, having episodes of anxiety may lead to temporary but dramatic changes in your blood pressure.

In cases when you experience those temporary spikes daily, they may lead to damage of the kidneys, heart, or blood vessels just like chronic high blood pressure would. Additionally, anxiety tends to increase the chances of resorting to unhealthy habits like overeating, drinking alcohol, or smoking, each of which can also increase your blood pressure.

There are also certain medications that increase the blood pressure as a side effect and these include those for mental health conditions such as anxiety, including norepinephrine reuptake inhibitors (SNRIs) and serotonin.

How Does Anxiety Affect Blood Pressure?

When you experience anxiety, this is your fight or flight system being activated despite the lack of danger present. This system leads to multiple physical changes designed to help you respond to a threat or predator. When these changes occur outside of dangerous situations, however, they can be distressing.

Various types of anxiety will have different effects on your blood pressure, but the following are some of the possible effects.

  • Increased Heart Rate. When you are anxious, your heart rate will increase (to give more blood to areas which will need it for fight or flight). The issue is that this increased cardiac output leads to increased pressure, raising your systolic heart rate (although the diastolic usually remains the same).
  • Contracting Ventricles. Contracting ventricles are directly related to your heart rate. Blood usually goes through your ventricles with the same pressure but when you suffer from anxiety, the ventricles will contract while the blood pumps through them and this leads to an increase in pressure.
  • Hypoventilation. It is important to remember that not every blood pressure change will increase the level. Hyperventilation is low blood pressure and can also be due to anxiety. People tend to breathe poorly when anxious and this means breathing out large quantities of carbon dioxide. This leads to the body being weaker so the blood vessels dilate and the blood pressure lowers. Although blood pressure may decrease, it rarely gets dangerously low.

What Can I Do to Reduce Effect of Anxiety on Blood Pressure?

Here are some suggestions:

1. Find a Good Doctor

You will notice that the anxiety associated with having your blood pressure taken decreases drastically if you are comfortable with your doctor. The best way to accomplish this is to visit the same doctor every time as this will help you build a rapport. This also reduces any surprise they feel at your freaking out.

2. Monitor at Home

You should also do your best to monitor your heart rate and blood pressure at home to keep track of your levels. Some people are overwhelmed or intimidated by large old-fashioned monitors you find at the doctor’s office, but you can find smaller, battery-operated wrist cuffs. Not only measure your blood pressure, but be sure to write down your numbers. This will give your doctor a better idea of how you are truly doing. It can prevent you from going on unnecessary medication that a bad doctor may simply prescribe because they don’t understand your fear.

3. Exhale Slowly

While you are having your blood pressure taken, try to take long and slow exhalations. This can help relax you and keep your reading nice and low. Try to breathe out longer than you breathe in.

4. Take It Twice

Ask your doctor to take your blood pressure twice during your visit: once at the beginning and once at the end. Chances are that your anxiety will have decreased by the end of your doctor’s appointment so your second reading will better indicate your normal level, even if it is still slightly high.

5. Reward Yourself

If you are truly dreading your doctor’s visit, plan a reward for afterwards. Pick something that you will enjoy such as getting a new CD, a manicure, your favorite dessert, or a new book.

6. Don’t Go Alone

Sometimes it can help a great deal if you have someone with you at the doctor’s office. Simply have them hold your hand and you will probably notice you are more relaxed. You can even ask the doctor to take your friend or family member’s blood pressure also if it will reduce your anxiety.

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