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Can anxiety cause high blood pressure?

Anxiety attacks can cause a rise in your BP, but here’s what you should know about long-term effects

All of us feel anxious at  times—maybe you’re nervous about a presentation or you’re stressed about arriving somewhere on time. You may  joke that you can feel your blood pressure rising. But if you experience anxiety on a regular basis, should you be worried about it also causing high blood pressure? 

Anxiety and blood pressure: What’s the link? 

Anxiety is the body’s physical response to stress. Heavy breathing, feeling “butterflies” in your stomach, or getting a sudden burst of energy are all physical manifestations of anxiety. Feeling anxious at times is completely normal and can even be helpful in certain situations.  We all have a fight or flight response, like if you saw a bear in the woods your body would generate the epinephrine needed to run quickly. When you experience these short episodes of anxiety, increased heart rate and a temporary blood pressure spike is both likely and helpful.

“Blood pressure varies moment to moment in all people,” says Evan Jacobs, MD, a primary care physician at Conviva Care Center in Parkland, Florida. “Stressors such as pain, discomfort, or anxiety will elevate blood pressure temporarily and this is a normal reaction.” 

But long-term high blood pressure, also known as hypertension, isn’t just the temporary result of a stressful situation—it’s when blood pressure is consistently too high, according to the American Heart Association. Hypertension is a common health condition, nearly half of American adults have it. When patients have uncontrolled elevated blood pressure, patients feel anxious.  When the blood pressure is controlled with medication, patients often feel calmer and less jittery.

So, can anxiety cause high blood pressure? It’s still unclear to researchers whether experiencing frequent episodes of anxiety or having an anxiety disorder directly increases the risk of having hypertension. They do know that chronic anxiety and anxiety disorders—like general anxiety or social anxiety—are associated with cardiovascular disease and have been linked to adverse cardiovascular outcomes, including hypertension. The “why” isn’t clear. Maybe anxious people use unhealthy behaviors like smoking, excessive alcohol use, or overeating as coping mechanisms. Each of these activities are risk factors for high blood pressure. 

Additionally, mental health and physical health are linked, says Georgia Gaveras, DO, the chief psychiatrist at Talkiatry. “Anxiety can be related to increased blood pressure, and to protect one, we must protect the other.”

What is white coat syndrome?

One interesting phenomenon related to anxiety and hypertension is white coat syndrome or white coat hypertension. This occurs in 15% to 30% of patients who have a rise in their blood pressure due to nerves or anxiety when they are in a clinical setting, such as a doctor’s or dentist’s  office (hence the “white coat” name). It’s a concern for patients because they may be prescribed unnecessary medication that can have detrimental side effects. What makes it even trickier is that white coat syndrome can sometimes be an early warning sign for actual hypertension.  

Luckily, it’s unlikely that a doctor will prescribe medication or treatment based on one high blood pressure reading. If you or your doctor believe you may be experiencing white coat syndrome, it’s likely you’ll be asked to monitor your blood pressure readings at home or wear an ambulatory blood pressure monitor for a few days to get a more accurate depiction of your blood pressure. Blood pressure goals are under 135/85.

RELATED: What are normal blood pressure levels?

Side effects of medication

Treating anxiety and/or high blood pressure is important to your health, but you may be wondering if medication could make either condition worse. The answer? It depends. 

“Most of the typical medications used to treat anxiety actually tend to lower blood pressure by blunting the stress response to anxiety,” Dr. Jacobs says. 

In fact, beta blockers, a commonly prescribed medication for hypertension and heart disease, are also prescribed as an off-label drug for anxiety. On the flip side, if you’re prescribed a serotonin-norepinephrine reuptake inhibitor (SNRIs), an antidepressant, there’s a chance that it can raise blood pressure. If that’s a concern, be sure to let your healthcare providers know so you can discuss if another medication might be better suited or you can work out a plan to mitigate any possible side effects. 

If you are being treated for both an anxiety disorder and hypertension, it’s important to disclose all medications you’re taking with all your doctors and follow medical advice so they can design a treatment plan that works to improve both conditions concurrently. 

How to manage symptoms

If you’re experiencing anxiety and/or high blood pressure readings, incorporate these lifestyle changes and take prescribed medication:

1. Exercise daily  

Keeping physically active  helps reduce anxiety and improves heart health. Even a 10-minute walk may be just as good for your mental health and wellness as a longer workout. Exercise releases feel-good hormones, called endorphins, that can have lasting effects. Making exercise a regular habit has long-term effects, too, such as training the brain to help cope with stress even better. 

Exercising more doesn’t mean you have to go from being a couch potato to a marathon runner overnight. The best exercise for you is the one that you do: hiking, dancing, going on long walks while listening to podcasts, or weightlifting. Check with your doctor to confirm that it is safe to start a new routine. 

2. Reduce alcohol 

While unwinding with a glass of wine or a bottle of beer  can feel good, it’s likely doing more harm to your anxiety and high blood pressure. Drinking temporarily increases your blood pressure, which alleviates within a few hours. But if you’re drinking alcohol over several days, it can lead to a sustained increase in blood pressure—one that doesn’t decrease after a few drinks and can lead to an increased risk of hypertension.

If you find yourself drinking a few days a week, you may also be drinking more calories than you’d like or making food choices you wouldn’t otherwise make. These decisions can lead to weight gain and thereby increases your risk of high blood pressure. 

And when it comes to anxiety and stress levels, alcohol often exacerbates it. In fact, there’s even a word for it—“hangxiety.” While you may feel less stressed while drinking, as the alcohol wears off, quite often you’ll feel worse than when you began drinking. It’s estimated that 20% of people with social anxiety disorder also experience from some type of alcohol dependence.  

If you’re trying to reduce anxiety or your blood pressure, drinking alcohol less frequently can help. 

3. Meditate  

If you’re looking for something that you can do anywhere, at any time, to reduce high blood pressure and ease anxiety, meditation is it. Studies have found that meditating can produce “small yet meaningful” reductions in blood pressure, either on its own or with medication. 

Meditation techniques like slowing down your breath, concentrating on your breathing, and deep breathing also help with anxiety. You can incorporate these helpful techniques throughout your day to ground yourself and reduce the physical symptoms of anxiety. There are many apps that offer guided meditations to help incorporate the practice into your life. 

4. Get more (and better) sleep 

If you’re frequently cutting your sleeping hours short, you may be paying for it. Researchers know that skimping on sleep can lead to higher blood pressure. But it turns out that it’s not just how much time you spend in bed that matters, but also the quality of rest. 

A recent study found that people who had lower sleep efficiency—the amount of time in bed that’s spent sleeping soundly—showed an increase in blood pressure both that night and the next day. 

Getting enough high-quality sleep can be difficult if you have anxiety, but not sleeping enough can worsen the condition, as it can make you more irritable and increase anxious responses. So what’s an anxious person to do? 

Adding meditation to your nighttime routine can help. Avoiding coffee and alcohol in the afternoons and evenings can also make it easier to fall asleep. Keeping your phone out of bed and picking up a book instead can help get your brain into sleep mode. 

5 tips for taking your blood pressure at home | Heart

It’s not uncommon for patients to have normal blood pressure readings at home but high blood pressure readings at their doctor appointments. This can be very frustrating for hypertensive patients, especially those who are diligent about keeping their high blood pressure under control.

Patients often are nervous about what their blood pressure will be when it’s measured at their doctor’s office, and that anxiety causes their blood pressure to go up. It’s known as “white coat hypertension,” and it’s particularly common among elderly patients.

For that reason, I encourage my patients who take hypertension medication to monitor their blood pressure numbers at home.

Five tips for at-home blood pressure monitoring

Measuring your blood pressure at home is easy, and providing your doctor with a sheet of blood pressure readings gives a fuller picture than a single reading in the office once every three months.

  1. Relax: Measure your blood pressure when you are relaxed, not when you’re running late or on the go.
  2. Proper timing: Blood pressure is often highest early in the morning – 5 a.m. or 6 a.m. – so choose another time to take it.
  3. Be consistent: Take your blood pressure at the same time of day. Discuss with your health care provider how often you should measure your blood pressure.
  4. Average your readings: Hypertension specialists recommend taking three readings and then averaging the last two for the most accurate measurement.
  5. Know the recommendations: Ask your doctor what is a safe target blood pressure for you.

Blood pressure machines are widely available for purchase at drug stores and online, and many machines keep track of the measurements for you. Measuring your blood pressure at home can help you work with your physician to keep your blood pressure within a “normal” range between appointments.

I recommend that my patients purchase a blood pressure monitor with an arm cuff as opposed to a wrist cuff to get the most precise readings. It’s a good idea to bring your machine along to your appointments to make sure the readings you get at home are accurate.

What’s a ‘normal’ blood pressure?

For most patients, a “normal” blood pressure reading is less than 120 for systolic (the top number in the reading, which measures when your heart is contracting) and less than 80 for diastolic (the bottom number, when your heart is relaxed).

At the doctor’s office, a systolic measurement of 120 to 139 and a diastolic of 80 to 89 are considered prehypertension for most patients. Anything above 140/90 is considered hypertension.

Away from the doctor’s office, a reading above 135/85 is considered to be high – often, people are more relaxed during readings that don’t occur at the doctor’s office.

Aside from white coat hypertension, other factors can cause your blood pressure to read higher at the doctor’s office. When a patient has to use the restroom, his/her blood pressure can increase slightly. Likewise, if a patient has to walk up a flight of stairs to reach the doctor’s office or is frustrated by a long wait to see the physician, his/her blood pressure may increase.

Consider monitoring your blood pressure at home if you’re concerned that your regular check-ups don’t provide an accurate view of your blood pressure.

If your at-home readings are higher than your target range, request an appointment with your doctor to make sure you’re measuring correctly at home, and to rule out another health condition.

Stress and its Effect on Blood Pressure

Life can be hectic, and with everything we have to manage, it’s normal to sometimes feel stressed out. But that stress can affect our bodies in more ways than we realize.

How does stress affect the body?

“Everyone feels stress at different times in their life. But it’s when those pressures go unaddressed and build up over time that we’re left with chronic stress,” explains Dr. Michael Kayal, a cardiologist at Geisinger Community Medical Center, “which can show up in the body as physical symptoms.”

Some of these symptoms include:

  • Sleep problems
  • Depression or anxiety
  • Nausea
  • Diarrhea
  • Headaches
  • Heart palpitations
  • Body aches

Chronic stress, if left untreated, can also lead to higher blood pressure. “Elevated blood pressure is a common side effect of stress. And because high blood pressure doesn’t typically cause symptoms, when it happens, we often have no idea,” Dr. Kayal says.

Over a prolonged period, untreated high blood pressure (also called hypertension) can increase your risk of developing heart disease or put you at a higher risk of having a heart attack or stroke.

How does stress put me at risk for high blood pressure?

In stressful situations, your body produces hormones like adrenaline, which triggers your fight or flight response. This natural, fear-based response can make your heart temporarily beat faster and work harder. When your heart beats faster and harder, your blood vessels become narrower, which can lead to high blood pressure. 

During stressful times, your blood pressure may rise for a short time. Typically, your blood pressure will return to normal once the stressful situation ends.

How to reduce stress

The good news is that managing stress is easy, and it’s free. Infusing a few simple, healthy habits into your lifestyle can help lower your stress levels.

  • Get some exercise: Exercise is good for your heart. Not only does it help reduce stress and lower blood pressure, it makes you feel good. When you exercise, your brain releases endorphins, the chemicals responsible for boosting your mood. Aim for 20 minutes a day, 3 to 4 times a week, of physical activity like walking, running, swimming or lifting weights to get your blood pumping. 
  • Reduce your caffeine intake: While many people rely on caffeine to get them through the day, too much caffeine can increase your stress levels. Coffee isn’t the only culprit — tea, chocolate, many sodas and certain medications contain caffeine. Cutting down your intake can lower blood pressure and lessen some of the physical symptoms of stress, like an increased heart rate or feeling jittery.
  • Tickle your funny bone: They say laughter is the best medicine — and in this case, it’s a great one. Laughing boosts mood and just makes you feel better. Read a joke book, get silly with your family or watch your favorite comedy, and laugh the stress away.
  • Talk to the people you love: Phone calls, video chats and texts are all great ways to stay connected with those close to you, even for just a few minutes. Take time to talk about anything — even discussing ordinary topics like what you made for dinner can help lighten your mood.
  • Breathe: When you’re feeling stressed, practicing deep breathing or meditation for a few minutes a day can help calm you. A variety of free meditation or mindfulness apps are available to download onto your cell phone or tablet. If you have a home assistant, you can even ask it to help with deep breathing or meditation. There are also plenty of guided meditations available online. 
  • Get enough rest: When we don’t get enough rest, it affects our mood. Being tired can also impair your judgment and cause brain fog. It’s important to take time for yourself and make sure you’re getting enough rest. A short afternoon nap or going to bed a few minutes earlier can give you the restful sleep your body needs.

“It’s perfectly OK to take some time off to relax and recharge, whether that’s with some gardening, binge-watching a favorite show or taking a walk,” reminds Dr. Kayal.

Don’t be afraid to ask for help

If you find yourself struggling, you’re not alone. It’s normal to feel stressed and overwhelmed, and it’s OK to ask for help. Whether that’s asking for help with household responsibilities, getting your friends or family involved or talking to a professional.

Next steps:

Make an appointment with Michael Kayal, DO
Get help managing your blood pressure
Learn more about heart care

6 High Blood Pressure Facts

There’s a good reason why every doctor’s appointment starts with a blood pressure check. While one in three American adults has high blood pressure, about 20% of people are unaware that they have it because it is largely symptomless.

In fact, most people find out they have high blood pressure during a routine office visit. 

Blood pressure is the force of blood pushing against the walls of arteries as the heart pumps blood. High blood pressure, also referred to as hypertension, is when that force is too high and begins harming the body. If left untreated, it willl eventually cause damage to the heart and blood vessels.

Your blood pressure is measured in two numbers: The top systolic blood pressure measures the force pushing against artery walls when the heart is contracting. The bottom diastolic blood pressure measures pressure in the arteries when the heart is resting between beats.

Normal blood pressure levels are 120 mmHg/80 mmHg or lower. At risk levels are 120-139 mmHg/80-89 mmHg. Readings of 140 mmHg/90 mmHg or higher are defined as high blood pressure.

Here are six other things you should know about high blood pressure.

1. Blood pressure is linked to other medical issues. 

High blood pressure can be the first indication of a serious underlying condition. When a patient comes in with high blood pressure, doctors will check their urine and kidney function; do an electrocardiogram to check the size of the heart; and look for lung changes.

Stress on the blood vessels makes people with hypertension more prone to heart disease, peripheral vascular disease, heart attack, stroke, kidney disease and aneurysms. Correspondingly, chronic conditions such as diabetes, kidney disease, sleep apnea and high cholesterol increase the risk for developing high blood pressure.

In some women, pregnancy can contribute to high blood pressure, leading to preeclampsia. Postpartum blood pressure typically goes back to normal levels within six weeks. However, some women who have high blood pressure during more than one pregnancy may be more likely to develop high blood pressure and other cardiovascular diseases as they age.

Some of these medical issues can also cause spikes in high blood pressure (see below).

2. Lowering systolic blood pressure more may cut health risks.

One major study found that lowering systolic blood pressure to well below the commonly recommended level also greatly lowered the number of cardiovascular events and deaths among people at least 50 years old with high blood pressure.

When study participants achieved a systolic blood pressure target of 120 mmHg — compared to the higher target of 140 mmHg recommended for most people, and 150 for people over 60 — issues such as heart attack, stroke and heart failure were reduced by almost one-third, and the risk of death by almost one-fourth.

“That’s important information, because more lives may be saved and more deaths may be prevented if we maintain lower blood pressure in certain patients,” says Lynne Braun, NP, PhD, a nurse practitioner at the Rush Heart Center for Women.

Braun cautions, however, that your personal blood pressure target depends on a variety of things, including your current blood pressure, lifestyle, risk factors, other medications you are taking and your age. “Every person has to be evaluated as an individual,” she says. “Realistically, we can’t get everybody down to 120, and trying to do so may create unintended problems.”

It can be dangerous, for instance, to keep an older person on medications that have unsafe side effects, such as diuretics (water pills), which can cause dehydration and dizziness in older adults.

And there can be other issues involved with taking multiple medications, such as cost and compliance.

Bottom line: If you have high blood pressure, talk to your doctor about what your target should be and how best to achieve it.

3. You shouldn’t ignore white coat hypertension. 

Some people experience white coat hypertension, when blood pressure is elevated in the doctor’s office but not in other settings. These patients need to monitor their blood pressure at home or wear an ambulatory blood pressure monitor that takes your blood pressure every 30 minutes for 24 hours.

While white coat hypertension was formerly considered simple nervousness, recent research suggests otherwise.

A study published in the journal Hypertension found that people with white coat hypertension are at a significantly greater risk for developing sustained high blood pressure than people who have normal blood pressure. One possible explanation is that people with white coat hypertension have a harder time managing stress and anxiety.

People with high blood pressure and those at a high risk for developing hypertension, including adults over 50 and black men and women, should have no more than 1,500 milligrams of sodium daily (less than 3/4 tsp.) of salt.

4. Learning to cope with stress can help. 

Stress and hypertension have often been linked, but researchers are still looking into a direct relationship between the two. Still, the best advice to hypertensive patients: Try to relax.

When you are stressed, your body sends stress hormones — adrenaline and cortisol — into the bloodstream. These hormones create a temporary spike in blood pressure, causing your heart to beat faster and blood vessels to narrow. When the stressful situation is over, blood pressure goes back to its normal level.

Chronic stress, however, may cause your body to stay in this highly-charged state longer than natural.

While stress itself may or may not affect blood pressure, how you cope with stress does. For instance, overeating, smoking and drinking alcohol in response to stressful situations are direct causes of sustained high blood pressure. On the flip side, healthier coping mechanisms like exercising, practicing yoga and meditating can all help lower blood pressure.

5. Good sleep can prevent and manage high blood pressure. 

Most people experience a dip in blood pressure during the deepest stage of sleep (also known as slow wave sleep), which is the body’s normal and healthy reaction to sleep. Not having that nighttime dip is a risk factor for heart disease and may increase daytime blood pressure.

Typically people spend 90 minutes to two hours in slow wave sleep per night. A recent study published in Hypertension found that men who got less slow wave sleep each night were a higher risk for hypertension than men who got more deep sleep.

While sleep disorders, like sleep apnea, and age can both affect the amount of deep sleep you get, there are steps you can take to ensure a good night’s sleep. Getting seven to eight hours of sleep a night, maintaining a consistent sleep schedule and being more active during the day can help improve the quality of your sleep.

6. Excessive salt raises blood pressure. 

Too much sodium can cause water retention that puts increased pressure on your heart and blood vessels. People with high blood pressure and those at a high risk for developing hypertension, including adults over 50 and black men and women, should have no more than 1,500 milligrams (mg) of sodium daily (less than 3/4 teaspoon) of salt.

Even people with normal levels should eat salt in moderation. Stick to no more than 2,300 mg of sodium (about one teaspoon of salt), per day.

Most dietary sodium comes from processed foods. Rules of thumb are to choose foods with 5% or less of the daily value of sodium per serving and opt for fresh poultry, fish and lean meats, rather than canned, smoked or processed. Similarly, fresh or frozen vegetables are better than canned.

A  study published in the New England Journal of Medicine found that if people cut just 1/2 teaspoon of salt per day, it could help lower the number of new cases of heart disease per year by up to 120,000.

Further, potassium — found in foods like sweet potatoes, spinach, bananas, oranges, low-fat milk and halibut — can counterbalance the pressure-increasing effects of sodium by helping to rid the body of excess sodium.

Common causes of high blood pressure spikes

Some people with high blood pressure will experience sharp rises in their blood pressure. These spikes, which typically last only a short period of time, are also known as sudden high blood pressure. These are some possible causes:

  • Caffeine 
  • Certain medications (such as nonsteroidal anti-inflammatory drugs) or combinations of medications
  • Chronic kidney disease
  • Cocaine use
  • Collagen vascular disorders
  • Overactive adrenal glands
  • Pregnancy-related high blood pressure
  • Scleroderma
  • Smoking
  • Stress or anxiety
  • Thyroid issues (such as overactive or underactive thyroid gland)

If you have high blood pressure and experience the sudden onset of any of the following symptoms — which may signal a blood pressure spike or other serious condition — seek medical attention right away:

  • Blurred vision
  • Chest pain (angina)
  • Headache
  • Coughing
  • Nausea or vomiting
  • Shortness of breath (dyspnea)
  • Weakness or numbness in your arms, legs, face (this can be a sign of stroke)
  • Anxiety, fatigue, confusion or restlessness

6 harmless reasons your blood pressure measured high

Beautiful young female doctor is checking the blood pressure of the patient. (iStock)

If you’ve never had a problem with your blood pressure before, it can be jarring to hear that your reading measured higher than the normal cutoff of 120/80 millimeters of mercury (mm Hg).

But you don’t need to freak out just yet.

Blood pressure is the force of your blood pushing against the walls of your blood vessels. If your blood pressure is consistently high, it can damage those vessels, raising your risk of conditions like heart attack, stroke, or even erectile dysfunction, says the American Heart Association.

Related: 6 guys who suffered a heart attack tell you what it really feels like

But normal blood pressure that’s just temporarily higher—even up to 15 to 20 points above usual— is pretty much harmless, says Orlando Health Physicians Internal Medicine Group internist Benjamin Kaplan, M.D.

In fact, there are a number of innocent things that can also be responsible for a fleeting BP spike. Here are 6 to consider if your reading seems weirdly high.

1. Doctors freak you out.
If you get nervous the second you step into your doctor’s office, your heart might start pounding.

“The body essentially reacts in a fight-or-flight manner, increasing the heart rate and getting ready to make a move,” says Dr. Kaplan.

Experts call the resulting increase in blood pressure “white coat hypertension,” which can cause your reading to spike by as much as 15 points, suggests a review published in Hypertension.

Taking deep breaths in through your nose and out through your mouth can help you calm down, which will slow your heart rate and bring your blood pressure back down to normal, says Dr. Kaplan.

Related: How to de-stress in under 2 minutes

Waiting until the end of your appointment to have your BP measured might help, too. “By then, you’ll hopefully have all of your questions answered, and you’ll be less anxious,” he says.

2. You rushed to your appointment.
It’s happened to all of us: The only available parking spot is a block away—and you have 5 minutes to make it to your doctor’s office on the building’s third floor. That’s bad news for your blood pressure, and not just because of the effect of the mental stress of being late.

When you walk fast or run, your heart rate increases as it pumps more blood to power your muscles. More blood pumping through your vascular system means more pressure on the walls of your blood vessels.

That causes your blood pressure to temporarily rise, says Dr. Kaplan.

Related: 3 ways to stop procrastinating

If your doctor takes your blood pressure before your heart rate has had a chance to return to normal—which can take up to 30 minutes, depending on how fast your heart was beating—the reading will probably be higher than you expect.

So instead of having your BP checked at the beginning of your appointment, ask your doctor if he can wait until the end.

“By then, your body’s physiology will have come back to a normal resting state,” Dr. Kaplan says. And your BP reading will be more accurate.

3. You have to pee badly.
When your bladder is full, your body signals the release of stress hormones like adrenaline, which activate your fight-or-flight response. That causes your blood vessels to constrict, which can raise your blood pressure by as much as 15 points, says New Providence, New Jersey cardiologist Steve Sheris, M.D.

As you might’ve guessed, the fix is pretty easy.

If you get to the doctor’s office and you have to pee, don’t hold it in. Go, and then let the doc take your BP, Dr. Sheris says. Your BP should go back to normal in three or four minutes.

Related: How to stop getting up at night to pee

4. You drank coffee or an energy drink.
The culprit here is the caffeine, though experts aren’t sure exactly how it sends your blood pressure skyrocketing.

Two possibilities? It might signal to your body to produce more adrenaline, which speeds up your heart rate. It could also cause your blood vessels to constrict, according to the Mayo Clinic.

Caffeine seems to affect blood pressure more in people who generally don’t drink coffee than those who are already used to the stuff, says Dr. Kaplan.

Related: Why coffee makes you poop

Regular coffee drinkers could have a spike of up to 5 mm Hg. And if you don’t normally drink it, your BP could jump by as much as 15 mm Hg.

So if you don’t normally guzzle double espressos, the day of your annual physical isn’t the time to start. But even if you drink coffee or energy drinks daily, don’t walk into your appointment with the stuff in hand.

Most experts agree that patients should steer clear of caffeine for at least 30 minutes before having their BP taken, Dr. Kaplan says.

5. You sat with your legs crossed.
Sitting with your legs crossed compresses the veins in your legs, which can cause blood to pool up down there.

To compensate and make sure enough blood makes it to other important parts of your body—like your chest—your heart starts pumping more blood, says Dr. Sheris. And that sends your blood pressure up, sometimes by as much as 8 mm Hg.

For the most accurate BP reading, you should sit in a comfortable, upright position.

Your feet should be flat on the floor and your elbows should rest on the armrest of the chair, Dr. Sheris says. The position is standard protocol, so if you aren’t sitting right, your doctor should let you know. (If you’re at a self-serve BP reading place like a pharmacy, and you’re not sure that you’re sitting correctly, ask the pharmacist for help.)

6. The exam room is freezing.
When it’s chilly, the blood vessels near the surface of your skin constrict to send more blood towards your core. This helps keep you your vital organs warm, but it can also drive up your BP by as much as 20 mm Hg, says Dr. Sheris.

When your blood vessels are narrower, the blood flowing through them exerts more pressure.

Since you can’t exactly crank the heat in the doctor’s building—or keep your coat on when he’s taking your BP—the best you can do is make sure you’re not too cold beforehand. If the room seems weirdly chilly, you could leave your coat on until right before the reading.

But if you’re always freezing no matter what, mention it to your doctor—she might recommend that you try taking your BP at home.

So should you worry about one high blood pressure reading?
If you get one strange reading, don’t worry too much.

Your doctor should take at least two BP readings, at least one minute apart, and average the two readings, recommends the American Heart Association. But if your BP seems higher than usual, and one of the above factors was in play, mention it to your doctor. He can decide if you should wait longer before taking the second reading.

“It’s the average of many BP readings that matters,” says Dr. Kaplan. “You need to have elevated readings on multiple days to have the official diagnosis of hypertension.”

If the number continues to measure over 140/90 (which is the cutoff for high blood pressure), you and your doctor can talk about lifestyle changes that can help bring them down—like exercising, eating right, cutting back on salt and alcohol, and quitting smoking—as well as any possible meds like acetaminophen, antidepressants, NSAIDs, or corticosteroids.

First published on MensHealth.com

15 Surprising Things That Raise Your Blood Pressure

The Bigger Picture

You’ve probably heard to watch the amount of salt you eat, especially if you’re concerned about your blood pressure. That’s because it makes your body hold on to water, putting extra stress on your heart and blood vessels. Salt — and worry, and anger — aren’t the only things that can raise your blood pressure. Although temporary “spikes” aren’t necessarily a problem, numbers that remain high over time can cause serious damage.

Added Sugar

It may be even more important than salt in raising your blood pressure, especially in a processed form like high-fructose corn syrup. People with more added sugars in their diet see a significant rise in both their upper and lower numbers. Just one 24-ounce soft drink causes an average 15-point bump in systolic pressure (the top number, or the pressure during a heartbeat) and 9 in diastolic (the bottom number, or the pressure between beats).

Loneliness

This isn’t just about the number of friends you have — it’s about feeling connected. And being stressed or depressed doesn’t fully explain the effect. It also gets worse with time: Over 4 years, the upper blood pressure of the loneliest people in a study went up more than 14 points. The researchers think an ongoing fear of rejection and disappointment and feeling more alert about your safety and security may change how your body works.

Sleep Apnea

People with sleep apnea have higher odds of getting high blood pressure and other heart problems. When your breathing is repeatedly interrupted while you’re sleeping, your nervous system releases chemicals that raise your blood pressure. Plus, you’re getting less oxygen, which could damage blood vessel walls and make it harder for your body to regulate your blood pressure down the road.

Not Enough Potassium

Your kidneys need a balance of sodium and potassium to keep the right amount of fluid in your blood. So even if you’re eating a low-salt diet, you could still have higher blood pressure if you’re not also eating enough fruits, veggies, beans, low-fat dairy, or fish. While you may think of bananas as the go-to source, broccoli, water chestnuts, spinach, and other leafy greens are better to get potassium if you’re watching your weight.

Pain

Sudden, or acute, pain ramps up your nervous system and raises your blood pressure. You can see this effect when you put one hand in ice water, press on your cheek or fingernail, or get an electric shock to your finger.

Herbal Supplements

Do you take ginkgo, ginseng, guarana, ephedra, bitter orange, or St. John’s wort? These and others can raise your blood pressure or change how medications work, including drugs to control high blood pressure.

Thyroid Problems

When this gland doesn’t make enough thyroid hormone, your heart rate slows, and your arteries get less stretchy. Low hormone levels also might raise your LDL “bad” cholesterol, another thing that can stiffen arteries. Blood moves through hard vessels faster, pushing on the walls and raising the pressure. Though not as common, too much thyroid hormone can make your heart beat harder and faster, which will also bump up your numbers.

You Have to Pee

Systolic pressure went up an average of about 4 points, and diastolic, 3 points, in a study of middle-aged women who hadn’t gone to the bathroom for at least 3 hours. Men and women of different ages saw similar effects. High blood pressure becomes more likely as you age, so you need to get accurate readings. An empty bladder could be one way to help do that.

NSAIDs

All nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen, can raise your numbers — whether you’re healthy or you already have high blood pressure. Though the average rise is only a few points, there’s a wide range, which means it could affect some people much more than others.

Your Doctor’s Office

You might see a difference if you compare readings during an appointment to the numbers you get at home. Named for the traditional garb of medical professionals, the “white coat effect” is the rise in blood pressure — up to 10 points higher for systolic (the upper number) and 5 for diastolic (the lower number) — that can happen simply because of where you are. The bump is likely due to nerves or anxiety.

Decongestants

Ingredients like pseudoephedrine and phenylephrine can narrow your blood vessels. That means the same amount of blood has to squeeze through a smaller space, like a crowd pushing through a hallway. These drugs can also make blood pressure medications less effective. Your doctor or pharmacist can help you choose over-the-counter products for sinus problems and colds that are safer if you have high blood pressure.

Dehydration

When your body’s cells don’t have enough water, your blood vessels tighten up. This happens because your brain sends a signal to your pituitary gland to release a chemical that shrinks them. And your kidneys make less pee, to hang on to the fluid you do have, which also triggers tiny blood vessels in your heart and brain to squeeze more.

Hormonal Birth Control

Pills, injections, and other birth control devices use hormones that narrow blood vessels, so it’s possible your blood pressure will go up. It’s more likely to be a problem for women who are older than 35, overweight, or smokers. You may want to keep an eye on your blood pressure, checking every 6-12 months. A lower dose of estrogen may keep your numbers closer to normal.

Talking

It happens whether you’re young or old and no matter where you are. The higher your resting blood pressure, the higher the numbers go when you start speaking. And the effect lasts for a few minutes. It seems the subject and emotional content of what you’re saying matters more than the fact that you’re moving your mouth.

Antidepressants

Medicines that target brain chemicals like dopamine, norepinephrine, and serotonin — including venlafaxine (Effexor), monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and fluoxetine (Prozac, Sarafem) — can change not only your mood but also your blood pressure. Selective serotonin reuptake inhibitors (SSRIs) might raise it if you’re also taking lithium or other drugs that affect serotonin.

Increased nerve activity may raise blood pressure in anxiety — ScienceDaily

Sympathetic nerve activity to skeletal muscle blood vessels — a function of the nervous system that helps regulate blood pressure — increases during physiological and mental stress in people with chronic anxiety, a new study finds. Over time, this response may increase the risk of high blood pressure and heart disease, although the study did not test this specifically. The study, published ahead of print in the Journal of Neurophysiology, was chosen as an APSselect article for May.

Researchers from the University of Iowa studied the responses of two groups of volunteers after they experienced physiological and mental stressors. One group of people had chronic anxiety as determined by standardized scales used to measure anxiety and depression. The control group did not have anxiety. The research team placed the volunteers’ hands in an ice-water bath for two minutes to assess their responses to physiological stress. After a brief recovery period, the participants verbally solved simple math problems as fast as they could for four minutes to induce mental stress. Before the start of each test, the researchers gave the participants a two-minute “warning” countdown.

The research team inserted a tiny microelectrode into a nerve near the back of the participants’ knee to measure sympathetic nerve activity throughout testing. They monitored the volunteers’ rate of blood flow and blood pressure in the upper arm and heart rate via a finger cuff during both activities. Blood samples showed that the anxiety group had higher levels of norepinephrine, a hormone that sympathetic nerve fibers release in response to stress, before testing began. Norepinephrine causes the blood vessels to contract, which raises blood pressure.

The researchers observed increased nerve responses in both groups before and during the ice bath and math activities. However, the increase “was significantly greater among [the anxiety group] compared with [the control group], suggesting an enhanced sympathetic anticipatory response,” the research team wrote.

Heart rate increased during the two-minute countdown, another sign that the anticipation of impending stress or discomfort caused physiological changes in the body. However, there was no significant difference between the anxiety and control groups. “Future studies are warranted to determine whether augmented [sympathetic nerve activity] is associated with deleterious end-organ consequences in persons with anxiety and cardiovascular disease or cardiovascular disease risk factors,” the researchers wrote.

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Materials provided by American Physiological Society. Note: Content may be edited for style and length.

How to cope with stress and pressure without pills – Rossiyskaya Gazeta

Stress management is one of the main ways to prevent arterial hypertension, which often remains outside the focus of our attention. Specialists from Harvard Medical School have prepared a special report “Control your blood pressure.” It outlines a behavioral strategy that should be followed in order to avoid high blood pressure in a popular, accessible form for patients.One section of the report deals with the need to reduce stress levels.

Such prophylaxis helps to keep blood vessels healthy longer, delaying the start of regular use of antihypertensive drugs.

The Harvard Health Pablishing has published seven key steps to helping you manage your stress levels.

1. Get enough sleep. Inadequate or poor quality, intermittent sleep negatively affects your mood, mental alertness, energy level, and physical condition.

2. Learn relaxation techniques. Meditation, muscle relaxation, self-hypnosis (auto-training), breathing exercises help to cope with stress. The most powerful complex of all possible relaxation techniques is presented in yoga.

3. Strengthen your social connections. Connect with other people, find like-minded people, join an interest group.

4. Manage your time. The better you learn to balance work and family responsibilities without sacrificing one for the other, the lower your stress levels will be.

5. Try to avoid stressful situations as much as possible. Don’t let yourself get caught up in interactions that bring negative emotions. Do not drive family problems deep, learn to discuss and solve them. Use your negotiation skills at work and at home.

6. Take care of yourself. Keep fit with exercise and massage. Learn to have fun in your daily life. For example, get into the habit of eating slowly, focusing on the taste of the food and how you feel.Get in the habit of walking in the fresh air, listen to your favorite music.

7. Ask for help. Do not hesitate to ask for help from your loved ones, relatives, friends, neighbors, if you need it. If stress and anxiety persist, this is an occasion to discuss your concerns with your doctor.

Observing these seven rules, remind the authors of the article, it is also necessary to adhere to a healthy lifestyle, maintain a normal weight, quit smoking.

Where does hypertension come from and why measure blood pressure if you are all right?

Hypertension is the worst enemy of mankind.This is not an exaggeration, there are millions of deaths on the conscience of sores. Perhaps you are also sick and do not even know about it.
Diseases of the cardiovascular system are the most common cause of death in the world. More than 17 million people die from them a year, this is one in three. And 9.5 million cases are complications of hypertension
WHO Global Summary on Hypertension
Hypertension is high blood pressure. The heart pumps blood, which spreads through the vessels and acts on their walls, and this is how blood pressure appears.The heart suffers the most from high blood pressure, because it has to work harder.
Normally, the systolic (upper) pressure is 120 mm Hg, it is determined when the heart contracts, at the time of blood ejection. Diastolic (lower) – 80 mm, it is fixed at the time of relaxation of the heart.
These figures are not absolute: both 130 and 105 mm of systolic pressure are still the norm. When the systolic pressure exceeds 140, and the lower one exceeds 90, this is hypertension (hypertension)
With it, blood does not flow to all organs, heart failure develops.
Due to the strong blood pressure, the walls of the vessels deteriorate. They become thinner and bulge, aneurysms are formed. And such a thin, deformed vessel can rupture and cause a life-threatening condition.
In addition to the fact that high blood pressure is a direct road to heart attacks and strokes, this condition also affects other organs. For example, on the kidneys and on the nervous system. The consequences are chronic renal failure and encephalopathy (disruption of the brain).
Where does hypertension come from
Basically, people get sick who are predisposed to high blood pressure.But if you look at the statistics again, it turns out that a third of the planet is unlucky.
At the same time, the incidence is only increasing. And experts from the World Health Organization blame urban growth and lifestyle changes that affect the so-called behavioral factors of hypertension:
Smoking and alcohol. Nicotine and ethyl alcohol constrict blood vessels, which means it is more difficult for the heart to push blood.
Sedentary lifestyle. Due to the fact that a person moves a little, the heart and blood vessels are lazy, for them even calm work becomes too difficult.
Overweight. Simply because fat is deposited on internal organs, including the heart.
Stress. Constant nervous tension also affects the blood vessels.
Age doesn’t really matter. The pressure can rise at 25 and at 65, although at 65 this happens more often.
How to recognize hypertension
The sooner you know about the onset of the disease, the better. The drugs help to effectively reduce blood pressure, and diet and a healthy lifestyle in the early stages of the disease show excellent results.
Among adults, every third person is sick, but not everyone knows about it, because the onset of hypertension occurs without symptoms.
When the pressure rises, a person may feel that his head often hurts, after light exertion, shortness of breath appears, insomnia begins, and fatigue rolls in too quickly. Sometimes patients feel that the heart beats faster, notice swelling of the legs at the end of the day, some have nosebleeds.
To track hypertension before symptoms begin, find out if you are at risk. Remember which family member was sick or sick with hypertension, think how often you get nervous and drink. If you smoke, then you are automatically at risk.
Buy an electronic tonometer in your home first aid kit and measure the pressure yourself. To draw any conclusions, you need to take some time to measure the pressure in the morning and evening and record the results. Ideally, such monitoring is needed for at least a couple of weeks to see the average value and draw conclusions about the state of the vessels. Such checks must be completed at least once a year.
And if you are not at risk, then at least do not shy away from mandatory medical examinations and do not hesitate to ask for a tonometer at a party for a check.
What if the pressure is high?
First of all, go to the doctor and check why your blood pressure has increased.
Hypertension is primary, that is, it is the main disease that appeared on its own, and secondary, when high blood pressure is only a consequence of another disease.
The doctor will check what type you have and select the appropriate treatment.It usually consists of blood pressure pills and changes in diet and habits.
In many cases, drugs for hypertension have to be taken always, for life, regardless of what pressure you had in the morning and how you feel.
Check with your doctor. If this is your case, do not quit treatment because you “feel better”.
How to protect yourself from high pressure
All we can do is get out of the risk group. This is the best way that really works in the case of hypertension.
For example, every extra 5 kg increases the pressure by an average of 2-5 points
What else needs to be done to preserve blood vessels:
There is less salt. The maximum rate is 5 g per day, this is a teaspoon. This includes the salt found in finished products.
There are at least 400 g of vegetables and fruits a day.
Every day, devote half an hour to something active. You don’t have to go to the gym or run in the morning, just go for a walk after work and walk a few stops at a moderate pace.
Do not smoke or drink alcohol.
Less worry. Learning to manage emotions is difficult, but necessary. Please your heart, stop worrying. #national projectdemography89 #national project health care89

GBUZ RK EGP – Life under pressure

Life under pressure.

Every fifth Russian suffers from blood pressure. And after 50 years – every second. It is impossible to get rid of this disease completely, but it is imperative to control your pressure.If you want to protect yourself from stroke and coronary heart disease, you must make friends with a tonometer. This is what experts from the A.L. Myasnikov Institute of Clinical Cardiology advise

Vessels are sending a distress signal.

How can you suspect you have hypertension? Symptoms of the disease can be different: uneven gait, headaches (both severe and weak, usually occurring in the morning in the back of the head or temples), tinnitus, dizziness, nausea, nosebleeds, insomnia, facial flushing, “chills” or fog in front of the eyes . ..

Often patients are concerned about pain under the scapula, in the chest, in the fingers.Unfortunately, like many dangerous diseases, hypertension often does not manifest itself for a long time. And some do not even feel pressure surges, sometimes the body adapts to them so that at such moments people, on the contrary, feel very good. Therefore, you need to regularly monitor your blood pressure using an automatic or mechanical tonometer.

If hypertension is not treated, then very soon a stroke or coronary heart disease may develop, which, among other things, increases the risk of premature death.Suffice it to cite the following figures: in 68 out of 100 cases of myocardial infarction and 75 out of 100 cases of stroke in Russian patients, there was an increase in blood pressure.

If at the initial stage you can fight hypertension with the help of a diet, a correct lifestyle, regular control of your blood pressure, then at other stages you cannot do without drugs.

Which numbers are correct?

There is a debate among doctors and patients about what blood pressure should be considered normal.According to the recommendation of the WHO (World Health Organization), an elevated pressure is considered to be above 140 to 90 mm Hg. But, as noted by hypertensive patients, these numbers can fluctuate significantly – depending on the time of day, stress experienced, physical activity, alcohol intake. Therefore, it is much more important for the attending physician to know how quickly the blood pressure returns to normal after the jump. It is good if it takes no more than 30 minutes to stabilize. Moreover, the less stress or physical activity was, the sooner the pressure should return to its original level.

There is also such an amendment. For each patient, the ideal pressure indicators are different, they depend on what the pressure was when the person was healthy. For example, for a hypotensive person (a person with a constant pressure below 100/60 mm Hg for men and 95/60 mm Hg for women) who has become ill with hypertension, the indicators taken as the norm can mean almost a state close to hypertensive crisis. Therefore, experts resort to the term “target blood pressure”. Under this expression, doctors mean individual indicators in millimeters of mercury, to which the patient should strive.For example, in patients prone to stroke, the target pressure may be slightly higher than normal. In hypotonic patients, the opposite is true. With diabetes mellitus, nephropathy and other ailments, there are target numbers that the doctor should calculate. The diagnosis of “hypertension” is made to the patient only on the basis of the results of multiple blood pressure measurements (at least five times a day – they will have to be measured both at night and early in the morning), performed on different days. When blood pressure rises slightly, measurements with a tonometer should be taken for several months.

Self-medication is not permitted.

Recently, there have been some changes in the treatment of hypertension. Doctors prefer to prescribe more than one drug, but a combination of several drugs. Sometimes they are put in one tablet. It is comfortable for the patient and effective for therapy. Since the combination of agents of different mechanisms of action allows them to be prescribed not in high doses. The result is an effective drop in blood pressure, good tolerance, and a significant reduction in side effects.Now there are modern long-acting drugs that lower blood pressure by 24 hours with a single dose. Among the popular drugs for the treatment of hypertension are:

1. Diuretics, or diuretics. It is with them that the treatment of hypertension is often started. These drugs lower blood pressure gently. Diabetes mellitus, gout are considered a contraindication for their appointment.

2. Beta blockers. Facilitate the work of the heart. Reducing the energy consumption of our “motor”. They also have many other useful properties, but they also have contraindications (for example, bronchial asthma).

3. Angiotensin converting enzyme (ACE) inhibitors and direct angiotensin antagonists are very effective drugs. However, the doctor, when prescribing them, must take into account the condition of the patient’s kidneys.

4. Calcium antagonists. Effective, patients’ favorite drugs.

5. Blockers of alpha-adrenergic receptors. Appointed infrequently. Convenient for diseases of peripheral arteries, prostate adenoma.

6. Centrally acting antihypertensive drugs.Prescribed less frequently than they should.

7. Direct vasodilators.

But the main thing is that any of these drugs should be prescribed by a doctor. With hypertension, in no case should you prescribe yourself drugs. Very often people use drugs that are not prescribed by them, recommended by neighbors, friends, relatives. Only a doctor can choose the medicine itself and its dosage after examination and examination. Based not only on the diagnosis, but also on the patient’s age, the stage of the disease (there are 3 stages of hypertension), the patient’s heart condition, the presence of obesity, diabetes mellitus and other ailments.

Antihypertensive (pressure lowering) drugs are often very powerful, and the consequences of a sharp and strong decrease in pressure can be unpredictable. In addition, the dosage during the entire treatment period is repeatedly changed both upward and backward, depending on the patient’s condition. It must be remembered that the full effect of taking the drug often appears only after 1-2 weeks.

If medications do not help, one can suspect that hypertension is not caused by hereditary causes, bad habits (excess of fatty and salty foods, a tendency to overeat, a sedentary lifestyle, smoking) or poor vascular condition in old age, but is associated with other problems.Among the ailments that increase blood pressure, various diseases of the kidneys and renal arteries, thyrotoxicosis (thyroid disease), problems with the adrenal glands, heart disease, brain injury. In this case, the patient will have to undergo all kinds of research. If the underlying disease is not treated, hypertension will not go away and drugs that lower blood pressure will help little.

Beware of delusions!

Sometimes a person cannot cope with hypertension, because he makes very common mistakes in treatment.For example, it reduces blood pressure very quickly. It is much safer to do this in 2-3 stages over several months, gradually accustoming the body to the new blood pressure. If the pressure is lowered sharply, ischemia of the heart, brain, and other organs may occur.

Another misfortune that a hypertensive person sins. Feeling better, the person immediately stops taking the drugs. This cannot be done. Hypertension is a chronic illness. Having arisen once, it will not go anywhere, therefore, the drug therapy selected by the doctor for hypertension should be lifelong.Unfortunately, any non-drug remedies against the formed hypertension are not effective enough. Most modern drugs are taken twice a day, but other regimens are also possible. It is very harmful to reduce the dose of the medicine on your own. Only a doctor can make such a decision. It is especially risky to reduce the dose of beta-blockers without the doctor’s permission. This threatens a heart catastrophe, for example, a heart attack. The patient cannot take into account the factors that increase blood pressure, and will not be able to adjust the dosage in accordance with the dangerous moments.Dangerous circumstances can be very different – a change in the weather, experiences, physical activity, intense sex, and so on. They can only be identified during a very detailed conversation with a doctor.

Another mistake that patients make. Many believe that a good blood pressure lowering drug must have a quick effect. In fact, this is not the case.

Sometimes a person piously believes in folk remedies, rejecting drugs from the pharmacy. But beet juice, black chokeberry, infusions of various herbs can help only at the very first stage of the disease.

Down with stress and excess weight!

There is a huge field of activity for hypertensive patients who are struggling with illness. First of all, this is following a healthy lifestyle.

If a person’s daily life is full of stress at work and at home, it can be assumed that sooner or later he will get hypertension. Constant nervous overstrain leads to disruptions in the activity of the mechanisms that regulate the work of the heart and blood vessels. Stress causes the adrenal glands to secrete large amounts of adrenaline, which makes the heart rate fast, which is dangerous for the myocardium (heart muscle).Therefore, it is so important for hypertensive patients to remain calm in all situations. It is necessary to master the ability to relax and treat momentary troubles as if they happened a week ago. If the patient cannot cope with the nerves, the doctor will prescribe medications that reduce emotional overstimulation. It is important for hypertensive patients to move more. Of course, you should not immediately run to the gym and work out on the simulators. But a daily half-hour walk in the park (with a dog or Nordic walking sticks) and swimming become an excellent prevention of serious vascular problems for a person with high blood pressure.

It is imperative to get rid of excess weight. This will not only alleviate the course of hypertension, but also reduce the likelihood of diabetes, gout, arthrosis, osteochondrosis and other diseases that often accompany this disease. Hypertensive patients will have to follow a diet. The most common recommendations are to limit fatty, smoked, pickled and especially salty foods. Excess salt in the body immediately raises blood pressure. Salt intake should be reduced to half a teaspoon per day (this is about 2.5 g).But keep in mind that this is not only the salt that you put from the salt shaker into the plate. Consider all the salt, and it is hidden in any finished product – in bread, canned sausages. Even garden herbs contain a lot of salt. For example, the champion in NaCI content is celery.

Recipes of Tibetan monks.

Not so long ago, American cardiologists and neurologists confirmed the benefits of meditation in the treatment of hypertension. Try to engage in this oriental practice – what if the ancient Buddhist technique will help you, allowing you to achieve enlightenment and tranquility? If you do everything correctly, then after 15 minutes the pressure is more likely to stabilize.Meditation is especially effective in situations where you are nervous. The principle of meditation lies in the fact that for a while, “turn off” thoughts, do nothing, not strive for anything, not think about anything. And just feel your body, hear your breath, how to see, feel yourself from the inside.

Place. It is best to meditate in the same place, on a special mat. For completeness, you can light a candle, turn on quiet pleasant music (without words), pick up a rosary.Later, when you learn to meditate, you can do it anywhere, even in crowded transport and in line to see a doctor.

Pose. Choose any comfortable one, only the back should be straight, and the position should be stable. You can even sit in a chair.

Glance. Eyes should be half-closed, gaze is directed to a point at a distance of a meter in front of you. It is good to sit facing the wall so as not to be distracted by anything. If the gaze is still looking for something to catch on, close your eyes.

Breathing. Listen to him. No need to hold your breath or work with it, just focus on it. After about a minute, you will notice that it becomes slower and lighter, and thoughts, concentrating on the breath, will stop jumping over foreign objects. Whatever pictures your imagination draws to you, whatever thoughts come to mind – do not give them a go. Let them come and go.

Your health is in your hands! Be healthy!

In preparing the material, the magazine “Be healthy” was used.

Missal O.G. – m / s of the department of medical prevention “EGP”

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