How does anxiety impact blood pressure. What are the long-term effects of chronic stress on cardiovascular health. Can managing anxiety help reduce hypertension risks. Explore the intricate connection between mental health and heart health.

The Intricate Link Between Anxiety and Blood Pressure

Anxiety and blood pressure share a complex relationship that has garnered significant attention in medical research. While it’s well-established that anxiety can cause temporary spikes in blood pressure, the long-term effects of chronic anxiety on cardiovascular health are still being studied. Understanding this connection is crucial for managing both mental and physical well-being.

When we experience anxiety, our body’s stress response kicks in, triggering a cascade of physiological changes. This “fight or flight” reaction can lead to:

• Increased heart rate
• Elevated blood pressure
• Muscle tension
• Heightened alertness

While these responses are normal and even beneficial in short-term stressful situations, chronic anxiety can potentially contribute to sustained high blood pressure over time.

The Prevalence of Anxiety Disorders in America

Anxiety is a widespread mental health concern in the United States. According to the National Institutes of Health, approximately 31% of American adults will experience an anxiety disorder at some point in their lives. This statistic underscores the importance of understanding anxiety’s potential impact on physical health, including blood pressure.

What distinguishes normal anxiety from an anxiety disorder? An anxiety disorder is characterized by:

• Persistent and intense feelings of worry or fear
• Difficulty controlling these feelings
• Interference with daily activities
• Physical symptoms such as restlessness, muscle tension, and trembling

For the estimated 25 million Americans living with an anxiety disorder, the potential health implications extend beyond mental well-being.

Chronic Stress and Its Impact on Cardiovascular Health

The relationship between chronic stress, anxiety, and cardiovascular health is multifaceted. Long-term stress and anxiety can lead to:

1. Increased cortisol production
2. Elevated blood pressure
3. Weight gain
4. Higher risk of heart disease

These factors collectively contribute to an increased risk of heart attacks and strokes. The American Heart Association has recognized the link between chronic stress and the development of anxiety and depression, further emphasizing the interconnected nature of mental and cardiovascular health.

The Role of Cortisol in Stress-Related Hypertension

How does cortisol influence blood pressure? Cortisol, often referred to as the “stress hormone,” plays a crucial role in the body’s stress response. When produced in excess due to chronic stress or anxiety, cortisol can:

• Increase blood sugar levels
• Raise blood pressure
• Contribute to weight gain, especially around the abdomen
• Affect sleep patterns

These effects can create a cycle that perpetuates both anxiety and hypertension, making it essential to address both conditions simultaneously.

Understanding High Blood Pressure (Hypertension)

High blood pressure, or hypertension, is a prevalent health concern affecting nearly half of the adult population in the United States, according to the Centers for Disease Control and Prevention. But what exactly is high blood pressure?

Hypertension occurs when the force of blood pushing against the walls of your arteries is consistently too high. This condition is particularly dangerous because it often has no noticeable symptoms, earning it the moniker “the silent killer.” Regular blood pressure checks are crucial for early detection and management.

The Dangers of Uncontrolled Hypertension

Why is high blood pressure so concerning? Uncontrolled hypertension can lead to:

• Increased risk of heart attacks
• Higher likelihood of strokes
• Damage to blood vessels and organs
• Potential cognitive decline

Given these serious health implications, understanding and managing factors that contribute to high blood pressure, including anxiety, is of paramount importance.

The Bidirectional Relationship Between Anxiety and Hypertension

Research has revealed a fascinating bidirectional relationship between anxiety and hypertension. Studies show that individuals with chronic anxiety may have an increased risk of developing high blood pressure. Conversely, people with hypertension appear to have a higher likelihood of experiencing anxiety compared to those with normal blood pressure.

This interplay raises important questions about causality and treatment approaches. Does anxiety lead to hypertension, or does living with high blood pressure contribute to increased anxiety? The answer likely involves a complex interaction of biological, psychological, and environmental factors.

Shared Risk Factors and Mechanisms

What factors contribute to both anxiety and hypertension? Several shared mechanisms and risk factors may explain the connection:

• Autonomic nervous system dysregulation
• Inflammation
• Genetic predisposition
• Lifestyle factors (e.g., poor diet, lack of exercise, substance use)
• Environmental stressors

Understanding these common threads can help in developing comprehensive treatment strategies that address both conditions simultaneously.

Treatment Approaches for Anxiety and Hypertension

Given the potential link between anxiety and high blood pressure, addressing both conditions is crucial for overall health. What treatment options are available for managing anxiety and its potential impact on blood pressure?

Psychotherapy and Counseling

Psychotherapy, particularly cognitive-behavioral therapy (CBT), has shown significant efficacy in treating anxiety disorders. How does CBT work? This approach helps individuals:

• Identify and challenge negative thought patterns
• Develop coping strategies for anxiety-inducing situations
• Learn relaxation techniques
• Gradually face fears through exposure therapy

By reducing anxiety levels, psychotherapy may indirectly contribute to better blood pressure control.

Medication Options

In some cases, medication may be recommended to manage anxiety symptoms. Common medications include:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Benzodiazepines (for short-term use)
• Beta-blockers (which can help with both anxiety and blood pressure)

It’s important to note that while these medications can be effective, they should always be prescribed and monitored by a healthcare professional.

Lifestyle Modifications

Lifestyle changes play a crucial role in managing both anxiety and hypertension. What lifestyle modifications can help?

• Regular exercise
• Stress reduction techniques (e.g., meditation, deep breathing)
• Healthy diet
• Adequate sleep
• Limiting alcohol and caffeine intake
• Smoking cessation

These changes not only help reduce anxiety but also contribute to overall cardiovascular health.

The Power of Exercise in Managing Anxiety and Blood Pressure

Exercise stands out as a particularly effective intervention for both anxiety and hypertension. How does physical activity benefit mental and cardiovascular health?

Regular exercise can:

• Release endorphins, improving mood and reducing stress
• Lower blood pressure
• Strengthen the heart muscle
• Improve sleep quality
• Boost self-esteem and confidence

The Anxiety & Depression Association of America suggests that for some individuals, exercise can be as effective as medication in reducing anxiety symptoms.

Types of Exercise for Anxiety and Blood Pressure Management

What types of exercise are most beneficial? While any form of physical activity can be helpful, certain exercises have shown particular promise:

• Aerobic exercises (e.g., walking, jogging, cycling)
• Yoga and tai chi
• Strength training
• High-intensity interval training (HIIT)

The key is to find activities that you enjoy and can maintain consistently. Even short bouts of exercise, such as a 10-minute walk, can provide immediate benefits in terms of mood and stress reduction.

The Importance of Regular Monitoring and Follow-up

For individuals managing anxiety and hypertension, regular monitoring and follow-up with healthcare providers are essential. Why is consistent monitoring so crucial?

Regular check-ups allow for:

• Timely adjustments to treatment plans
• Early detection of any complications
• Opportunities to discuss concerns and ask questions
• Reinforcement of healthy lifestyle habits

Both anxiety and hypertension can be “silent” conditions, meaning they may not always present obvious symptoms. Regular monitoring helps ensure that these conditions are properly managed before they lead to more serious health issues.

Home Blood Pressure Monitoring

In addition to regular check-ups, home blood pressure monitoring can be a valuable tool. How can you effectively monitor your blood pressure at home?

1. Use a validated, automated upper arm cuff device
2. Measure at the same time each day, preferably in the morning and evening
3. Take multiple readings and record the average
4. Share your readings with your healthcare provider

Home monitoring can provide a more comprehensive picture of your blood pressure over time and help identify any patterns or triggers related to anxiety or stress.

Holistic Approaches to Managing Anxiety and Blood Pressure

While traditional medical treatments are essential, many individuals find complementary holistic approaches beneficial in managing both anxiety and blood pressure. What holistic strategies can be incorporated into a comprehensive treatment plan?

Mindfulness and Meditation

Mindfulness practices and meditation have gained significant attention for their potential to reduce stress and anxiety. How do these practices work?

• They help focus attention on the present moment
• Reduce rumination on anxious thoughts
• Promote relaxation and calmness
• May help lower blood pressure over time

Regular mindfulness practice, even for just a few minutes a day, can have cumulative benefits for both mental and cardiovascular health.

Nutrition and Dietary Approaches

Diet plays a crucial role in both mental health and blood pressure management. What dietary strategies can help?

• The DASH (Dietary Approaches to Stop Hypertension) diet
• Mediterranean diet
• Reducing processed foods and added sugars
• Increasing intake of omega-3 fatty acids
• Limiting caffeine and alcohol consumption

A balanced diet not only supports cardiovascular health but can also have positive effects on mood and anxiety levels.

Sleep Hygiene

Quality sleep is fundamental to both mental and physical health. Poor sleep can exacerbate anxiety and contribute to high blood pressure. How can you improve your sleep hygiene?

1. Maintain a consistent sleep schedule
2. Create a relaxing bedtime routine
3. Limit screen time before bed
4. Ensure a comfortable sleep environment
5. Avoid caffeine and large meals close to bedtime

Prioritizing good sleep habits can have far-reaching benefits for managing anxiety and blood pressure.

The Role of Social Support in Managing Anxiety and Hypertension

The importance of social support in managing chronic conditions like anxiety and hypertension cannot be overstated. How does social support contribute to better health outcomes?

Strong social connections can:

• Provide emotional support during stressful times
• Encourage adherence to treatment plans
• Offer practical assistance in managing health conditions
• Reduce feelings of isolation and loneliness
• Promote overall well-being and life satisfaction

Building and maintaining a supportive social network can be an integral part of managing both anxiety and hypertension effectively.

Support Groups and Peer Support

Joining support groups or seeking peer support can be particularly beneficial. What advantages do these groups offer?

• Shared experiences and understanding
• Practical tips and coping strategies
• Reduced stigma and increased sense of community
• Opportunities for education about anxiety and hypertension

Whether in-person or online, support groups can provide valuable resources and connections for individuals managing these conditions.

Emerging Research and Future Directions

The field of research exploring the relationship between anxiety and hypertension continues to evolve. What are some of the emerging areas of study?

Genetic and Epigenetic Factors

Researchers are investigating the genetic underpinnings that may predispose individuals to both anxiety and hypertension. How might genetic factors influence these conditions?

• Shared genetic vulnerabilities
• Epigenetic changes due to stress and environmental factors
• Potential for targeted therapies based on genetic profiles

Understanding these genetic links could lead to more personalized treatment approaches in the future.

Technological Interventions

Advancements in technology are opening new avenues for managing anxiety and hypertension. What innovative approaches are being explored?

• Mobile apps for stress management and blood pressure tracking
• Wearable devices that monitor physiological responses to stress
• Virtual reality therapies for anxiety disorders
• Telemedicine platforms for remote monitoring and support

These technological solutions hold promise for more accessible and personalized care.

Integrative Medicine Approaches

There is growing interest in integrative medicine approaches that combine conventional treatments with complementary therapies. What integrative strategies are being studied?

• Acupuncture for stress reduction and blood pressure management
• Herbal supplements and their potential effects on anxiety and hypertension
• Mind-body interventions like tai chi and qigong
• Biofeedback and neurofeedback techniques

While more research is needed, these approaches may offer additional tools for managing the complex interplay between anxiety and blood pressure.

As our understanding of the relationship between anxiety and hypertension continues to grow, so too do the opportunities for more effective and personalized treatment strategies. By addressing both conditions holistically and staying informed about the latest research and interventions, individuals can take proactive steps towards better mental and cardiovascular health.

The Link Between Anxiety and High Blood Pressure

We’ve all experienced anxiety from time to time. Our heart rate increases and we feel tense, on edge or even fearful. Many people are able to cope appropriately to reduce their anxiety. However, some people experience anxiety on a daily basis. This can have serious health consequences because anxiety can affect your blood pressure.

How Stress and Anxiety Can Build Over Time

Constant, chronic stress can lead to an increased risk of heart attack and stroke. Long-term stress may increase cortisol production, which can raise both your blood pressure and body weight, two factors that influence a person’s risk of heart disease. According to the American Heart Association, chronic stress can also cause chronic anxiety and depression.

Understanding Anxiety

Anxiety affects many of us. In fact, an estimated 31% of American adults will have an anxiety disorder at some point in their lives, according to the National Institutes of Health. You may feel anxious when making a big decision, leading up to a deadline or even visiting your doctor if you are worried about a health condition. However, if feelings of anxiety are intense and linger, you may be one of 25 million Americans who live with an anxiety disorder.

Symptoms of anxiety can include restlessness, muscle tension, difficulty controlling feelings, irrational worries, trembling and shaking.

People who live with untreated anxiety may feel trapped, isolated or paralyzed with fear. Anxiety can limit your ability to interact with others, complete day-to-day tasks and face your fears.

Similarly, people with anxiety disorders are at an elevated risk of cardiovascular disease. Thankfully, with treatment, you can gain control of your anxiety. If you’re concerned about anxiety, talk with your primary care provider, who can recommend strategies that might include:

• Psychotherapy or talk therapy. Certain types of therapy, including cognitive behavioral therapy and cognitive therapy, can teach individuals how to change their thinking or identify unhelpful ways of thinking. A psychotherapist or licensed clinical social worker may guide patients through exposure therapy to face their fears.
• Certain medications include beta blockers, antidepressants and anti-anxiety medications. These treatments may help control anxiety and its related symptoms, but medications alone cannot cure anxiety-related disorders.

In addition to psychotherapy and medication, some people find relief from anxiety with lifestyle changes that include exercise. Even a short walk outside can give you a sense of control and a change of scenery. Exercise can improve your mood by releasing endorphins, distract you from concerns or worries, and reduce tension in your muscles. For some, exercise can work as well as medication to reduce symptoms of anxiety or depression, according to the Anxiety & Depression Association of America. Exercise can also help your brain better cope with stress, which has the potential to improve your mental health.

Understanding High Blood Pressure

High blood pressure, or hypertension, is when blood pushes against the artery walls at a higher rate than normal. Long term, high blood pressure greatly increases the chance of experiencing a serious cardiac event, such as a heart attack and/or stroke. High blood pressure is one of the most common diseases worldwide and may affect as many as half of the adults in the United States, according to the Centers for Disease Control and Prevention.

Unlike other chronic conditions, high blood pressure doesn’t cause noticeable symptoms or warning signs. High blood pressure can only be uncovered through a blood pressure measurement done at your doctor’s office, a clinic, pharmacy or at home. If you or a loved one are at risk for high blood pressure, learn how to do an at-home blood pressure check. Talk with your physician about how often and when to do these checks.

High Blood Pressure and Anxiety: How Are They Related?

When you experience anxiety, it can lead to brief periods of high blood pressure. Some studies show an overlap between people with anxiety and people who have high blood pressure. People with chronic anxiety may have an increased risk of high blood pressure when compared to people without anxiety, and people with high blood pressure have a higher risk of anxiety than people without high blood pressure.

It’s vital for people with high blood pressure to discuss stress and anxiety with their health care provider. While the association between anxiety and hypertension isn’t explicitly clear, both conditions have similar treatment approaches. In other words, taking steps to reduce high blood pressure can also help reduce anxiety.

Both high blood pressure and anxiety require regular follow-up and monitoring individually and under the care of your health care provider. Both high blood pressure and anxiety may be treated with medications appropriate for each condition.

Tackling Your Risk of Anxiety and High Blood Pressure

By proactively taking control of your blood pressure, you can lower your risk of heart attack or stroke. You may also be able to reduce your stress and treat anxiety in the following ways:

• Reduce stress. Does your day include time for self-care or doing something that is solely beneficial for you? Reducing stress can look different for everyone, but it may include spending time around people who love and support you, moving your body to improve your mood, reading or meditating.
• Address anxiety. If you live with anxious thoughts and feelings, find a psychologist or therapist to address stress, anxiety and depression. These specialists help an individual reframe their thoughts and help develop coping strategies to manage day-to-day life circumstances that cause anxiety or depression.
• Exercise. Engaging in physical activity can improve your mood, prevent weight gain, manage high blood pressure and more. Plan to exercise most days of the week for the most benefits. Exercise can be as simple as a daily 15- to 30-minute walk, following an at-home aerobics video, participating in an exercise or dance class, biking, jogging, or simple calisthenics. Still not sure how to fit it in? Consider multitasking—doing laundry, cleaning, gardening or raking—as your movement.
• Quit smoking. Smoking increases your risk of heart attack and stroke and can raise your blood pressure.
• Sleep. Did you know sleep helps keep blood vessels healthy? Not getting enough sleep can lead to an increased risk of heart disease, high blood pressure and stroke. A lack of sleep also can contribute to depression and feelings of frustration or stress.
• Eat a healthy diet. The foods we eat impact high blood pressure. Consider the DASH eating plan, or Dietary Approaches to Stop Hypertension. This diet includes choosing vegetables, fruits, and whole grains; low-fat dairy and lean poultry and fish; and limiting foods high in saturated fats, oils and sugar-sweetened beverages and foods.

If you live with stress and anxiety, talk with your primary care provider about the impact of anxiety on your overall health and high blood pressure.

More to Read

• How Exercise Can Boost Your Mood
• Expert Tips on How to Sleep Better
• Break the Cycle of Seasonal Affective Disorder (SAD)
• Managing Stress When You Have Heart Disease

Do you live with stress and anxiety or high blood pressure?

The University of Maryland Medical System has experts who can help. Talk to a primary care provider near you.

Find a Provider

Medically reviewed by Nika Bitsko, CRNP.

• Category:
  Health Awareness, Heart Conditions, Stress Management, Vascular Disease
• Tag:
  Concerning Symptoms, Health Awareness, Heart Conditions, Heart Disease

Can anxiety cause high blood pressure?

Anxiety and high blood pressure can be symptoms of each other. Anxiety may lead to high blood pressure, and high blood pressure can trigger feelings of anxiety.

The American Psychological Association (APA) defines anxiety as feelings of worry or tension. It can cause certain physical symptoms, including increased heart rate and sweating. The APA also notes that anxiety may increase a person’s blood pressure.

Additionally, having long-term high blood pressure, or hypertension, can cause people to feel anxious about their health and future. Severe hypertension can also cause a person to experience anxiety.

Keep reading to learn more about the link between anxiety and high blood pressure, as well as how to treat both conditions.

Anxiety is the body’s natural response to stress. A person may feel anxious before a test or when waiting for important news.

It occurs when the body releases stress hormones. These hormones trigger an increase in heart rate and a narrowing of the blood vessels. Both of these changes can cause a person’s blood pressure to rise.

A 2015 review indicates that people with intense anxiety have a higher risk of hypertension than those with lower levels of anxiety. Researchers conclude that early detection and treatment of anxiety are particularly important in people with hypertension.

Anxiety-induced increases in blood pressure are usually temporary and subside once the anxiety lessens. Regularly having high levels of anxiety, however, can cause damage to the heart, kidneys, and blood vessels in the same way that long-term hypertension can.

In the long term, anxiety-related hormone changes may cause increased fat deposits, particularly around the abdomen. Anxiety can also prompt behavior changes in people, such as stress eating, which may indirectly contribute to hypertension.

Additionally, some medications for anxiety can increase blood pressure. Research from 2017 found that serotonin and noradrenaline reuptake inhibitors (SNRIs), which people use to treat anxiety disorders, can increase blood pressure.

Anxiety is a response to stress. Stress causes the release of hormones, such as epinephrine and cortisol. These hormones induce the “fight-or-flight” response, which prepares the body to flee or confront the perceived threat.

Fight-or-flight hormones can cause a person to experience an increase in:

• heart rate
• blood pressure
• muscular strength

Once a person has dealt with their stress, their body systems should return to normal. However, a person who has long-term stress can develop health problems, such as:

• diarrhea
• stomach pain
• weight gain
• weakened immune system
• depression
• lack of sleep
• fatigue
• inability to make decisions
• memory issues
• increase in fats in the blood

Having high blood pressure may trigger feelings of anxiety in some people. A person with hypertension may worry about their health and their future.

Additionally, the symptoms of hypertension can cause panic or anxiety. Symptoms of hypertension include:

• vision changes
• headaches
• irregular heart rhythm
• buzzing in the ears

Severe hypertension can also cause a person to experience anxiety. If a person experiences extreme anxiety alongside symptoms such as headache or shortness of breath, they should seek medical attention immediately.

It can be difficult to distinguish between anxiety and changes in blood pressure. Hypertension does not usually cause symptoms. This means it is important for a person to have a doctor check their blood pressure regularly.

There is currently no evidence to suggest that anxiety lowers a person’s blood pressure. However, having low blood pressure may cause a person to become anxious or worried.

Symptoms of low blood pressure can be similar to those of anxiety. Symptoms of both low blood pressure and anxiety include:

• dizziness
• lightheadedness
• nausea
• fainting
• difficulty concentrating

Learn more about fluctuating blood pressure here.

A person with low blood pressure may experience symptoms similar to those of anxiety. If a person is unsure whether their symptoms are due to anxiety or low blood pressure, they should speak with a doctor.

Additionally, people who have severe or recurrent symptoms of either should see their doctor. A doctor will be able to diagnose the underlying cause of the symptoms and can prescribe any necessary treatments.

There are several treatment options for anxiety. A person may require a combination of these treatments.

Medication

Several medicines can relieve the symptoms of anxiety. Different types of medication will work for different people. Options include:

• buspirone, an anti-anxiety drug
• certain antidepressants
• benzodiazepines, which are a type of sedative medication for short-term anxiety relief
• beta-blockers, which help a person’s heart beat more slowly and gently

Psychotherapy

Working with a psychotherapist can help people manage their anxiety symptoms.

Cognitive behavioral therapy (CBT) is one of the most effective forms of psychotherapy for anxiety. CBT teaches people to change their thinking patterns to help them reduce anxious thoughts and worries.

During CBT, a person learns techniques to manage their anxiety and gradually expose themselves to situations that trigger it. This helps the person become less fearful and anxious in these situations.

Lifestyle changes

A person can make lifestyle changes to help reduce feelings of anxiety. The National Alliance on Mental Illness (NAMI) suggests the following to help with anxiety:

• exercising regularly
• practicing mindfulness
• eating a balanced diet
• avoiding alcohol and drugs
• getting consistent, high-quality sleep
• learning a new skill
• trying to reduce negative thoughts, countering them with positive ones
• setting goals and rewards
• creating or maintaining a support system

Read about natural remedies for anxiety here.

A person who has hypertension may be given a treatment plan by their doctor. This can involve lifestyle changes, medications, or both.

Lifestyle changes

A person can make various lifestyle changes to lower their blood pressure, including:

• avoiding or limiting alcohol
• reducing salt intake
• eating a heart-healthy diet that is rich in fruit, vegetables, and whole grains
• exercising regularly
• quitting smoking, if appropriate
• maintaining a moderate weight
• managing stress
• getting good-quality sleep

Learn about 15 natural ways to lower blood pressure here.

Medication

There are several types of medication for treating high blood pressure. These include:

• angiotensin converting enzyme (ACE) inhibitors, which prevent blood vessels from narrowing as much
• angiotensin II receptor blockers (ARBs) to stop blood vessels from narrowing
• calcium channel blockers, which allow blood vessels to relax
• diuretics, which remove excess water and sodium from the body
• beta-blockers

The type of medication that a person needs will depend on several factors, including their general health and the severity of their hypertension. Some people may need more than one type of medication to keep their blood pressure under control.

People who think they may have anxiety, hypertension, or both, should speak with a doctor. Those who have severe symptoms should seek immediate care, as this can indicate a medical emergency.

Symptoms to look out for include:

• fatigue
• nausea
• vomiting
• confusion
• chest pain
• muscle tremors
• shortness of breath
• back pain
• numbness or weakness
• difficulty speaking

Both hypertension and anxiety are highly treatable conditions. A person with anxiety will not necessarily develop hypertension.

However, seeking help as early as possible can improve the outcome for people with either condition and reduce the risk of complications.

There is a link between anxiety and high blood pressure. A person with anxiety may develop hypertension, especially if they regularly experience intense anxiety.

Other people may develop anxiety as a result of high blood pressure. Treatment for one condition can often improve the other.

A person who suspects they have one or both conditions should see a doctor for diagnosis and treatment.

The role of anxiety disorders in hypertension and the possibility of their correction | #03/07

In recent years, more and more evidence has been accumulating that anxiety and some other psychopathological conditions are independent risk factors for the development of arterial hypertension (AH) and should be considered in conjunction with recognized risk factors [7]. These pathologies increase morbidity and mortality from hypertension and coronary heart disease (CHD) [2]. Anxiety disorder should be detected and treated in a timely manner, as it worsens the prognosis of somatic pathology [1]. The importance of anxiety disorder in cardiology is confirmed by the results of a prospective 32-year study conducted in the United States by the Centers for Disease Control and Prevention [7], which showed that with increased anxiety, the probability of fatal myocardial infarction increases by 1.9times, sudden death – 4.5 times. At the same time, social epidemiological studies using objective methods conducted at the State Research Center for Preventive Medicine showed that the population experienced an increase in the level of psychological stress. It was found that about 70% of the country’s population lives in conditions of chronic high- and medium-level psychosocial stress [3].

In this regard, special attention is paid to the study of the role of anxiety in the development of hypertension, one of the main risk factors for coronary artery disease. It is known that hypertension is one of the most common cardiovascular diseases affecting, in particular, 25–35% of the Russian population. Assumptions that affective disorders, most often anxiety and depression, occupy an important place in the development and course of hypertension, were expressed at the beginning of the last century. Currently, work on the study of the relationship between hypertension and affective disorders is carried out in two directions.

On the one hand, the results of large studies have been published demonstrating the relationship between symptoms of anxiety or depression and the development of hypertension, on the other hand, hypertension is considered as a psychosomatic disease, in the treatment of which psychotropic drugs play a very important role [4].

According to the literature, the prevalence of neurotic and somatoform disorders with anxiety symptoms in patients with hypertension can reach 51.3% [2, 5]. However, the number of studies is limited, and there are no clear recommendations for the management of these patients. It is known that comorbid anxiety-depressive disorders, like hypertension, in themselves lead to a significant decrease in working capacity, while they aggravate the course of a somatic disease, contribute to the formation of a hypochondriacal type of internal disease [7]. In this regard, it seems very interesting and important to determine the possibility of the effect of complex therapy with antihypertensive drugs and a “daytime” anxiolytic on the course of hypertension in patients with anxiety.

Anxiolytic therapy significantly improves the quality of life of patients with cardiovascular diseases, contributes to their better compensation in the process of somatotropic therapy, and further adaptation to the disease. Tranquilizers are the most adequate, effective and safe drugs for the relief of adaptation disorders in cardiac patients [2, 3]. However, patients often avoid taking benzodiazepines, fearing the development of addiction symptoms, unpleasant side effects in the form of lethargy, muscle weakness, and impaired attention. Elderly patients often fear the development of coordination disorders in them due to the fear of falling, the appearance of instability.

Taking into account the noted problems, in recent years there has been an increasing need for drugs with a tranquilizing effect of the non-benzodiazepine series. These drugs include Tenoten.

The drug Tenoten is an ultra-low dose (ULD) to the brain-specific protein S100. The mechanisms of action of anti-S100 SMD in anxiety states are probably associated with a modification of the functional activity of the endogenous S100 protein and its ligands. As a result, its GABA-mimetic effect is realized, restoration of GABAergic neurotransmission. The clinical effect in this case is manifested by facilitating falling asleep, reducing behavioral manifestations of anxiety, improving memory, and reducing asthenia.

The aim of the study was to evaluate the efficacy and tolerability of combined treatment with antihypertensive drugs and the anti-anxiety drug Tenoten in patients with hypertension. The duration of the study is 4 weeks.

The study involved 60 patients with hypertension aged 61.41 ± 6.91 years (from 38 to 77 years). Patients were divided randomly into two groups (main and control) of 30 people. There were 18 men and 12 women in the main group, 19 in the comparison group.men and 11 women.

AH in the main group with a moderate course (II degree) was observed in 60% of patients, with a severe course (III degree) – in 40%; in the comparison group, there were 66.6% of patients with a moderate course, and 33.4% with a severe course. The average duration of AH disease was 10.61 ± 4.1 years (from 3 to 20 years).

Of great importance in the course of hypertension is a family history, lifestyle, risk factors and comorbidities.

Persons with symptomatic hypertension and complicated forms of hypertension were excluded from the study.

In the comparison group, patients received only antihypertensive therapy – ACE inhibitors, β-blockers, diuretics (Enap, Hypothiazid, Acridilol, Arifon). Patients of the main group received combined treatment with antihypertensive drugs in combination with Tenoten, which was prescribed according to the scheme: 6 tablets per day for the first 2 weeks, and then 1 tablet 3 times a day.

Treatment was prescribed for a month. Monitoring in dynamics was carried out at the beginning of the study, after 2 and 4 weeks of therapy.

The personal anxiety scale (J. Teylor) was used to assess the mental status, which is designed to measure the level of anxiety (adapted by T. A. Nemchininov).

The questionnaire consists of 50 statements. Evaluation of the results of the study is carried out by counting the number of responses of the subject, indicating anxiety; the total score is:

40-50 points – an indicator of a very high level of anxiety;

20-40 points – high level of anxiety;

15-20 points – average level of anxiety with a tendency to high;

5-15 points – average level of anxiety with a tendency to low;

0-5 points – low level of anxiety.

A study of the mental status of patients in both groups revealed anxiety symptoms of varying severity in a significant proportion of patients. The number of patients with an initial high level of anxiety was 40% in the main group and 43% in the comparison group. The number of patients with an initial average level of anxiety with a tendency to high was 60% in the main group and 56.6% in the comparison group.

Research results

By the end of the study, the high level of anxiety decreased in the main group by 39.39% and reached the average level of anxiety with a tendency to low, and in the comparison group, the level of anxiety decreased only by 3.6%.

In patients of the main group who took Tenoten, a clear decrease in the level of anxiety was noted already after 2 weeks and by the end of the month it reached significance in comparison with the group of patients who received standard antihypertensive therapy. The relief of affective disorders was accompanied by a decrease in complaints of anxiety, feelings of helplessness, self-doubt, a sense of threatening danger, poor sleep ( tab. 1 ).

The demonstrated differences in the dynamics of anxiety indicators in the studied groups of patients confirmed the possibility of effective correction of these disorders in patients with AH with Tenoten. However, it was extremely interesting to assess whether this therapy and the severity of associated anxiety disorders affect the effectiveness of antihypertensive therapy in general.

A decrease in the values ​​of maximum systolic and diastolic pressure occurred in both studied groups. By the end of the month of treatment, the decrease in blood pressure (BP) reached a statistically significant significance. In the main group of patients who additionally took Tenoten, systolic blood pressure (BP) decreased by 24.28% – almost to the age norm, in the comparison group there was a decrease by 16.48%, i.e. there was some excess of normal values. The decrease in diastolic pressure by the end of the 4th week in the main group (by 17.7%) and in the comparison group (by 5. 9%) was also significant ( tab. 2 , 3 ).

The addition of Tenoten to the complex therapy in patients with high and moderate levels of anxiety made it possible to achieve a much more pronounced improvement in blood pressure. Against the background of therapy with Tenoten, a more rapid effect of antihypertensive drugs is observed – after 2 weeks of combined administration of the drug in patients of the main group, blood pressure decreased to the target level, in contrast to the comparison group, where it remained above the target.

Conclusion

The results of our study show that all patients with hypertension have anxiety symptoms of varying severity, which aggravate the course of the disease, contributing to higher levels of both systolic and diastolic blood pressure. The inclusion of the modern “daytime” anxiolytic Tenoten in the complex therapy of patients with hypertension increases the effectiveness of the treatment, reduces the level of anxiety, which contributes to a more rapid onset of the hypotensive effect. Tenoten is well tolerated by patients, does not cause orthostatic hypotension and any other undesirable side effects.

Literature

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I. N. Nikolskaya , doctor of medical sciences, professor
I. A. Guseva , candidate of medical sciences, associate professor
E. V. Bliznevskaya , Ph.D.
NSMU, Medical Unit No. 25, Novosibirsk

Anxiety and high blood pressure – what is the connection? | Medical Insider

Anxiety and high blood pressure can sometimes go hand in hand. Anxiety can lead to high blood pressure, and high blood pressure can make you feel anxious.

Doctors characterize anxiety as a feeling of intense anxiety or fear. Anxiety is accompanied by many physical symptoms, including rapid heart rate and shallow breathing. Periods of anxiety can also temporarily raise blood pressure. Meanwhile, long-term high blood pressure, which doctors call hypertension , can cause people to worry about their health and future.

Anxiety causes the release of stress hormones in the body. Hormones increase heart rate and constrict blood vessels. Both of these factors cause an increase in blood pressure, sometimes sharp. Doctors believe that anxiety is the cause of white coat hypertension, a phenomenon in which some people have higher blood pressure readings in the doctor’s office than at home. The rise in blood pressure caused by anxiety is temporary and will subside as soon as the anxiety subsides. However, persistently high levels of anxiety can cause damage to the heart, kidneys, and blood vessels, just as long-term hypertension can.

Research from 2015 shows that people with high anxiety are more at risk of hypertension than people with low anxiety. Early detection and treatment of anxiety is especially important in people with hypertension.

Living with an anxiety disorder, in which anxiety occurs daily and interferes with daily life, can also increase the likelihood of behaviors that contribute to hypertension. Examples include:

• drinking alcohol
• not exercising
• unhealthy diet
• smoking

Researchers report an association between anxiety and unhealthy lifestyles—including physical activity, smoking, and poor diet—in people at risk for cardiovascular disease (CVD). Hypertension is one of the most significant risk factors for CVD. In addition, some medications used for anxiety can increase blood pressure.

High blood pressure can cause anxiety in some people. Those diagnosed with hypertension by doctors may worry about their health and their future. Sometimes the symptoms of hypertension, which include headaches, blurred vision, and shortness of breath, can be enough to cause panic or anxiety.

Sometimes anxiety works in the opposite way, causing a drop in blood pressure. The reason for this may be that when anxious, people breathe shallowly. Blood vessels become wider, lowering blood pressure. Scientists in 2011 found an association between symptoms of anxiety and depression and lower blood pressure, especially in people who had high levels of anxiety symptoms for decades. This link seems to work both ways, as low blood pressure or hypotension can sometimes cause anxiety and panic. Symptoms may be similar to those of anxiety and include:

• blurred vision
• dizziness
• fainting
• nausea
• dizziness

Sometimes it can be difficult to distinguish between anxiety and changes in blood pressure. It is important to know that hypertension usually does not show symptoms unless it is very high. If so, then urgent treatment is needed. Low blood pressure is more likely to cause symptoms, and they are very similar to anxiety symptoms. People with severe or recurring symptoms should see a doctor. A doctor will be able to diagnose the underlying cause of the symptoms and, if necessary, prescribe treatment for both anxiety and hypertension.

There are several treatments for anxiety. Most people require a combination treatment.

• sedatives
• antidepressants
• benzodiazepines, which are a type of sedative for short-term anxiety relief
• beta-blockers, which are used to treat hypertension

Working with a psychotherapist often helps deal with anxiety symptoms. Cognitive behavioral therapy (CBT) is one of the methods that a psychotherapist may prescribe. CBT teaches people to change their thought patterns to reduce anxious thoughts and anxieties. Once people have learned to manage their anxiety, they are gradually exposed to situations that cause anxiety. Thus, a person becomes less fearful in such situations.

Simple changes can reduce anxiety symptoms. Examples include:

• deep breathing or progressive muscle relaxation techniques
• meditation
• regular exercise
• adequate sleep
• healthy diet and caffeine restriction
• avoidance of alcohol, tobacco a and recreational drugs
• reducing, if possible, stressors at home, at work and at school
• replacing negative thoughts with positive or realistic ones

Most people with hypertension will benefit from lifestyle changes. Some people need medicines. There are several types of drugs for the treatment of high blood pressure. These include:

• diuretics
• calcium channel blockers
• angiotensin converting enzyme (ACE) inhibitors
• angiotensin II receptor blockers
• aldosterone antagonists

9 0072 renin inhibitors

• vasodilators
• alpha-blockers
• alpha-beta blockers
• beta -blockers

The type of medication a patient needs will depend on several factors, including general health and the severity of hypertension. Some patients may need more than one type of medication to keep their blood pressure under control.

People who think they have anxiety, hypertension, or both should see a doctor. People with severe symptoms should seek immediate medical attention, as symptoms may indicate a medical emergency. Symptoms to look out for include:

• blurred vision
• shortness of breath
• dizziness
• headaches
• nausea and vomiting
• palpitations

Both hypertension and anxiety are manageable conditions.