Is stress making you hypertensive?

We’ve all felt it – that feeling of blood pressure rising when we are faced with a stressful situation. Why does this happen and is it potentially dangerous for our health?

The body and the brain are in constant two-way communication, so when the body experiences a stressful event the brain responds by elevating your blood pressure. Likewise, having high blood pressure can make you feel stressed. According to health surveys, patients with hypertension report more feelings of stress and anxiety than those without hypertension.

How do you know if you’re stressed?

Our minds and bodies have ways of letting us know when stress is becoming too much. Stress can affect you physically, emotionally and behaviourally.

Emotional symptoms include –

• feeling upset and tearful;
• feeling scared, anxious, panicked or worried;
• getting angry easily and having a short fuse;
• feeling alone or hopeless; and
• feeling numb and uninterested in life.

Physical symptoms include –

• an increased heartbeat (palpitations);
• dry mouth;
• headaches, odd pains, feeling dizzy or sick;
• tiredness or trouble sleeping;
• poor appetite or comfort eating; and
• sudden weight loss or gain.

Behavioural symptoms include –

• skin picking; and
• nail biting.

What happens when you’re stressed?

In addition to the emotional discomfort we feel when faced with a stressful situation, our bodies react by releasing the stress hormones adrenaline and cortisol into the blood. These hormones prepare the body for the “fight or flight” response by making the heart beat faster and constricting blood vessels in order to supply more blood to the core of the body instead of the extremities.

Fight or flight is a valuable response when we are faced with life-threatening danger, but in our modern world most stressful events cannot be handled with either of these options. Chronic (constant) stress causes our bodies to go into high gear on and off for days or weeks at a time. Inevitably, this may lead to blood pressure fluctuations. This is problematic because even temporary frequent spikes in blood pressure can damage your blood vessels, heart and kidneys in a way similar to long-term high blood pressure.

What psychological and lifestyle factors are linked to hypertension?

Unsurprisingly, high job strain is associated with increased blood pressure at work, at home, and during sleep. Overcommitment and an imbalance between work efforts and rewards received are also related to high blood pressure, both during and outside work.

In general, the effects of job strain on blood pressure tend to be stronger in men than women. In a study involving nearly 2 000 workers with high blood pressure over a period of almost 18 years, those who reported having both a stressful job and poor sleep were three times more likely to die from heart disease than those who slept well and didn't have a taxing job.

Other research has found that men and women who reported being in a loving, supportive relationship had lower blood pressure at home and at work, compared to those who reported intermediate or poor relationships, as well as those without a partner.

There is also a link between a decline in income and hypertension. Additionally, a lack of available healthy foods, safety, and social cohesion have been associated with a greater likelihood of hypertension.

Mental health and hypertension are also linked. Studies show that depression is the most important psychological variable to discriminate between sustained hypertension and normal blood pressure.

Anxiety also causes the release of stress hormones in the body. These hormones trigger an increase in the heart rate and a narrowing of the blood vessels that cause blood pressure to rise, sometimes dramatically. Anxiety-induced increases in blood pressure are temporary and will subside once the anxiety lessens, but regularly having high levels of anxiety can damage your health in the same way that long-term hypertension does.

The way you respond to stress can greatly influence your blood pressure. Smoking, drinking too much alcohol, and eating unhealthy foods are all known to have a negative impact on blood pressure and increase the risk of hypertension. If you’re worried about your blood pressure, it’s wise to quit smoking, limit your alcohol intake and adopt healthy eating habits.

Stress and diet

When it comes to adapting your diet to regulate your stress levels, blood sugar balance is the key. This means that your meals should contain enough protein and fat to balance out your carbohydrate intake. For example, instead of having just a bowl of oats for breakfast (a high carbohydrate meal) you can combine it with some almonds and even a scoop of decent protein powder.

Stress also tends to make us crave sweet, sugary foods. However, sugar increases insulin levels which in turn activate the sympathetic nervous system, leading to increases in heart rate and blood pressure. This is why it’s so important to follow a healthy diet when feeling stressed

Following the DASH diet (Dietary Approaches to Stop Hypertension) is one way to address hypertension. The DASH dietary pattern, which emphasises fruit, vegetables, fat-free/low-fat dairy, whole grains, nuts and legumes, and limits saturated fat, cholesterol, red and processed meats, sweets, added sugars, salt and sugar-sweetened beverages, is widely recommended by international diabetes and heart association guidelines. The DASH diet plan was developed to lower blood pressure without medication.

In combination with diet, exercising three to five times a week for 30 minutes can reduce your stress levels. Doing activities that can help manage your stress and improve your health can make a long-term difference in lowering high blood pressure.

In summary, controlling stress can help manage high blood pressure. If you have hypertension or have a heightened risk for developing the disease, making changes to curb stress can lower your blood pressure and make it easier to manage. Chronic stress and particularly the non-adaptive response to stress are more likely causes of sustained elevated blood pressure. Uncontrolled high blood pressure can silently damage your body for years before symptoms develop.