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Can Stress Cause High Blood Pressure?

By Terez Malka, MD

Medically reviewed

February 2, 2022

Nearly half of all American adults have high blood pressure, also called hypertension. It’s a condition that can be deadly: In 2019, more than 500,000 deaths in the U.S. involved hypertension as either a primary or secondary cause. There can be many causes of high blood pressure. In some cases, stress may worsen it or trigger it.

In this article, I’ll explain what hypertension and stress are and how stress can affect your blood pressure. I’ll also discuss some treatment options, and tell you when you should talk to your doctor or healthcare provider—and how K Health can help.

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What is Hypertension?

Before we get to high blood pressure, let’s talk about what blood pressure is: As your blood circulates through your body, it applies force against the walls of your blood vessels.

That force is your blood pressure, and it’s determined by both the amount of blood your heart pumps through your body’s arteries and the amount of resistance to this blood flow. Blood pressure is measured using two numbers: Systolic pressure and diastolic pressure, which are represented as a fraction.

The fraction for normal blood pressure is under 120/80 mm Hg, commonly said as “120 over 80.” Systolic refers to the first, or top, number used to calculate your blood pressure. This is the pressure in your arteries when your heart beats.

Diastolic refers to the second, or bottom, number used to measure your blood pressure. This is the pressure in your arteries between heartbeats. The systolic number is written over the diastolic number to give you your overall blood pressure.

Hypertension is the medical term for high blood pressure. This hypertension can be short-term, in response to a specific activity, pain, or a stressful situation.

For instance, people sometimes have higher than normal blood pressure in a doctor’s office due to anxiety, which is referred to as “white coat syndrome.” Your blood pressure can also rise from stress, pain, anxiety, and fatigue.

Some medications may also affect your blood pressure. When your blood pressure is consistently too high at different times of the day, across several different days, you may be diagnosed with chronic hypertension.

There are different levels of high blood pressure:

Elevated blood pressure: Higher than 120/80 and up to 130/80

Stage 1 hypertension: 130/80 to 140/90

Stage 2 hypertension: 140/90 or higher

Hypertensive emergency: Go to the ER immediately or call 9-1-1 if systolic pressure is 180 or higher and/or diastolic pressure is 120 or higher and you are experiencing symptoms such as headache, vision changes, chest pain or pressure, or shortness of breath.

Depending on your blood pressure levels, your doctor may treat you with blood pressure medication, lifestyle changes, a special diet, or a combination of all three. Even mildly elevated blood pressure should be addressed by your healthcare provider.

Over time, blood pressure that is even a little too high can increase your risk for cardiovascular disease, stroke, or heart attack. Finding the right way to lower your blood pressure is important for your long-term health.

What is Stress?

Stress is your body’s physical response to challenges, demands, or tension. It can be triggered by emotional or physical situations. The stress response is sometimes referred to as “fight or flight.”

Effects of stress on the body

Your body has hormones designed to manage your stress response. Cortisol, insulin, catecholamines, and even thyroid hormones help to ramp up your body’s ability to act in stressful situations. If your stress becomes constant, your body does not have time to rebound from the stress overload.

This is called chronic stress, and it can lead to myriad health problems:

Obesity
Diabetes
Heart disease
Skin problems
Menstrual changes
High blood pressure
Depression or anxiety

If you have chronic stress, you may have symptoms that extend just beyond mentally feeling overwhelmed. You might also be more forgetful, have headaches, or a loss of focus. You may be more tired than usual, feel nausea, have trouble sleeping, or deal with more aches and pains.

Difference between stress & anxiety

Your stress response can help you avoid danger and respond to crises. But if you still feel stressed after the stressful situation has resolved, you may be experiencing anxiety.

Both stress and anxiety can produce similar symptoms. The best way to tell them apart is to determine what is causing your stress. If the situation is tied to something specific, situational, and ongoing, you are probably experiencing stress.

This could mean a current overwhelming work project, or potentially tense family interactions during the holidays. But if your constant feelings of stress seem nonspecific, or you feel stressed about almost everything, you may be dealing with anxiety.

As many as 31 percent of the U.S. adult population may experience anxiety at some point in their lives.

Can Stress Cause High Blood Pressure?

While stress is not the only cause of high blood pressure, studies show that anxiety and chronic stress can lead to an increased risk of hypertension. Anxiety and stress can trigger an increase in blood pressure and angiotensin II, a protein hormone that narrows blood vessels.

When your blood vessels are narrowed, the pressure of your blood flow is increased—just as it would be if you pressed your finger over part of the end of a garden hose.

Persistent anxiety can also create reduced vascular variability, which means that blood vessels don’t widen and narrow as effectively. This can also cause higher blood pressure.

Anxiety also activates the sympathetic nervous system, which handles factors like sweating, body temperature, and your cardiovascular system reflexes.

Long-term stress can flip the switch of the sympathetic nervous system more easily. This means that blood pressure may more easily rise in response to minor triggers, and take longer to come down.

The sympathetic nervous system can also increase how much sodium the body retains and alter fat metabolism, which may trigger blood pressure increases too.

The longer it takes to return to normal blood pressure after stress, the more likely that blood pressure disruptions could linger even when stress or anxiety is not present.

Treatment Options

Stress

The most effective way to address your stress may depend on its cause and other health factors.

Lifestyle management for stress can include:

Eliminating causes of stress from your schedule
Practicing deep breathing or meditation
Getting regular exercise and sleep
Journaling

If lifestyle modifications are not effective or do not improve how you feel, talk to your doctor about treatment options. Your healthcare provider may recommend psychotherapy, which can be an effective way to reduce stress.

Your physician may also suggest medications that could help, such as beta-blockers or selective serotonin reuptake inhibitors (SSRIs).

Hypertension

There are many effective ways to treat high blood pressure. Your doctor may recommend certain lifestyle changes, like getting regular physical activity and adequate rest. They may also suggest a low-sodium and low-cholesterol diet.

There are also many types of medications that can treat hypertension, including:

Beta-blockers (acebutolol, atenolol, nadolol)
Alpha-blockers (alfuzosin, silodosin, terazosin)
Vasodilators (hydralazine)
Calcium channel blockers (amlodipine, nicardipine, verapamil)
Diuretics (chlorthalidone, indapamide, metolazone)
Central agonists (methyldopa, clonidine)
Angiotensin II receptor blockers (candesartan, irbesartan)
ACE inhibitors (benazepril, captopril, moexipril)
Renin inhibitors (aliskiren)
Aldosterone receptor antagonists (eplerenone)

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When to See a Doctor

If your blood pressure is elevated, you should always check in with your doctor. If you feel unrelenting stress or feel like you are not able to get a handle on your stress response, talk to your doctor so they can help you find relief.

How K Health Can Help

K Health offers affordable and convenient access to highly qualified doctors to treat and manage high blood pressure, as long as you are not having a hypertensive crisis.

You can meet with your K Health doctor from the comfort of your own home via the K Health app, all while knowing that you’re getting individualized and expert care.

Frequently Asked Questions

How much does anxiety raise blood pressure?

Anxiety can raise blood pressure momentarily, but how much or how quickly depends on your individual health factors. If your doctor suspects that anxiety is affecting your blood pressure, they may ask you to monitor your blood pressure at home throughout the day to track the impact of anxiety on your readings.

Is high blood pressure from stress temporary?

Sometimes. But it can also be a cause of hypertension. While stress alone does not immediately cause hypertension, if the elevations in blood pressure happen on a regular basis, this can contribute to the development of high blood pressure. Work with your healthcare provider to find healthy ways to manage your stress and address your blood pressure.

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

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

Terez Malka, MD

Dr. Terez Malka is a board-certified pediatrician and emergency medicine physician.

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