The relationship between hypertension and anxiety disorders

High blood pressure and anxiety: how are they related?

Klaus Bernhardt
by Klaus Bernhardt

Underestimating the influence of the psyche in high blood pressure is a common mistake. Anyone who takes antihypertensives even though everything is physically fine and it is actually only an anxiety disorder that is responsible for the high values often risks further problems. This is because antihypertensives can cause a number of unpleasant side effects, such as dizziness, lightheadedness, skin problems or gastrointestinal complaints. What you should therefore pay attention to and what you can do if your high blood pressure is also suspected to be triggered by anxiety is the subject of this blog article from the Institute for Modern Psychotherapy in Berlin.

Antihypertensive drugs are only recommended for permanently elevated blood pressure

We always advise our patients to have a long-term blood pressure measurement taken over 24 hours before they start taking blood pressure medication. If the measurement results are then predominantly in the green zone, you should seriously discuss with your family doctor whether these medications are really necessary. If you take antihypertensives for years without any reason because you were diagnosed with hypertension based on incorrect measurement results, your body may suffer serious damage in the long term.

Isolated phases of high blood pressure, spread throughout the day, are definitely not yet a reason to immediately take countermeasures with medication.

High blood pressure is sometimes important and helpful

Short-term high blood pressure is usually a normal and healthy reaction of your body. Under stress, which includes anxiety, your body uses more energy. Cell turnover is higher, so oxygen and nutrients now have to be transported to the cells more quickly. And it is precisely this faster transport that the body does by briefly increasing blood pressure, which allows blood to flow faster. As soon as the stress subsides, the high blood pressure disappears all by itself, because normal blood pressure is now sufficient again to carry out all other tasks. It is therefore advisable to ask critical questions when blood pressure lowering drugs are prescribed all too quickly without first asking what the current life stress is like.

By the way:

By asking whether you have been suffering from increased anxiety lately, you can very easily tell whether your attending physician really has all the possible causes of supposed hypertension in mind.

If not, be sure to bring it to his attention; after all, your health is at stake.

High blood pressure as an indication of an anxiety disorder

If high blood pressure was causally triggered by exaggerated fears or phobias, then it makes much more sense to take psychotherapeutic action against the anxiety disorder than to merely suppress the symptoms with antihypertensives. According to a study by Franziska Einsle (University of Dresden, Germany) about one in ten people suffers from the white coat syndrome (white coat hypertension) mentioned at the beginning. In addition to the suddenly increased blood pressure, which is mainly triggered by the fear of a possibly bad measurement result, those affected often suffer from other symptoms such as:

  •     Panic
  •     Dizziness
  •     Shortness of breath
  •     Sweating

If one or even more of these symptoms apply to you, we advise you to consider whether your high blood pressure could also be the result of an undiscovered anxiety disorder.

It is not without reason that all four of these symptoms are among the main symptoms of most anxiety disorders.

Elderly people suffer surprisingly often from white coat syndrome

In recent years, several clinical studies (e.g., the IDACO and HYVET studies) have investigated the extent to which elderly patients in particular suffer from white coat hypertension. The proportion of those affected was usually far above the presumed value, in some cases even more than 50% of the participants. Patients over 80 years of age represent the largest risk group. Physicians treating these patients should therefore devote a great deal of time to them. If a few reassuring words have been exchanged after a first (too high) measurement, a second blood pressure measurement a few minutes later often shows a significantly lower result.

Since older people often take far too many different medications anyway, which also influence each other, every tablet that can be taken less thanks to a second measurement is a real gain here.

What is the relationship between hypertension and anxiety disorders?

The connection between anxiety disorders and high blood pressure is now well researched, as the German Medical Journal reported back in 2012. And our experience at the Institute for Modern Psychotherapy in Berlin also confirms that anxiety patients are diagnosed with high blood pressure more often than average. However, we have also observed that many people with generalized anxiety disorder, agoraphobia or cardiac anxiety neurosis have been able to completely discontinue their blood pressure medication after successful anxiety therapy.

Through the individually appropriate form of psychotherapy, not only could the anxiety disorder be overcome, but blood pressure also returned to normal in many cases.

Antihypertensive medications often unnecessary in anxiety disorders

In the vast majority of cases where anxiety is the actual trigger of high blood pressure (hypertension), treatment with antihypertensive drugs is unnecessary. Nevertheless, the risk of chronic hypertension is significantly increased if one does nothing about one’s anxiety disorder for too long and there are also other risk factors, such as:

  • Smoking
  • Lack of exercise
  • Being overweight
  • Much stress
  • Frequent eating of highly salted foods
  • Regular alcohol consumption

Therefore, in addition to choosing a form of psychotherapy that is right for you, you should also avoid these risk factors as much as possible.

Get rid of not only anxiety disorders but also high blood pressure with psychotherapy

Not every form of psychotherapy is suitable for everyone. Especially people who have already had negative experiences in this regard are often reluctant to try new approaches. This is more than understandable, especially since many of the therapies offered in this country are now outdated.

Especially if you look at the latest findings in brain research, you find that even long-standing anxiety disorders could often be overcome in just a few weeks if the neuroplasticity of the brain were adequately taken into account. Neuroplasticity is understood to be the brain’s ability to rewire itself into old age, and thus to literally shut down neuronal access to anxiety. However, this cannot be achieved by long psychotherapeutic group sessions, nor by confrontational therapy, which is often extremely unpleasant. The use of psychotropic drugs is also viewed critically by more and more psychotherapists and rejected accordingly, as is the protracted digging into childhood memories.

That is why the Institute for Modern Psychotherapy in Berlin also focuses its therapeutic work on the structural rewiring of the brain. Using sometimes astonishingly simple techniques that anyone can apply at home, the neuroplasticity of the brain is specifically used here to reduce anxiety and thus also the resulting high blood pressure within a few weeks to such an extent that medication can be permanently dispensed with in many cases. If you would like to learn more about the work of the Institute, I recommend our new video course “The Anxiety Cure”. With the help of the techniques described therein, many former anxiety patients have already managed by their own efforts to lead a life full of joy and ease again.