(Huffington Post) — High blood pressure, medically known as hypertension, affects 73 million Americans. A common misconception is that those with hypertension are excessively nervous or stressed out. In my practice, this is actually one of the most common questions that I am asked by a new patient. So I’ll say it publicly. Hypertension is a disease. You cannot develop hypertension by being “stressed out.” Numerous studies have examined animals and humans subjected to stress and have not found that stress leads to hypertension.
What Exactly Is Hypertension?
Although it contains the word “tension,” what hypertension really means is that you have blood pressure high enough to cause damage to your organs. “Blood pressure” is the force of blood pushing against the walls of the arteries as the heart pumps blood. If this pressure rises and stays high over time, it can damage the kidneys, heart and blood vessels without any symptoms. When kidneys are injured by elevated blood pressure, the result can be progressive kidney failure.
Your kidneys aren’t the only organs hurt by hypertension — the heart and blood vessels can be targets as well.
When high blood pressure damages the heart, it leads to enlargement and congestive heart failure. The brain is damaged by strokes in patients with hypertension. Blood vessels are damaged, forming aneurysms that may burst and blood vessels in the eyes can be damaged to cause blindness.
What Causes Hypertension?
As is the case with so many other problems, you may have your parents to blame. Most commonly, hypertension is inherited. If you have the genetics, the older you are, the more likely you are to develop hypertension. Hypertension can also be caused by underlying diseases such as kidney disease. So, chronic kidney disease can be both a cause and effect of hypertension. Excess dietary salt intake can also cause hypertension.
Hypertension is also associated with weight gain and obesity, hardening of the arteries, diabetes, sleep apnea and can be caused by many drugs as well as alcohol. So take a deep breath and do try to manage your stress, but know that it’s not the root cause of your hypertension.
What Is the Ideal Blood Pressure Number?
The systolic blood pressure is the top number on your blood pressure recording, and this is the pressure that your heart generates with each beat. The diastolic blood pressure is the bottom number, which is the basic resting blood pressure in your vessels at the end of a heartbeat. The target blood pressure for control should be 130/80. In some cases, we recommend a blood pressure to be controlled to 125/75. Some elderly patients and people with hardening of the arteries will have an elevated systolic blood pressure only. We pay the most attention to the systolic blood pressure because that is the pressure that is most associated with organ damage.
How Is Hypertension Diagnosed?
Hypertension is diagnosed when blood pressure is elevated above 140/90 on at least three different occasions at least three months apart. Your blood pressure should be taken while you are seated for at least five minutes, with your arm resting. It should be taken in both arms, but the non-dominant arm should usually be used. So, if you are right handed, it is best to record your blood pressure in your left arm. The blood pressure should be recorded as the average of at least two recordings. If there is a difference between your two arms, the highest blood pressure should generally be recorded.
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The physician who wrote this article is of the opinion that stress does not cause hypertension, but this opinion is not based on scientific study. While hypertension is a disease, there are some individuals who experience elevated blood pressure as a result of stress.
I would have to disagree with his findings as well. Stress often produces elevated readings 10-20 points above normal. As a sufferer of white-coat syndrome I have dealt with this for years with readings as high as 190/90 and after being diagnosed with generalized anxiety (stress) I made some significant lifestyle changes and now have consistent readings well below 120/80 (usually in the range of 115/65). My stress levels were directly related to my hypertension. The body produces a surge of hormones when you’re in a stressful situation. Stress releases hormones that temporarily increase your blood pressure by causing your heart to beat faster and your blood vessels to narrow. whether stress by itself causes long-term high blood pressure, is still not certain. But for me it lasted over 20 years.And according the the Mayo clinic, adding up short-term stress-related spikes in your blood pressure may put you at risk of developing long-term high blood pressure.
I think the answer to the question of this article is hypertension can mean you are stressed. Supposedly stress can cause short term dramatic increases in BP. I think this statement applies to myself. Mark, I have essentially the same situation as you did with the White Coat syndrome, however I have not determined how to resolve it. My BP is normal, around 116/63 at home and then surges up to 190-200/100 in the doctor office due to anxiety I suppose. Can you offer me any suggestions as to how to achieve a normal reading in the doctor/dental office and how to overcome this White Coat anxiety? I have stresful days at work and it rarely exceeds 135/70 so my high readings only occur in doctor/dental office settings. I’ve tried deep breathing and it has no effect. Supposedly it is this fight or flight response which causes the increase then the decrease.
I too need help with white coat at dental visits. In the first place, why do they have to take your bp when they are just cleaning your teeth?
I think the general public has been misinformed about hypertension as apparently the author of this article has been. It’s easy to blame everyone’s problems on genetics. As Joel Fuhrman states in his book “Eat to Live” 99% of our genes are designed to keep us healthy, we just never give them a chance to do their job! While it is true that a genetic predisposition to hypertension may shed some light on being at increased risk for the disease, that condition need never occur if one takes the necessary preventative measures. Truth be told, this is not a genetic disease but merely a food borne illness. There are rural cultures in China and Africa where hypertension and heart disease are unheard of. Is it due to their genes? It doesn’t appear so. When these people start consuming a Western diet, the rates of hypertension and heart disease increase dramatically. Everyone should read the “China Study”. If you’re serious about taking control of your hypertension, my advice is to get serious about your diet. If you simply want to control HBP with medication then you can consume the same foods and diet that cause insult to injury. That injury being to the endothelium, the delicate cells that line the arteries. When healthy, these cells produce a wonderful supply of nitric oxide that is the strongest vasodilator in the body. If you absolutely want to annihilate this disease, then seriously consider going plant based. I feel so strongly about this nutrition program, that I am thinking of starting another blog so that those who are interested can explore plant based nutrition and share their experiences. I was able to eliminate BP medication using this diet. It was the diet not exercise that solved the problem.
Nick,
Nice to see read your update.However, I am a vegeterian rather eggeterian and suffering from hypertension since last 5 yrs and also on medications.After taking medicines,my BP is still on borderline (135/90).I would like to know about the diet your are talking about and how did it help you to get rid of medications.
Nitin,
I had similar results with meds as you did initially. I changed meds a few times but the side effects were to hard to endure so that is when I embarked on a plant based diet. For me it involves no animal protein, dairy or oils just fruits, vegetables, whole grains, seeds and some nuts. If I adhere to this it keeps my BP normal.
Nick and Nitin,
I think you are right about the plant-based diet. I follow it with mixed results. It is my belief that salt may be the bigger issue for some people.
I eat all the right foods but have found the no sugar part to be extremely difficult for me.
I have suffered a tendancy to HBP since my 30s, and I was thin. I do have sleep apnea which is still a problem even with C-PAP as it can never be 100% effective (for me at least).
I believe more than normal exercise has helped me most to control the BP. I am on one medication which is a channel blocker. I suspect these various meds over the years may have led me into brachycardia (slow HR) which is a worrisome problem. I took atenenol for many years and it seems the HR has been below normal ever since even as low as 38 at times. My average is 55 BPM.
Dr. Fuhrman is at drfuhrman.com (his web site).
I’ve had good results on a plant based diet. I also eliminated all oils and dairy which may make a difference too. I also don’t use sugar of any kind, just the natural form that occurs in fruit which is bound to the fiber.
From what I understand there is a specific variant of hypertension termed “Labile Hypertension” which is characterized by abrupt fluctuations in BP due to emotional stress and/or anxiety. It supposedly is hard to treat and does not respond well to anti-hypertensive medication. Stress reduction techniques are probably helpful with this.
I agree.
I am stressed a lot of the time, but cycle 20 miles a day and eat a lot of salads, fruit and veg and get massive spikes in blood pressure up to dangerous levels like 160/100.
My parents are 79 and 80 (37 years older than me) they eat a lot of fatty food, cheese and dairy and my dad smoked for 40 years,neither does any exercise. They have no stress in their lives and guess what? – excellent blood pressure:- 120/80 in my dad’s case – at 80 years of age…
So much for genetics in your case. My parents are the same ages and both have hypertension though. My doc told me it’s ok to get spikes as long as the average or typical values over time are <140/90. I didn't originally know that. He also said frankly, a lot of these problems go away when the stress goes away so I definitely agree with you. Supposedly if it stays over 140/90 on average, it requires treatment. I also exercise heavily and consume a Vegan type diet but still get an occasional spike but the diet and exercise helped a lot as I was high all of the time and needed medication but was weaned off about 2 months ago. Are you finding that to be the case for the most part? Just curious as to what others are observing with the whole diet/exercise regimen.
Hi Jason, that is helpful to hear that an average of 140/90 including the spikes is ok. Here in the UK there was a report in the British Medical Assn journal that even one reading of HBP needed to be taken seriously and medication offered. There is just so much conflicting information around. Your information makes me feel less worried of the spikes – my BP oscillates between 150 to 160/ 85 (stressed) and 123-130/80 (relaxed). Great that you have come off your medication – I only took it for 2 months but hated the side effects and have been working with other methods since. Not sure that I have found the solution yet to the spikes.
BP does fluctuate with everyone including those who are normotensive according to my doctor. A big spike ever so often is not an issue as long as that average is in the normal range. I keep a log of my readings (twice per day) and then tabulate these in a spreadhseet which calculates a 30 day average. I call this number in to my doctor and he tells me “right on target” so I know everything is where it needs to be. Diet and exercise were the key to getting me off the meds. I also take Fish Oil, CoQ10 and Magnesium. they do a great job also, without those awful side effects you elude to. Fortunately it only took 2 months to wean myself off of them.
Hi Jason, its really impressive that you got off your meds. I also take Q10, Magnesium and Fish Oil. What quantity do you take? I have largely worked out what to take by research – I may take too little as I have never been sure on the quantities. How many mgs do you take of each? Thanks.
Marie, I might add that I didn’t self medicate with any of this. I started on meds which had awful side effects and knew I couldn’t function feeling like that, so I went to a Naturopathic doctor who weaned me off meds and on to 4g of Fish Oil, 200mg of CoQ10 and 400mg of Magnesium. We had to fine tune it, but that in conjunction with the diet keeps me status quo.
Thanks Jason, that is helpful. I have worked with a nutritionist and a herbalist but found the Q10 and magnesium connection myself. I take the same mgs apart from the fish oil. Many thanks.
I am not on any meds.
I have had several high readings but my doctors have passed it off as white coat.
I tend to wake up with readings of about 115/75 to 120/85 but often get dizzy when stressed.
My readings at night when I return from work tend to be more in the 145/85 to 150/90 range.
A couple of times recently when stressed at home I took the reading and got 160/100.
I don’t know if I need meds or what?
I had an echo done and one doctor said my heart was enlarged by stress and hypertension, the other said it was an athletes heart.
My heart closes 100% with each beat it has 100% Ejection Fraction and is 14mm thick at the septum, which means it is a much harder beating, larger heart than normal.
With my normotensive morning readings, excellent exercise tolerance and low heart rate, I don’t know what to make of my regular dizzy spells and extreme spikes of up to +40 systolic/20 diastolic…
My worst suspicion is I am one of those individuals with hypertrophic cardiomyopathy that tend to drop dead suddenly from cardiac arrest.
I have labile hypertension and drs don’t know how to treat successfully. What stress reduction techniques are helpful? I get sooooooo frustrated at my own self because I can’t control the stress that makes it spike. Help anyone?
Here is another one. I had markedly increased BP when I resided at high altitude a few years ago. It required medication to normalize it. When I returned to sea level, the medication was discontinued, so environmental stress seems to have an impact too.
As a hypertension patient ,i do not agree with the Physician who says stress does not increase BP. My expereiance is when a person is stressed emotionally or physically ,BP reading will 10 to 15 points higher
First of all, after following this site, I can attest to the BP lowering effects of pomegranate juice–expensive and yuck city–but it worked. I had a BP in the 115/76 range which it had been in the 140/85 range. I am a nurse. Stress? How about 11 hours into a 12 hour shift…190/101. You tell your charge nurse and she says…well be glad you only have an hour left…my thought–“For my life?”
You are so right Miriam!!! I also am a nurse. Running around like a crazy person stressed out for 12 hours will kill anyone after awhile. I would take my pressure after a stressful shift and it would be dangerously high. I got smart and switched jobs – my blood pressure is back to normal! Yes, nursing will kill you.
I absolutely agree with all your responses to the article – in my experience stress both creates my blood pressure spikes and relaxation caused it to drop to a more normal range. I too suffer white coat syndrome, and even underwent a course of hypnotherapy to help me cope with visits to the Drs office. I was still not able to control my fear while there. I have a very labile blood pressure – any form of stress elevates it – and then it comes down. I guess for most people this is the case but my highs, like others are writing, is at too high a level. I think I have an anxiety prone personality and there is some evidence now through neuroscientific research that cortisol levels may be set in the last trimester of gestation or in the first couple of months after birth. As I understand, in a rudimentary sort of way, cortisol and adrenaline are the hormones involved in flight or fight. So it may be very difficult to find ways to calm this physical response down. Meditation, resperate etc are very helpful but so far I have not found a natural substance that can help control the spikes. I would be keen to hear from others.
Marie
Same situation with me for the most part. Just anxiety in the doctors office visit is what does it to me in terms of the big spikes. I get home and my BP averages 116/63 lately. Nothing seems to help with the White Coat syndrome so far. BP meds will send my BP down to about 88/43 as was the case last year when they thought I needed medication. I’m usually ok with other stress though. I might get a slight uptick af 20 points but not real high. It’s just the White coat syndrome that gets me.
Hi Jose, the moral of your story seems to be to stay away from the Dr’s office. My last Dr told me to take my own at home and she would be ok with that – she thought it was cruel to put me through taking my BP in her office. Your BP sounds great, and with spikes of just 20 points it does not sound as though that would take you beyond the 140/90 range. However, I also persevere with trying to find ways of keeping it down in the Drs office as there are, at times, other reasons to see a GP and they always want to take one’s BP. At times I have refused knowing that the next thing will be the prescription written up and the dubious looks and lecture when I say I am unwilling to take it.
I had been running very high numbers for BP and have been seeing a Naturopath for quite awhile now. She put me on Rauwolfia (a tincture) and BPRelax (a Naturopathic capsule) and by taking 3 drops of the Rauwolfia in the morning and at night plus 2 capsules of the BPRelax I have been able to get my blood pressure back into normal range. It took a lot of trial and error but, finally, I am doing well and it is such a relief. Hope this was helpful. Joyce
If the doctor who wrote this article maintains that stress can’t cause spikes in BP, then I think he is wrong. But perhaps he is merely saying that stress alone does not create the essential hypertension, but merely aggravates it. I’d like him to clarify what he means, because, like most people here, I know that stress can definitely increase blood pressure. Heck, even playing a stressful computer game can raise the BP, much less stress in the workplace. I have noticed something else, too. If I visit a doctor where the nurse takes my reading the old-fashioned “manual” way, I get lower readings, and when a nurse takes an automated reading, the numbers are higher. One doctor’s office told me they don’t trust the machines. I don’t know if that makes any difference, but it might. But then, I get reasonable readings with my battery-powered machine at home, so maybe it is only the “white-coat syndrome. If you’ve been sitting a long time in the doctor’s waiting room, that may or may not increase your BP. I guess it depends on how you emotionally handle the wait. If you get aggravated by the wait, especially if the chairs are uncomfortable, you might be seething inside by the time you get called in the “back.”
The bottom line is that there seems to be so many factors that contribute to “spikes,” so you really have to take frequent readings at home to find out where you stand.
Hi Ron, thanks for your contribution. What really struck me was your statement about ‘how you emotionally handle the wait’. I think how I emotionally handle situations is really the key – I think, for me, learning to be a more relaxed person is the key. I think years of a stressful job, raising a family, loss of loved ones, aging etc has taken its toll and my adrenals are exhausted and I have become a more edgy person than I was years ago. Meditation and resperate as well as herbs to support my adrenals have been really helpful, but I think keeping my blood pressure down is now a lifelong journey for me. Excuse me if this sounds wacky, but I believe dealing with blood pressure (or any illness for that matter) involves working with the body, the emotions and spiritually. By that I mean, having high blood pressure has really caused me to evaluate how I live and for what.
I had similar situation as you describe about a year ago. My BP was all over the place and just too high in general. The doc wrote me an Rx and that stabilized things but I couldnt handle the terrible side effects. I would keep a log of the readings at home for a few weeks. Take readings a few times a day at various times. I log all my numbers in a spreadsheet that calculates an average over a 30 day period. That result is your average BP. If you’re happy with that number do nothing. Based on my experience, I would avoid the meds and take the natural route. It sounds like you already exercise. I’ve had good results with a Vegan diet. DASH might be an alternative also. You could also add CoQ10 in 100mg increments in addition to 3g of Fish Oil and Magnesium in 200 mg increments to fine tune your results. Yoga and Resperate might be worth a try also.
Hope that helps.