Stress and hypertension: Understanding the link

Hypertension is a silent killer that stealthily progresses in the body and causes irreversible damage if unchecked. Of the various factors that trigger hypertension in the body, the most common one is stress.

Stress and hypertension

are two very pervasive health issues that have affected millions of people worldwide. The link between the two is somewhat intricate since stress is both a cause and an effect of hypertension.

What is hypertension?

Hypertension is a chronic medical condition in which the force of blood against the walls of the arteries is consistently too high. Normal blood pressure is defined as below 120/80 mmHg, where “120” is the systolic pressure (when the heart beats) and “80” is the diastolic pressure (when the heart rests between beats). Hypertension is generally categorized as:

Prolonged hypertension can lead to severe health complications such as heart disease, stroke, kidney failure, and vision loss.

Higher perceived stress over time was associated with an increased risk of developing hypertension: Study

A 2019 study published in the Journal of the American Heart Association (JAHA), found that moderate and high perceived stress over time were associated with a 15% and 22% increased risk of developing hypertension over a median of 7 years, respectively. For this, the researchers examined the association between perceived stress levels assessed annually for up to 13 years and incident hypertension in the Jackson Heart Study, a community‐based cohort of blacks.

Prevalence of stress in hypertensive patients was found to be 84.3%

A hospital-based, cross-sectional study done in Western India for 1 year in 2019 found that the prevalence of stress in hypertensive patients was found to be 84.3% and the common stressors were financial dependence on others, living in rented house, having a daughter of marriageable age because of associated dowry, death of a loved one, sleep-related problem, and owing a debt among others. The study published in the Journal of Family Medicine and Primary Care found the prevalence of stress in hypertensive patients and the associated risk factors of stress and its implications in disease management.

How you behave/ react due to stress determines the risk of hypertension

There is an extremely close relationship between stress and hypertension, mainly based on physiological and behavioral responses of the body. When a person is subjected to stressful conditions, the body triggers the “fight or flight” response, releasing stress hormones like adrenaline and cortisol. These hormones raise heart rate and blood pressure briefly to ensure short-term survival; however, chronic stress causes the body to stay in a prolonged state of high alert, which may lead to increased blood pressure and finally hypertension.
Stress affects one’s behavior, and unhealthy behaviors such as overeating, smoking, higher alcohol consumption, and lower physical activity may result. Such behaviors over time lead to weight gain, poor

cardiovascular health

, and raised blood pressure. Moreover, sleep is interrupted by stress, thereby increasing anxiety and depression through acts of worsening their respective conditions, complicating regulation of blood pressure.
Chronic stress may also directly impact the cardiovascular system by causing inflammation in blood vessels and reducing their elasticity, making it harder for blood to flow smoothly. Research has shown that individuals in high-stress environments, such as demanding jobs or financial hardship, are at a higher risk of developing hypertension. Thus, managing stress effectively is crucial for maintaining healthy blood pressure and overall well-being.
“There’s no proof that stress by itself causes long-term high blood pressure. But reacting to stress in unhealthy ways can raise blood pressure and increase the risk of heart attack and stroke,” says a report by MayoClinic. It says unhealthy lifestyle habits like drinking too much alcohol or caffeine, eating unhealthy foods, eating too much and not moving enough can lead to hypertension.
“Stress can cause a steep rise in blood pressure. But when stress goes away, blood pressure returns to what it was before the stress. However, short spikes in blood pressure can cause heart attacks or strokes and may also damage blood vessels, the heart and the kidneys over time. The damage is like the damage from long-term high blood pressure,” the report explains.

How to reduce the impact of stress?

Stress- reducing activities like meditation, deep breathing exercises can lower stress hormone levels and improve emotional resilience. Regular physical activity helps maintain healthy blood pressure levels. Exercise releases endorphins, natural mood elevators that counteract stress. A balanced diet rich in fruits, vegetables, whole grains, and lean proteins supports cardiovascular health. Reducing salt, caffeine, and sugar intake can prevent stress-induced blood pressure spikes. Good sleep hygiene reduces stress levels and allows the body to repair itself, improving blood pressure regulation.