How are High Blood Pressure and Stress Related?

Stress is common in modern society and can present in physical or mental forms. In stressful situations, people may manifest secondary physiological changes such as higher blood pressure and heart rate.

Chronic psychosocial stress is associated with distorted lifestyle and mental distress, which can contribute to prolonged elevation of blood pressure. Understanding the impact of stress on blood pressure can help doctors to prescribe patient-specific therapies.

How Does Stress Affect The Body?

When our brain perceives stress, there are hormonal changes which occur in a rapid and prolonged manner. A surge in stress hormones such as adrenaline can cause the heart to beat faster, harder and at the same time cause blood vessels to narrow.

Stress cardiomyopathy

Negative life stressor events are able to trigger a health condition known as stress cardiomyopathy. Commonly referred to as Takotsubo syndrome (TTS) or “broken heart syndrome”, the symptoms of stress cardiomyopathy are similar to a heart attack. It also has a mortality rate comparable to that of a heart attack. However, in comparison to other heart conditions, most people recover from stress cardiomyopathy within a few days to a week.

Anger

Emotional reactions to stressors, such as anger, have the ability to impact heart health. According to a paper by Harvard Medical School, research showed that in the two hours after an angry outburst, a person has a slightly higher risk of having chest pain (angina), a heart attack, a stroke, or a risky heart rhythm.

Chronic stress

People who experience sustained levels of stress have been known to have higher risks of developing hypertension. Chronic stress can lead to alteration in the arteries in the form of chronic inflammation, increasing the risk of heart attack and stroke.

Can Stress Cause High Blood Pressure?

Stress-induced hormonal changes can drive up heart rates and blood pressure. White coat hypertension, defined as high blood pressure taken at the clinic while blood pressure taken at home is normal, is the most common example of stress-related elevated blood pressure. Likewise, many patients with acute pain or distress may experience an acute elevation in blood pressure, which restores to normal when they are no longer in a stressful situation.

How to Reduce Stress?

Stress management is important to lower the risk of developing high blood pressure and its associated heart conditions. While some stress is beneficial, it is vital to pay attention and take action to manage your stress levels if you consistently feel overwhelmed.

Stress reduction techniques

• Adopt a positive outlook by knowing yourself and your limits.
• Learn to manage time effectively and set realistic goals for your work tasks.
• Pursue your hobbies to relax.
• Confide in family, friends or support groups.
• Avoid unhealthy ways of coping, such as finding temporary relief in alcohol or smoking.
• Get adequate sleep.

You can also make important lifestyle changes to effectively control your blood pressure.

Healthy Habits to Lower Blood Pressure

Exercise
Besides maintaining weight, exercising is a good way to fight depression as it stimulates the body’s production of happy hormones known as endorphins, thus improving your mood.

Healthy diet
A poor diet can contribute to high blood pressure. Control the urge to binge on comfort food, which is often unhealthy, to reduce stress. Instead, stick to a diet rich in whole-grains, fruit and vegetables and low in salt content.

Weight loss
Every 1kg reduction in body weight is estimated to lower systolic blood pressure and diastolic blood pressure by 1mmHg.

Seek Help

If you struggle with stress, there is nothing wrong with seeking professional help to manage stress levels. Look out for signs that may suggest that your stress is seriously affecting your mental health, such as extremely high or low moods, memory and concentration problems,
insomnia, change in eating habits and social withdrawal.

Consider speaking with your doctor or a mental healthcare professional to keep your stress level low and prevent it from escalating into more serious mental health conditions such as anxiety, depression or physical health issues.

Counselling Resources

There are many channels available to seek help. One can consult a doctor, talk to family members and friends, find support in online forums, join a peer support group, or approach the following organisations for counselling.

• Care Corner Singapore
  Toll-free Mandarin Counselling Hotline – 1800 3535 800
• Fei Yue Counselling – 6235 5229
• Singapore Association for Mental Health
  Toll-free Helpline – 1800 283 7019
• Silver Ribbon (Singapore) – 6386 1928
• Touch Community Services
  TOUCHline (Counselling) – 1800 377 2252

Our heart and mind are inseparable, so to have a healthy heart, you need to have a healthy mind. Care for your mental health as it is an integral part of any healthy lifestyle that can greatly impact quality of life and lead to unwanted heart disease.

Article is contributed by Prof Tan Huay Cheem, Chairman of Singapore Heart Foundation; Senior Consultant, Department of Cardiology of National University Heart Centre, Singapore.