Stress has yet to appear as a cause of death in national health statistics. Yet few people would argue that it is one of the top health problems in the United States. Stress acts like an invisible, yet perceptible hand behind various body and mind mechanisms to trigger or aggravate many health conditions, including hypertension.
Blood Pressure Basics
In "Reversing Hypertension," North Carolina-based physician Julian Whitaker, MD, likens the cardiovascular system to a pump-and-pipe system where your heart is the pump, your blood vessels the pipes, and your blood the fluid that flows through the system. Like a hydraulic system, the heart pumps blood in waves, as it contracts and relaxes continuously. This is why clinicians report blood pressure in two numbers: the systolic pressure, or peak pressure during the heartbeat; and diastolic pressure, or pressure of the resting heart.
Hypertension Basics
Hypertension is defined as repeatedly elevated blood pressure. Primary or essential hypertension has unknown causes, while secondary hypertension results from disease. Your blood pressure (BP) can increase as a result of one or a combination of the following factors: increased fluid volume; increased resistance in blood vessels; or increased pumping intensity, rate and output. Stress raises your blood pressure by elevating your heart rate and the blood volume your heart pumps out.
Stress Physiology
The stress response is a reflex, or innate reaction to a real or perceived danger. Whenever you feel threatened or stressed, your brain issues a threefold alert to various parts of the body via chemical messengers. Your muscles tense to prepare your body for the proverbial "fight or flight." Simultaneously, the sympathetic nervous system revs up your body by releasing the stress hormones adrenaline and noradrenaline. Also, the adrenal glands release the immune-boosting hormones cortisol and aldosterone into the bloodstream. Since the heart is a muscle, and blood pressure regulation is under hormonal control, the stress response speeds up your pulse and respiration rates.
Chronic Stress and Hypertension
In a 2010 issue of the Hypertension journal, researchers remarked that people with high reactivity to stress and slow recovery from a stressful event are at greater risk of developing both elevated BP and hypertension. Stress-induced BP elevation is normally temporary because, once a threat is removed, body functions return to normal. However, accumulated stress maintains a rush of hormones that keeps your body in the "fight or flight" state, leading to hypertension.
Considerations
In the "Braunwald's Heart Disease" textbook, physician Peter Libby, MD, remarks that stress can lead to the onset or worsening of essential hypertension. Understandably, job strain stands out as a major cause of stress-related hypertension. However, stress alone is not likely to lead to chronic hypertension, unless another risk factor is present in your life. Hypertension risk factors you can control include: poor diet, obesity, smoking, heavy drinking and inactivity. Age, gender, race and genetics also affect hypertension risk.
Warning Signs
Because hypertension does not usually produce visible symptoms until it becomes severe, it is important for you to recognize and deal with risk factors, such as stress. The Harvard Medical School Guide to Lowering Blood Pressure lists numerous physical warning signs of chronic stress, including: stiff or tense muscles; backaches; headaches; sleep disturbances; tiredness; tremors; restlessness; and heart rate disturbances. You may also experience psychological manifestations, such as anxiety, depression, anger, crying, indecisiveness, hopelessness, poor concentration; lack of creativity, loneliness and perfectionism.
Stress Management
Relaxation is clearly the antidote to stress. However, unlike the stress response, it is learned behavior. Diaphragmatic breathing and progressive muscle relaxation exercises are some of the major stress management techniques. It also may be helpful to identify the specific sources of stress in your life, such as overcommitment, and seek out practical ways of dealing with them.
References
- Reversing Hypertension; Julian Whitaker, M.D.; 2000
- The Harvard Medical School Guide to Lowering Your Blood Pressure; Aggie Casey, R.N., M.S. and Herbert Benson, M.D.; 2006
- "Hypertension" journal; Greater Cardiovascular Responses to Laboratory Mental Stress Are Associated With Poor Subsequent Cardiovascular Risk Status; Yoichi Chida and Andrew Steptoe; Volume 55 (4); 2010
- Braunwald's Heart Disease (8th Ed.); Peter Libby, M.D. et al.; 2007
