May is National High Blood Pressure Education Month, so it’s only fitting to discuss what high blood pressure is, and the mental health connection related to this medical issue.
The National Heart Lung and Blood Institute website states that “high blood pressure (HBP) is a serious condition that can lead to coronary heart disease (also called coronary artery disease), heart failure, stroke, kidney failure, and other health problems.”
Blood pressure in general is the measure of the pressure of blood against artery walls while blood is pumped from the heart, according to the website. In order to be healthy, blood pressure must be consistently in the normal range.
In order to prevent or treat high blood pressure, it’s important to maintain a healthy lifestyle, follow the doctor’s orders and any treatment plans.
Risk factors for high blood pressure include older age, family history, certain races and ethnicities, and being obese or overweight. If you have a certain age and gender combination, or engage in unhealthy lifestyle choices like unhealthy diet and exercise routines, you may be at higher risk, according to the website.
The risk factors like being obese or overweight, as well as having an unhealthy lifestyle, can be linked to many other mental and physical health issues besides high blood pressure.
Besides these loose connections, there are some actual direct links between high blood pressure and mental health issues.
The American Heart Association website lists other risk factors for high blood pressure, including “drinking too much alcohol,” which could also be associated with the mental health condition of alcoholism.
Although the website concedes there is not a scientifically proven strong association among stress, sleep apnea and high blood pressure, those two conditions are related to mental health and could be risk factors.
Sleep apnea is a type of sleep disorder that is more specifically labeled as a “breathing-related sleep disorder” in the Diagnostic and Statistical Manual of Mental Disorders. According to the American Heart Association website, almost half of the people who have obstructive sleep apnea have high blood pressure as well.
In the case of sleep apnea, blood pressure doesn’t actually decrease when sleeping, like for most people. This could be due to a decrease in the blood’s oxygen levels, as well as the constant awakenings that happen with sleep apnea.
Stress can lead to high blood pressure, because people who are stressed also tend to deal with that stress by engaging in unhealthy eating habits, as well as smoking and drinking, according to the American Heart Association website.
Stress can momentarily increase blood pressure, but it’s not certain if it has a strong link to long-term high blood pressure. However, chronic (long-term) stress means that you’re stressed often and therefore your blood pressure is raised during that time too.
It’s not certain if that constant raising of blood pressure could lead to an actual medical condition, but it’s beneficial to overall health to learn to manage stress more effectively.
Stress and sleep apnea are not the only mental health conditions associated with high blood pressure. An article on the American Psychological Association’s website states that when people do not express anger properly, this can lead to an inward expression that can cause health issues like high blood pressure, hypertension (another term for high blood pressure) and depression.
Dr. Sheldon G. Sheps wrote on the Mayo Clinic website that anxiety doesn’t directly cause hypertension, which is a long-term high blood pressure. However, this doesn’t mean there is no connection between high blood pressure and anxiety.
“Episodes of anxiety can cause dramatic, temporary spikes in your blood pressure,” Sheps said. “If those temporary episodes occur frequently, such as every day, they can cause damage to your blood vessels, heart and kidneys, as can chronic high blood pressure.”
Anxiety can also lead people to make unhealthy lifestyle choices that can cause an increase in blood pressure as a result. These choices include overeating, drinking alcohol and smoking, according to the website.
In addition, medications used to treat the mental health condition anxiety can lead to higher blood pressure.
Cardiovascular diseases, some of which are associated with high blood pressure (like hypertensive heart disease), have been linked to several mental disorders, such as mood disorders and anxiety disorders.
One study linking cardiovascular disease to mental disorders used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC).
National Heart Lung and Blood Institute. What Is High Blood Pressure? Web. May 16, 2012.
American Psychological Association. What is Anger? Web. May 16, 2012. http://www.apa.org/topics/anger/control.aspx
Sheps, Sheldon G. Mayo Clinic. High blood pressure (hypertension). Can anxiety cause high blood pressure? Web. May 16, 2012. http://www.mayoclinic.com/health/anxiety/AN01086
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorder: Fourth Edition: Text Revision. Arlington, VA: American Psychiatric Association, 2000.
American Heart Association. Understand Your Risk for High Blood Pressure. Web. May 17, 2012. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/UnderstandYourRiskforHighBloodPressure/Understand-Your-Risk-for-High-Blood-Pressure_UCM_002052_Article.jsp
American Heart Association. Sleep Apnea and Heart Disease. Web. May 17, 2012. http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Sleep-Apnea-and-Heart-Disease_UCM_311244_Article.jsp
American Heart Association. Stress and Blood Pressure. Web. May 17, 2012. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Stress-and-Blood-Pressure_UCM_301883_Article.jsp
Goodwin, RD; Davidson, KW; Keyes, K. Journal of Psychiatric Research. Jan. 2009. Mental disorders and cardiovascular disease among adults in the United States. Web. May 17, 2012.
Reviewed May 17, 2012
by Michele Blacksberg RN
Edited by Jody Smith
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