Controlling Your Blood Pressure in Times of Stress -- and Always

Most people know this vital health measurement as a top and bottom number, which refers to the pressure of blood pushing against the walls of your arteries. There is no doubt of the importance of keeping your blood pressure with a normal range — a normal level is less than 120/80 mmHg.

Knowing your numbers includes blood pressure, blood sugar and your cholesterol, all readings you obtain after a regular checkup with your primary care physician. These days, though, nothing seems “regular” or “normal” and stress is having an effect on people’s blood pressure and other health factors. The COVID-19 pandemic, economic uncertainties and now a hotly contested national election have made stress a daily challenge for just about everyone.

Blood pressure can be directly affected by stress, particularly in those who are pre-hypertensive (or have borderline high blood pressure); or those who are hypertensive and don’t know it and have not been diagnosed.

“This is something that we see in clinical practice — people whose blood pressure has been well-controlled and then they suddenly go through a period in life that is particularly stressful,” says Ian Del Conde, M.D., a cardiovascular specialist at Miami Cardiac & Vascular Institute. “Unfortunately, you can pinpoint that there is a correlation between emotional stress that can lead to prolonged and elevated blood pressures.”

Here are some stark facts: Nearly half of adults in the United States (108 million, or 45 percent) have hypertension, defined as a systolic blood pressure greater than 130 mm Hg or a diastolic blood pressure greater than 80 mm Hg, or are taking medication for hypertension. Only about 1 in 4 adults (24 percent) with hypertension have their condition under control, says the U.S. Centers for Disease Control and Prevention.

High blood pressure is called the ‘silent killer’ for a reason, says Eli Friedman, M.D., medical director of sports cardiology at Miami Cardiac & Vascular Institute.

That’s “because most often people walk around with blood pressures of 160 systolic or 170 (120 or lower is normal) and won’t feel that,” explains Dr. Friedman. “Some people will have headaches, but a lot of people won’t … It’s really important to recognize when we’re feeling stressed.”

A stream of recent studies have confirmed that a regular exercise program can lower blood pressure as effectively as medication — although you should consult with your doctor about the effect of exercise on your treatment. The types of exercise in the studies included walking, jogging, running, cycling and swimming. Strength training with weights or other forms of resistance was also part of the research — as was a combination of aerobic and resistance training.

“I would like this to be much more common than it is, but I’ve certainly seen a lot of patients, who manage to reduce a substantial amount of weight and their blood pressure, their hypertension, completely disappears,” says Dr. Del Conde. “So for some patients, a real bold change in their lifestyles will be large enough for them to be able to come off drug therapy entirely. And that’s what I would wish for all patients. But obviously that’s not the case for all of them.”

Here are changes you can make to manage high blood pressure, according to the American Heart Association:

  • Eat a well-balanced diet that’s low in salt
  • Limit alcohol
  • Enjoy regular physical activity
  • Manage stress
  • Maintain a healthy weight
  • Quit smoking
  • Take your medications properly
  • Work together with your doctor

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