Can Depression And Anxiety Contribute To The Development Of Hypertension
You dont need a blood pressure monitor to know that a heated debate or a trip down a dark alley might raise your blood pressure. Your hot face and hammering pulse say it all. Stress can momentarily raise blood pressure: for example, some peoples blood pressure rises when they go to the doctors office.
Fortunately, these pressure spikes are usually too brief to be dangerous to your health. When emotional upheaval becomes a way of life, though, your blood pressure can rise to dangerously high levels over time.
Depression and extreme anxiety, according to the Centers for Disease Control and Prevention , may raise a persons chance of getting hypertension.
In the early 1970s, the groundbreaking CDC study began with psychological examination of approximately 3,000 persons with normal blood pressure.
Researchers discovered a striking trend when they assessed the individuals blood pressure and medical records seven to 16 years later: people who had significant depression or anxiety at the start of the trial were two to three times more likely than the others to acquire hypertension.
To arrive at the results, the researchers adjusted for smoking, age, heart disease history, and other characteristics. For the first time, researchers were able to see a link between depression and hypertension, two of the most common and costly diseases in the United States.
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Depression And Anxiety Linked To Hypertension
- Center For The Advancement Of Health
- People who experience symptoms of depression or anxiety are at increased risk of developing hypertension, suggest the results of a two-decade study. The increase in risk associated with depression or anxiety is similar among white women and all men but is substantially higher among black women, according to Bruce S. Jonas, ScM, PhD, and James F. Lando, MD, MPH, of the Centers for Disease Control and Prevention.
People who experience symptoms of depression or anxiety are at increased risk of developing hypertension, suggest the results of a two-decade study.
The increase in risk associated with depression or anxiety is similar among white women and all men but is substantially higher among black women, according to Bruce S. Jonas, ScM, PhD, and James F. Lando, MD, MPH, of the Centers for Disease Control and Prevention.
The increased risk for depression or anxiety persisted even after controlling for other hypertension risk factors including: age, gender, race, education, smoking, alcohol use, baseline diastolic and systolic blood pressure, and body mass index. The increased risk observed among people with high levels of depression or anxiety remained about the same even when the investigators further controlled for body mass index changes over time. The increase in risk is comparable to a 10-point change in baseline diastolic blood pressure or to a 10-point change in body mass index.
The Link Between Blood Pressure And Depression
There may be many reasons for the association between high blood pressure and low mood, but the most likely is that people who feel down tend not to look after themselves properly, or take their medication regularly, as prescribed. As a result, any pre-existing condition including hypertension is not optimally treated.
Another possibility is that having depression is associated with chemical imbalances in the central nervous system that cause blood pressure to rise, or that hypertension affects blood flow to the brain to lower mood. Certain blood pressure medications may also affect your mood and increase the risk of developing depression. Whatever the underlying cause, depression occurs at a higher rate in people with hypertension than in the normal population.
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Actions For Health Care Professionals
- Learn more about the link between mental health and heart disease19 with the following resources:
- Talk to your patients about the relationship between mental health and heart disease.1,28,39,45,46
- Incorporate mental health screening and treatment into care surrounding a major heart disease event and chronic disease.2,6,8,17,21,25,32,40,45,47
- Involve individuals and their family members in communication and decision making regarding treatment following a heart disease event.15
- For patients with severe mental health disorders and pre-existing heart disease or its risk factors:21
- Consider prescribing or switching a patient to a psychotropic medication with lower risk for heart disease, while weighing any clinical benefits and potential for adverse events.
- Consider the potential interactions between prescribed medicines for heart disease and prescribed psychotropic medications.
- Monitor heart health outcomes and risk factors, and adjust doses of heart disease medicines if required.
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Predictive Association Between Baseline Depression And Change In Blood Pressure
To the best of our knowledge, our study is the first to report the predictive association between depression and change in BP as a continuous variable among normotensive people and incident hypertension diagnosis in the same study sample. While BP tends to increase with age, we found that systolic BP increased less among people with depression compared to those without depression at baseline. This association did not vary by sex in our study, although there is evidence of effect modification by sex in another study which included people with hypertension. Our observations suggest that systolic BP is not a relevant mediator in the causal effect of depression on CVD as it was recently confirmed in the context of a bi-directional Mendelian Randomization study. In the MR study, a slight attenuation of the causal effect of depression on CVD was observed after adjustment for BP, but neither was a mediation analysis conducted, nor was the sample restricted to normotensive persons.
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American Heart Association News Stories
American Heart Association News covers heart disease, stroke and related health issues. Not all views expressed in American Heart Association News stories reflect the official position of the American Heart Association. Statements, conclusions, accuracy and reliability of studies published in American Heart Association scientific journals or presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the American Heart Associations official guidance, policies or positions.
Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered and proper attribution is made to American Heart Association News.
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Weight Loss Or Weight Gain
Your mood may impact your diet. For some, depression causes a loss of appetite that could lead to unnecessary weight loss.
For others with depression, feelings of hopelessness may result in poor eating choices and a loss of interest in exercise. Reaching for foods high in sugars, fats, and starchy carbohydrates is also common. Increased appetite and weight gain are also side effects of some medications for depression.
Obesity also seems to be common in people with depression, according to an older survey by the . The survey, conducted between 2005 and 2010, found that approximately 43 percent of adults with depression are obese.
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Seek Treatment For Hypertension
At Westmed Family Healthcare, we carefully consider your mental health and how it affects your work life and your family life. We work continuously to offer not only medical support, but access to the best remedies, research, and treatment. To schedule an appointment with one of our experienced providers, call our Westminster, Colorado, office or use our online booking system.
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Selective Serotonin Reuptake Inhibitors
SSRIs are most frequently used as first-line treatment of major depression . Their efficacy has also been demonstrated in the treatment of generalized anxiety, panic, social anxiety, and obsessivecompulsive disorders. This class includes citalopram, escitalopram, paroxetine, fluoxetine, fluvoxamine, and sertraline. Sertraline and paroxetine have also been approved for the treatment of post-traumatic stress disorder.
Table 2. Influence of antidepressant drugs on blood pressure and heart rate.
Citalopram, Escitalopram, and Paroxetine
Sertraline, Fluvoxamine, and Fluoxetine
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Choose Healthy Habits And Don’t Rush It
If you aren’t in the habit of exercising, start gradually.
Something as simple as taking a walk, 30 minutes a day, even if you do only 10 minutes at a time, can help your heart. Physical activity improves your mood while youre doing it, but regular physical activity can also improve your mental well-being, lower the risk of depression and improve your overall quality of life.
If reaching for unhealthy foods has become a habit, try using healthier cooking techniques or substituting ingredients to cut down on fat, added sugar, sodium and calories. Grab healthy snacks, such as fresh fruits and vegetables, or choose undressed salads and other low-fat dishes when eating out.
The Early Prediction Of Adolescent Depression Study
New-onset major depressive disorder: The presence of a new-onset DSM-IV diagnosis of major depressive disorder at either the second or third assessment was defined by excluding children who had a baseline diagnosis of DSM-IV major depressive disorder.
Blood pressure: An Omron 705IT sphygmomanometer was used to measure blood pressure at each assessment while the child was in a seated position with their arm resting on a flat surface. A standard cuff was used to measure blood pressure in children aged 11years and over and a small adult cuff was used for children under 11years, unless overweight. Systolic and diastolic blood pressures were measured using standardised guidelines set out by the American Heart association. At least two readings were taken at 1min apart using the right arm. When the difference between two readings was 5mmHg or less an average was taken.
Weight and other potential confounders: Weight was considered to be a confounder of the relationship between blood pressure and depression due to its potential association with both., Interviewers measured the weight of the children without shoes to the nearest 0.1kg using Seca scales. We also examined whether the results were affected by the presence of physical health problems , any medication use and using body mass index instead of weight.
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Things You Can Do To Feel Less Anxious
Whether you have an anxiety disorder or not, everyone can benefit from reducing their daily anxiety levels. Here are some changes that you can make in your daily life to lower your anxiety levels:
- Get enough sleep. Sleep is very important for overall health, and getting enough sleep can make a huge difference in daily anxiety levels. Most people need 7 to 9 hours of sleep each night, so make sure to aim for this.
- Eat a balanced diet. Eating nutritious foods can help support both your physical and mental well-being. Aim to fill your plate with whole foods, such as fruits, vegetables, whole grains, and lean proteins, whenever possible.
- Move your body. Moving your body is important, whether that involves weight training at the gym or taking a walk around the block. Daily exercise and movement can help increase your endorphins and lower stress levels.
- Practice mindfulness. Mindfulness is the practice of bringing your awareness to the present moment, which is incredibly important when you have anxiety. Meditation is a great mindfulness practice to reduce daily stress and anxiety.
Medications used to treat anxiety can help reduce overall anxiety levels, which can reduce blood pressure spikes. However, some anxiety treatment options may also cause an increase in blood pressure levels.
If dietary and lifestyle changes arent enough to lower your blood pressure naturally, certain may be prescribed, such as:
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What Is The Connection Between Mental Health Disorders And Heart Disease
A large and growing body of research shows that mental health is associated with risk factors for heart disease before a diagnosis of a mental health disorder and during treatment. These effects can arise both directly, through biological pathways, and indirectly, through risky health behaviors.5
People experiencing depression, anxiety, stress, and even PTSD over a long period of time may experience certain physiologic effects on the body, such as increased cardiac reactivity , reduced blood flow to the heart, and heightened levels of cortisol. Over time, these physiologic effects can lead to calcium buildup in the arteries, metabolic disease, and heart disease.1,6-11
Evidence shows that mental health disorderssuch as depression, anxiety, and PTSDcan develop after cardiac events, including heart failure, stroke, and heart attack.5,12-20 These disorders can be brought on after an acute heart disease event from factors including pain, fear of death or disability, and financial problems associated with the event.5,16
Some literature notes the impact of medicines used to treat mental health disorders on cardiometabolic disease risk. The use of some antipsychotic medications has been associated with obesity, insulin resistance, diabetes, heart attacks, atrial fibrillation, stroke, and death.21
Is It Possible That Antidepressant Medication Can Help Prevent Hypertension
It appears to help in some circumstances. The researchers at NYPH discovered that combining hypertension drugs with psychotherapy and antidepressants helped avert severe high blood pressure crises in more than 60% of their patients.
However, there is no evidence that treating depression will help prevent the more subtle kind of chronic hypertension that puts millions of Americans at risk of heart disease. In fact, the molecular interactions that contemporary antidepressants trigger can significantly increase blood pressure. Your doctor can determine which medications are most appropriate for your condition.
Still, theres no denying that depression treatment can be a life-changing experience. There is evidence that depressed people who are otherwise healthy are more prone to acquire cardiac disease than their non-depressed counterparts.
For example, a 13-year research at Johns Hopkins University of 1,500 individuals indicated that a depressive episode increased the chance of a heart attack by more than fourfold. Researchers at Duke University Medical Center recently found that a stress-management program reduced the likelihood of a heart attack or the need for surgery in cardiac patients by 74%.
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