Approximately 50 million Americans have hypertension -- systolic blood pressure of greater than 139 mm Hg or a diastolic blood pressure of greater than 89 mm Hg.
Although stress is not a direct cause of hypertension, in these day of long work days, holiday pressures, and constant status updates, stress has become a prevalent part of people's lives.
Its effects on blood pressure, therefore, are becoming more relevant and important.
• Stress can lead to repeated blood pressure elevations, which eventually may to hypertension.
• Stress factors affecting blood pressure include white coat hypertension, job stress, race and, social environment, and emotional factors..
• When one risk factor is coupled with other stress producing factors, the effect on blood pressure is multiplied.
To talk about stress factors that can affect blood pressure and how to manage both for better long-term health is Dr. Ellen Lunenfeld, Summit Medical Group hypertension specialist.
Selected Podcast
Can Stress Raise Your Blood Pressure?
Featured Speaker:
Ellen Lunenfeld, MD
Ellen Lunenfeld, MD, FASN, FACP, is an internist specializing in clinical hypertension, kidney disease, and internal medicine, with a focus on preventive care. In addition to her position at Summit Medical Group, Dr. Lunenfeld teaches and supervises residents in nephrology and hypertension at Overlook Medical Center in Summit, New Jersey, and she is a member of the Memorial Sloan-Kettering Cancer Center Consultant Medical Staff. She is a member of the American College of Physicians, Medical Society of New Jersey, Union County Medical Society, and American Society of Nephrology. Transcription:
Can Stress Raise Your Blood Pressure?
Melanie Cole (Host): Approximately 50 million Americans have hypertension, and although stress is not a direct cause of hypertension or high blood pressure, in these days of long work hours and holiday pressures and constant status updates, stress has become a more prevalent part of all of our lives. My guest today is Dr. Ellen Lunenfeld. She is a Summit Medical Group board-certified nephrologist and a hypertension specialist. Welcome to the show, Dr. Lunenfeld. So tell us a little bit about stress and its relationship to blood pressure, because we’re seeing so much stress today and we’re seeing so many people with high blood pressure.
Dr. Ellen Lunenfeld (Guest): Well, Melanie, as you said, stress is not a confirmed risk factor for hypertension. That doesn’t mean that hypertension isn’t affected by our level of stress. Certainly on the short-term basis, when we’re under stress, our blood pressure goes up, we get into this fight and flight response, and we’re really not sure how being under chronic stress really can affect you in the long term. There are a lot of things that we can do to manage our stress though, and additionally, when we’re under stress, we don’t have healthy behaviors, which really can impact our blood pressure.
Melanie: So can stress, as it happens right then, like if your children are throwing a tantrum, if you’re somebody with high blood pressure, right then and there, that kind of stress, will that raise your blood pressure?
Dr. Lunenfeld: It will raise your blood pressure temporarily, and in patients who have high blood pressure, they may have higher readings during that time. That doesn’t mean that it’s a cause of the chronic hypertension that people develop, however.
Melanie: Can you feel when your blood pressure -- because I’ve heard people, Dr. Lunenfeld, who say to me, “I feel my blood pressure going up,” as they’re getting mad about something or stressed out about something. Can you feel it when your blood pressure rises?
Dr. Lunenfeld: You might not necessarily feel the blood pressure itself, but you certainly can feel the effects of the high blood pressure. You can feel when you have constriction of blood vessels and you have more adrenaline and cortisol going through your body. You can definitely feel that. Whether or not you actually feel the blood pressure itself being higher, I’m not always so sure.
Melanie: So what about stresses that we might encounter just visiting the doctor—white coat hypertension, job stress, these kinds of things? What do you recommend that people do about that?
Dr. Lunenfeld: Any type of relaxation that you can do, whether it’s exercise or mindful thinking, certainly can help lower those stress levels even in a temporary basis and can help lower the blood pressure when those things happen.
Melanie: So I’m glad you brought up exercise, Dr. Lunenfeld, because it’s been shown to lower blood pressure up to four hours post one bout of exercise. So speak about what you would like somebody to do when you say exercise. To try and relieve some of that stress, what do you want them to do?
Dr. Lunenfeld: At least 40 minutes of some type of aerobic exercise, ideally four to five times per week would be recommended, whether that’s a brisk walk, a Zumba class, or anything that really is something that you enjoy would certainly be recommended.
Melanie: And what about medication? If you’re on medication, diuretics and beta blockers, and all these things to keep your blood pressure down, can it still raise your blood pressure if you’re under stress?
Dr. Lunenfeld: Yes. Stress could definitely raise your blood pressure when you are experiencing a stressful event, even if you are on blood pressure medications.
Melanie: Okay. So, people really need to figure out a way to manage their stress. What else would you like them to know about blood pressure and keeping that under control, including medication adherence?
Dr. Lunenfeld: Well, I think that when people are under stress, especially during the holiday season, many times the healthy behaviors we think about throughout the year kind of get pushed to the wayside. Whether that’s following a heart-healthy diet, especially a diet like the Dash Diet, which can help lower blood pressure, exercising, or also maintaining a healthy weight as soon as we have those holiday pounds. Maintaining all of those things that we do throughout the rest of the year to help control the healthy aspects of our behavior certainly can help control the blood pressure for the long term.
Melanie: So now, what about something like stress reduction techniques that maybe people haven’t tried before—yoga, acupuncture, massage—any of these kinds of things, can they help if done regularly or even on a one-time basis for a bout of high blood pressure?
Dr. Lunenfeld: I think of course they can. Again, yoga is a wonderful exercise, taking care of your mood, recognizing when you have control over a situation and when you don’t so that you can keep yourself more mindful of what can lower your level of stress. All of those things help quite a bit.
Melanie: What about sleep? Where does that play in this stressful society? So, many of us have trouble sleeping at night because our minds are going. What advice do you have for listeners, Dr. Lunenfeld, about sleep and its relation to stress as it would relate to high blood pressure?
Dr. Lunenfeld: I think many people you, again, have trouble turning things off at night. We are kind of addicted to our smartphones and we’re watching those at night, we’re watching TV, and we’re not really getting ready for a good night’s sleep. Sometimes turning off those things, getting back to an old book, or resting, not having caffeine right before bedtime, really giving your mind some time to turn off, as it were, can really help you get some rest that you need.
Melanie: That’s so important, good sleep hygiene, as they call it. What about time management? I think that is one of the major causes of stress right now is that people are trying to do so many things, especially women, Dr. Lunenfeld. What advice do you have for women that are trying to multitask and also might be battling hypertension?
Dr. Lunenfeld: Two little things that I would say. One is give yourself real expectations about how long things take. Don’t try to get something done in 15 minutes if it’s going to take 30 minutes. You can’t always do that, but as much as you can, if you’re chronically estimating that it’s going to take you less time, you’re always going to be under more stress. And also, especially for women, as you said, learning sometimes that you have to say no. If you can’t get it done and it’s just going to make you under more stress to try to get something that really can’t be done, sometimes you have to say no.
Melanie: What relationship is stress to heart disease?
Dr. Lunenfeld: Again, there hasn’t been a clear proven relationship between stress and heart disease, but certainly, when people are under higher stress, they eat poorly, they don’t exercise, they don’t maintain a healthy weight, and all of those things have definitely been proven to have a relationship between heart disease.
Melanie: Now, what about your social network? Help? You said say no sometimes. What about getting help? Are there ways that this can actually reduce your stress, or does it sometimes increase it?
Dr. Lunenfeld: I think it really depends on the people that you’re around. Being around people who help you with your stress levels, who make you calmer and who are supportive would be very important for maintaining a healthy lifestyle and maintaining your stress level.
Melanie: Well, it’s important, and maintaining our emotions, managing our emotions. Can our emotions and the way that we are -- you know, if it’s a chronic stress or a job loss or the loss of a spouse or a loved one, can those make your blood pressure worse on a regular basis?
Dr. Lunenfeld: Certainly if you’re experiencing these things and you’re under stress and you have too much of the fight and flight response going on permanently, yes, you can have more high blood pressure because of those things. And again that’s where relaxing when you can, spending time in relationships that are more supportive and nurturing, and doing some self-maintenance, whether it’s exercise, enjoying the activities that you find enjoyable to you can be helpful.
Melanie: What about taking your blood pressure, Dr. Lunenfeld? How often do you recommend people with hypertension take their blood pressure?
Dr. Lunenfeld: I really find that for many patients, it’s a personal thing. I do have many patients who get very anxious when they’re checking their blood pressure, and for them it can really be a counterintuitive thing where checking their blood pressure makes them more anxious and raises the blood pressure. But for other people, feeling a sense of control and knowing how their blood pressure is doing on a regular basis certainly helps them and their physician manage their blood pressure. And for them, I usually recommend a number of times per week and varying it throughout the day as a way to get a good sense of how your blood pressure is doing on a regular basis.
Melanie: In just the last minute or two, Dr. Lunenfeld, please give your best advice on controlling stress to help manage blood pressure and why people should come to Summit Medical Group for their care.
Dr. Lunenfeld: Again, controlling your stress is going to help you lead a healthier lifestyle, help you get more rest, and hopefully help you maintain your healthy weight, get the exercise that you need, and have a healthier diet. By going to the Summit Medical Group, you’re going to get a group of providers who are all related to each other, who know all of your care and can help manage those things, whether it’s, again, acupuncture, getting exercise through yoga, seeing your internist, or seeing a specialist when you need it.
Melanie: It’s a real multidisciplinary approach, and thank you so much, Dr. Ellen Lunenfeld. You’re listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.
Can Stress Raise Your Blood Pressure?
Melanie Cole (Host): Approximately 50 million Americans have hypertension, and although stress is not a direct cause of hypertension or high blood pressure, in these days of long work hours and holiday pressures and constant status updates, stress has become a more prevalent part of all of our lives. My guest today is Dr. Ellen Lunenfeld. She is a Summit Medical Group board-certified nephrologist and a hypertension specialist. Welcome to the show, Dr. Lunenfeld. So tell us a little bit about stress and its relationship to blood pressure, because we’re seeing so much stress today and we’re seeing so many people with high blood pressure.
Dr. Ellen Lunenfeld (Guest): Well, Melanie, as you said, stress is not a confirmed risk factor for hypertension. That doesn’t mean that hypertension isn’t affected by our level of stress. Certainly on the short-term basis, when we’re under stress, our blood pressure goes up, we get into this fight and flight response, and we’re really not sure how being under chronic stress really can affect you in the long term. There are a lot of things that we can do to manage our stress though, and additionally, when we’re under stress, we don’t have healthy behaviors, which really can impact our blood pressure.
Melanie: So can stress, as it happens right then, like if your children are throwing a tantrum, if you’re somebody with high blood pressure, right then and there, that kind of stress, will that raise your blood pressure?
Dr. Lunenfeld: It will raise your blood pressure temporarily, and in patients who have high blood pressure, they may have higher readings during that time. That doesn’t mean that it’s a cause of the chronic hypertension that people develop, however.
Melanie: Can you feel when your blood pressure -- because I’ve heard people, Dr. Lunenfeld, who say to me, “I feel my blood pressure going up,” as they’re getting mad about something or stressed out about something. Can you feel it when your blood pressure rises?
Dr. Lunenfeld: You might not necessarily feel the blood pressure itself, but you certainly can feel the effects of the high blood pressure. You can feel when you have constriction of blood vessels and you have more adrenaline and cortisol going through your body. You can definitely feel that. Whether or not you actually feel the blood pressure itself being higher, I’m not always so sure.
Melanie: So what about stresses that we might encounter just visiting the doctor—white coat hypertension, job stress, these kinds of things? What do you recommend that people do about that?
Dr. Lunenfeld: Any type of relaxation that you can do, whether it’s exercise or mindful thinking, certainly can help lower those stress levels even in a temporary basis and can help lower the blood pressure when those things happen.
Melanie: So I’m glad you brought up exercise, Dr. Lunenfeld, because it’s been shown to lower blood pressure up to four hours post one bout of exercise. So speak about what you would like somebody to do when you say exercise. To try and relieve some of that stress, what do you want them to do?
Dr. Lunenfeld: At least 40 minutes of some type of aerobic exercise, ideally four to five times per week would be recommended, whether that’s a brisk walk, a Zumba class, or anything that really is something that you enjoy would certainly be recommended.
Melanie: And what about medication? If you’re on medication, diuretics and beta blockers, and all these things to keep your blood pressure down, can it still raise your blood pressure if you’re under stress?
Dr. Lunenfeld: Yes. Stress could definitely raise your blood pressure when you are experiencing a stressful event, even if you are on blood pressure medications.
Melanie: Okay. So, people really need to figure out a way to manage their stress. What else would you like them to know about blood pressure and keeping that under control, including medication adherence?
Dr. Lunenfeld: Well, I think that when people are under stress, especially during the holiday season, many times the healthy behaviors we think about throughout the year kind of get pushed to the wayside. Whether that’s following a heart-healthy diet, especially a diet like the Dash Diet, which can help lower blood pressure, exercising, or also maintaining a healthy weight as soon as we have those holiday pounds. Maintaining all of those things that we do throughout the rest of the year to help control the healthy aspects of our behavior certainly can help control the blood pressure for the long term.
Melanie: So now, what about something like stress reduction techniques that maybe people haven’t tried before—yoga, acupuncture, massage—any of these kinds of things, can they help if done regularly or even on a one-time basis for a bout of high blood pressure?
Dr. Lunenfeld: I think of course they can. Again, yoga is a wonderful exercise, taking care of your mood, recognizing when you have control over a situation and when you don’t so that you can keep yourself more mindful of what can lower your level of stress. All of those things help quite a bit.
Melanie: What about sleep? Where does that play in this stressful society? So, many of us have trouble sleeping at night because our minds are going. What advice do you have for listeners, Dr. Lunenfeld, about sleep and its relation to stress as it would relate to high blood pressure?
Dr. Lunenfeld: I think many people you, again, have trouble turning things off at night. We are kind of addicted to our smartphones and we’re watching those at night, we’re watching TV, and we’re not really getting ready for a good night’s sleep. Sometimes turning off those things, getting back to an old book, or resting, not having caffeine right before bedtime, really giving your mind some time to turn off, as it were, can really help you get some rest that you need.
Melanie: That’s so important, good sleep hygiene, as they call it. What about time management? I think that is one of the major causes of stress right now is that people are trying to do so many things, especially women, Dr. Lunenfeld. What advice do you have for women that are trying to multitask and also might be battling hypertension?
Dr. Lunenfeld: Two little things that I would say. One is give yourself real expectations about how long things take. Don’t try to get something done in 15 minutes if it’s going to take 30 minutes. You can’t always do that, but as much as you can, if you’re chronically estimating that it’s going to take you less time, you’re always going to be under more stress. And also, especially for women, as you said, learning sometimes that you have to say no. If you can’t get it done and it’s just going to make you under more stress to try to get something that really can’t be done, sometimes you have to say no.
Melanie: What relationship is stress to heart disease?
Dr. Lunenfeld: Again, there hasn’t been a clear proven relationship between stress and heart disease, but certainly, when people are under higher stress, they eat poorly, they don’t exercise, they don’t maintain a healthy weight, and all of those things have definitely been proven to have a relationship between heart disease.
Melanie: Now, what about your social network? Help? You said say no sometimes. What about getting help? Are there ways that this can actually reduce your stress, or does it sometimes increase it?
Dr. Lunenfeld: I think it really depends on the people that you’re around. Being around people who help you with your stress levels, who make you calmer and who are supportive would be very important for maintaining a healthy lifestyle and maintaining your stress level.
Melanie: Well, it’s important, and maintaining our emotions, managing our emotions. Can our emotions and the way that we are -- you know, if it’s a chronic stress or a job loss or the loss of a spouse or a loved one, can those make your blood pressure worse on a regular basis?
Dr. Lunenfeld: Certainly if you’re experiencing these things and you’re under stress and you have too much of the fight and flight response going on permanently, yes, you can have more high blood pressure because of those things. And again that’s where relaxing when you can, spending time in relationships that are more supportive and nurturing, and doing some self-maintenance, whether it’s exercise, enjoying the activities that you find enjoyable to you can be helpful.
Melanie: What about taking your blood pressure, Dr. Lunenfeld? How often do you recommend people with hypertension take their blood pressure?
Dr. Lunenfeld: I really find that for many patients, it’s a personal thing. I do have many patients who get very anxious when they’re checking their blood pressure, and for them it can really be a counterintuitive thing where checking their blood pressure makes them more anxious and raises the blood pressure. But for other people, feeling a sense of control and knowing how their blood pressure is doing on a regular basis certainly helps them and their physician manage their blood pressure. And for them, I usually recommend a number of times per week and varying it throughout the day as a way to get a good sense of how your blood pressure is doing on a regular basis.
Melanie: In just the last minute or two, Dr. Lunenfeld, please give your best advice on controlling stress to help manage blood pressure and why people should come to Summit Medical Group for their care.
Dr. Lunenfeld: Again, controlling your stress is going to help you lead a healthier lifestyle, help you get more rest, and hopefully help you maintain your healthy weight, get the exercise that you need, and have a healthier diet. By going to the Summit Medical Group, you’re going to get a group of providers who are all related to each other, who know all of your care and can help manage those things, whether it’s, again, acupuncture, getting exercise through yoga, seeing your internist, or seeing a specialist when you need it.
Melanie: It’s a real multidisciplinary approach, and thank you so much, Dr. Ellen Lunenfeld. You’re listening to SMG Radio. For more information, you can go to summitmedicalgroup.com. That’s summitmedicalgroup.com. This is Melanie Cole. Thanks so much for listening.