Stress And Hypertension

Stress Management

If a person is “Type A Personality” or if he has a stressful lifestyle, then he is bound to have high blood pressure. Type A personality means a person who is competitive, intense, impatient and who is always in a hurry to meet deadlines. These are the common beliefs which the people have about hypertension. But it is not true. There are many type A individuals with normal blood pressure just as there are relaxed people with high blood pressure.

Stress can increase your blood pressure temporarily. When you are scared, nervous, or under a tight deadline your blood pressure naturally increases. But in most cases once you begin to relax, your blood pressure goes back down again. If you have high blood pressure, simply reducing your stress level may not lower your blood pressure. But managing stress is important for other reasons. Less stress often results in the following:

  1. Better control of blood pressure: The temporary increases in blood pressure caused by stress can make our high BP more difficult to manage. When we are under less stress, our lifestyle changes and medicines may work more effectively.
  2. A more positive attitude: Stress can interfere with and dampen our enthusiasm to take control of our high BP. It is easier to be physically active, eat healthy, lose weight and limit alcohol/ cigarette when we are relaxed and happy. There are many ways to manage stress. We may have to experiment with the various techniques until we find those stress relievers that fit our lifestyle and daily routine.


Imagine stress to be sugar. Too little sugar results in a bitter coffee or tea, and too much sugar makes the same coffee or tea like a sweet dish. But when we use the correct amount, the sugar enhances the taste of the drink.

Stress can be negative or positive. Negative stress occurs when we feel out of control or under constant pressure. We may have trouble concentrating on a project. We may feel isolated from others. Family, finances, work, isolation are all common causes of negative stress. The death of a near and dear one can make one feel very stressed out.

Positive stress provides us a feeling of excitement and opportunity. We may feel confident when approaching a situation. Among athletes positive stress often helps them perform better in competition than in practice. This positive stress acts as a ‘Driving Force’. Other examples of positive stresses may include a new job, marriage, birth of a child, etc.

Stress is also highly individualised. Some people cope well with difficult or tense situations. Others melt under the pressure. What may be a ‘stressor’ for one person may not cause stress in another. What may be a positive stress for one may be a negative stress for the other and vice versa. Failure in a school examination may be a positive stress for some students. They may take it as a challenge and work hard to get great marks in their next exam. Some shldents may become gloomy and drop out of school. Here the same failure works as positive and negative stress in different people.

It is up to the individual person whether to make a stress a positive or a negative one. Stress makes or breaks a person.

Stress Response

When dealing with a frightful event or an ongoing tension in our life our body’s physical response to any stressor is similar to a physical threat. Our body gears up to face the challenge (fight) or muster enough strength to move out of trouble’s way (flight).

This ‘fight’ or ‘flight’ response results from the release of an assortment of hormones that cause our body to shift into overdrive. Among them are the hormones, adrenaline and cortisol, which cause our heart to beat faster and our blood pressure to increase. Other physical changes also occur. More blood and nutrients are sent to our brain and muscles and less to our skin. That is why a person looks pale during moments of fright or high stress. Our body also releases a chemical fibrin that makes our blood clot more easily.

In case of a physical attack this would help slow or stop a bleeding wound. Our nervous system also springs into action. Pupils dilate to enhance our vision. Facial muscles tense up to make us look more intimidating. Perspiration increases to cool our body. Our body gives out signals to warn us when we are under too much stress. We become discouraged, irritable, cynical, emotional or even reclusive. All of these emotions affect our thinking capacity, our feelings and action. However, sometimes these changes are easily missed because they build up gradually over a long time.

Physical symptoms are easily perceived and are difficult to ignore. These include a headache, stomach upsets, insomnia, fatigue, frequent illness. A person may develop nervous habits such as biting his nails, smoking or even drinking alcohol. Some persons may even go into drug abuse and addiction.

Stress and Blood Pressure

The hormones Adrenaline and Cortisol released during the period of stress increase blood pressure by bringing about vasoconstriction (narrowing of blood vessels) and increasing the heart rate.

The increase in blood pressure caused by stress varies. In some, stress causes only a small increase in blood pressure. In others stress can produce extreme jumps in blood pressure. Although the effects of stress are usually only temporary, if we experience stress regularly, the increases in blood pressure it produces can, over time, damage our arteries, heart, brain, kidneys and eyes, just as with persistent high blood pressure.

Stress-relieving Strategies

We may be aware of the stress in our daily life but we may not know how to handle it. Making some changes in our normal routine can lessen our stress load. The various methods and strategies to cope up with stress are:

a) Get organised: We should become more methodical in our approach. Preparing a written schedule of our daily activities helps us to avoid last minute rushes and conflicts in reaching a particular place to keep up an appointment or in doing a particular work/activity in the scheduled time.

b) Simplify your schedule: We must adopt a relaxed pace. We must take up a practical approach. Instead of saying, “Yes! I can do,” blindly to everyone and everything we must not hesitate to say, ‘No’ to extra responsibilities that we can’t tackle. We must ask others to help in case we find something difficult to handle.

c) Exercise: Exercise not only controls blood pressure but also burns off the nervous energy that stress produces. Exercise must be at least done for 30 minutes most days of the week.

d) Eat well: A well balanced diet with all the nutrients is a must. It can make the immune system work well and also keeps our other body systems healthy. A healthful diet include grains, fruits, vegetables, low fat dairy products in the right amount.

e) Get plenty of sleep: When we are refreshed, we are better able to tackle the next day’s problems. Going to sleep and awakening at a consistent time each day can help us sleep well. A bed time ritual such as a warm bath, reading or a snack also helps many people relax.

f) Improve your appearance: When a person gets a hair cut, manicure or a new outfit, he feels better. Looking better will make one feel better. Improving one’s appearance gives a tremendous boost to one’s self-esteem.

g) An occasional break: Getting away from our regular routine and the stresses in our life gives a refreshing change. Taking a vacation even if it is just for a weekend can give us change and break from our stressful problems. Seeing a movie, enjoying a meal out, taking short breaks to stretch, walk, breathing deeply, relaxing in between the office or house work gives a lot of relief from a stressful routine.

h) Maintain good social relationships: Friends and family not only provide a release value that lets us vent our frustrations, they can also give us helpful advice that points us toward solutions. However, one must avoid talking with friends and family members who tend to be negative about everything and who foster bad feelings.

i) Practise positive thinking: We must use positive “Self-talk” to tone down our critical or negative feelings. Self-talk, also called ‘Auto Suggestion’, refers to all of the things that we say to ourself all of the thoughts that run through our head. For example, instead of, “I should never make a mistake,” we must say, “I will try to be more careful next time.” This approach creates less intense negative feelings. We can also practise old adages such as “Look for the silver lining in every cloud” and “Don’t make mountains out of molehills.” Overambitious persons must recall the adage, “Rome was not built in a day.” Only slow, sustained effort yields result rather than doing something in a feverish pitch.

j) Schedule worry time: Setting aside time for problem solving can keep our worries from adding up. Devote a half hour each day to work on solutions to problems. If a worry crops up outside of “worry time” write it down and worry about it later. This is the latest method prescribed by the counsellors.

k) Humour: Laughter is a great healer. It releases chemicals like endorphin, serotonin, etc., in our brain that ease pain and enhance a feeling of well being. It also stimulates our heart, lungs and muscles. Just 20 seconds of laughter produces an oxygen exchange that equals three minutes of aerobic exercise. Finding a movies that makes us laugh out loud and books by cartoonist and comedy writers that we enjoy are ways to be happy, jovial and stress free.

Relaxation Techniques

Not all stress is avoidable. There are certain events in life that we cannot prevent such as getting struck in an unexpected traffic jam, heavy rains all of a sudden, etc. But we can reduce the emotional and physical toll these events can cause. When we are feeling stressed we can take a few minutes to relax our body and clear our head. The following exercises are designed to help just do this skill. We need to practise it daily.

1. Deep Breathing: Unlike children (abdominal breathing) most of the adults breathe from their chest. Each time we breathe in, our chest expands and each time we breathe out it contracts. Children breathe from their diaphragm, the muscle that separates the chest from the abdomen. Deep breathing from our diaphragm-which adults can relearn-is relaxing. It also exchanges more carbon dioxide for oxygen to give us more energy. Here is an exercise to help us practise deep, relaxed breathing.

Step 1. Wear comfortable, loose clothes. Lie on bed or a padded floor.

Step 2. Place the feet slightly apart, resting one hand on your abdomen near your navel. Put your other hand on to your chest.

Step 3. Inhale through your nose. This filters and warms the air. Exhale through your mouth.

Step 4. Concentrate on the breathing for a few minutes and notice which hand is rising with each breath.

Step 5. Gently exhale most of the air from your lungs.

Step 6. Inhaling should be done while slowly counting to 4 about 1 second/count. As you inhale you must raise your abdomen about an inch. Movement should be felt by the hand, chest not to be moved and shoulders not to be raised up.

Step 7. As you breathed in you must imagine air to be flowing to all parts of the body, supplying you with cleansing and energising oxygen.

Step 8. Pause for a second with air in the lungs. Then slowly exhale counting to 4. Feel the abdomen slowly fall as the diaphragm relaxes. Tension seems to flow out of you. Imagine and reinforce this thought.

Step 9. After a ‘pause’ for a moment, repeat this exercise for 1 to 2 minutes until you feel better. If you experience light-headedness shorten the length or depth of your breathing.

2. Muscle tension exercises: When tension mounts it can tighten your muscles, especially in your shoulders. To relieve the tightness you must roll your shoulders, raising them toward your ears. Then relax your shoulder. To reduce neck tension you must move your head gently in a circle going clockwise, then anti-clockwise. Relieve tension in your back and torso, you must reach toward the ceiling and do side bends. For foot and leg tension you must draw circles in the air with your feet while flexing your toes. Daily stretching exercises also help reduce muscle tension.

3. Guided imagery: Also known as visualisation, this method of relaxation involves lying quietly and picturing yourself in a pleasant and peaceful setting. You experience the setting with all of your senses, as if you were actually there. You must imagine the sounds, scents, warmth, breezes and colour of this comforting place. The messages your brain receives as you experience these senses helps your body to relax.

4. Meditation: It involves sitting in a comfortable position and repeating a sound or word for 20 minutes usually twice a day. Your goal is to clear your mind of all distracting thoughts and reach a restful state. Instead of repeating a sound or word you can contemplate or concentrate on a particular word, symbol or thought. Keep your eyes closed and relaxed, this also helps.

5. Bio feedback: This technique helps you control body functions that you normally cannot-such as heart rate, breathing, skin temperature and even your blood pressure. Bio feedback requires the assistance of a certified bio feedback therapist and usually several training sessions. Electrodes that monitor body functions are attached to a person’s skin and a device such as a beeper or a flashing light alerts him when a certain function is beyond his target range. Then, using relaxation exercises or other strategies he learns how to change the function until it is within his target range.

6. Professional help: Sometimes life’s stresses can pile up and become more than what a person can handle or deal with on his own. In such a situation he can consider getting help from his family doctor, a community health organisation or a spiritual leader. There is nothing wrong in seeking help from outside. It is not a sign of weakness but strength of character to admit that he needs help. Learning how to control stress won’t guarantee a relaxed life, good health and normal blood pressure. Unexpected problems can occur. But having tools to deal with the stress can make those problems easier to face and overcome-and our blood pressure easier to control. A simple relaxation technique is given below. This can be practised by anybody. This stress relief involves blocking out the world and concentrating specifically on relaxing your body.

Step 1. Sit or lie in a comfortable position and close your eyes. You must allow your jaws to drop, make your eyelids heavy and relaxed (but not tightly closed).

Step 2. Mentally scan your body. Start with toes and work slowly up to the legs, back, torso, arms, hands, fingers, neck, head, face. As you do this, you must tighten each set of your muscles and hold them for a count of six before relaxing. As the muscles relax, you must imagine that your tension is melting away.

Step 3. During this exercise thoughts will flow through your mind. You must let the thoughts come and go without dwelling on them.

Step 4. Many people find that auto suggestion or mind over matter helps. You can suggest to yourself that you are relaxed and calm; your hands are heavy and warm (or cool if you are hot), that your heart is beating calmly and that you are at perfect peace.

Step 5. Breathe slowly, regularly and deeply during the exercise.

Step 6. Once you are relaxed, you must imagine yourself to be in a favourite place or in a spot of beauty and peace.

Step 7. After 5 to 10 minutes, you can gradually rouse yourself.

From the above discussion we have learnt three important points. They can be summarised as:

  1. Stress can increase your blood pressure temporarily and aggravate the existing high blood pressure. Over a period of time physical effects of stress can be damaging to your health.
  2. Although reducing stress may not lower your blood pressure, it can make your blood pressure easier to control.
  3. Lifestyle changes, relaxation techniques and professional assitance can help you avoid or manage stress.