Anxiety or High Blood Pressure: A Physician Explains Difference

Anxiety or High Blood Pressure? Know the difference. With Dr. Gregory Geiger.

Anxiety or High Blood Pressure: A Physician Explains Difference

Anxiety and stress can make the heart beat faster and the blood vessels tighten, leading to temporary high blood pressure. Symptoms can include chest tightness, fast pulse, headaches, and dizziness. Dr. Gregory Geiger, a SIMEDHealth Family Medicine physician explains the difference between anxiety and high blood pressure, diagnosis and treatment, and when to be concerned about your heart health.

Dr. Geiger helps patients understand and manage their mental and physical health.

To learn more about Gregory Geiger, MD, click here.

To schedule an appointment with SIMEDHealth Primary Care, click here.

Dr. Geiger is located: 4343 Newberry Road, Gainesville, Florida 32607.

 

 

Blood pressure, explained: what “high” means, why it matters, and what you can do. Blood pressure is the force of blood pushing against the walls of your arteries. It’s written as two numbers:

  • Systolic (top number): pressure when the heart squeezes
  • Diastolic (bottom number): pressure when the heart relaxes between beats

1) What is high blood pressure?

High blood pressure (hypertension) means your blood pressure is higher than it should be, often without you feeling any symptoms.

The American Heart Association 2025 guidelines classify blood pressure as:

  • Normal: less than 120/80
  • Elevated: 120–129 systolic and less than 80 diastolic
  • High blood pressure (Stage 1): 130–139 systolic or 80–89 diastolic
  • High blood pressure (Stage 2): 140+ systolic or 90+ diastolic
  • Hypertensive crisis: 180/120 or higher (especially concerning if symptoms are present)

2) Why is high blood pressure concerning?

High blood pressure is often called a “silent” condition because you can feel fine while damage accumulates over time.

Uncontrolled high blood pressure raises the risk of:

  • Heart disease (including heart attack and heart failure)
  • Stroke
  • Kidney disease (worsening kidney function)
  • Other blood vessel damage throughout the body

Because it’s so common and often without symptoms, routine screening is strongly recommended for adults.

3) How is high blood pressure diagnosed?

A single high reading does not always mean you “have hypertension.” Diagnosis usually involves:

  • Properly measured readings, on more than one occasion, and
  • Confirmation with readings outside the clinic (home monitoring or ambulatory monitoring).

Why technique matters: small mistakes (like poor arm support or wrong cuff size) can make readings falsely high or low.

Recommendations for ensuring an accurate measurement:

Before taking a blood pressure one should:

  • Avoid caffeine, exercise, and smoking for about 30 minutes beforehand.
  • Empty your bladder if needed (a full bladder can raise readings).
  • Sit quietly for at least 5 minutes before measuring.

Body position

  • Sit upright in a chair with your back supported.
  • Keep feet flat on the floor and legs uncrossed.
  • Rest your arm on a table or armrest so the cuff is at heart level.
  • Place the cuff on a bare upper arm (not over clothing) and make sure the cuff size fits your arm.

During the reading

  • Stay still, don’t talk, and breathe easy.
  • Take two readings, about 1 minute apart, and record both.

If your readings in the clinic are high, your clinician may recommend home blood pressure monitoring or 24-hour ambulatory blood pressure monitoring to confirm what your blood pressure is doing in real life.

4) Can anxiety affect blood pressure?

Yes. Stress and anxiety can temporarily raise blood pressure as part of the body’s “fight-or-flight” response (stress hormones make the heart beat faster and blood vessels tighten). When the stress passes, blood pressure often returns toward baseline.

5) Are there detectable signs to reassure that the blood pressure is high because of anxiety?

There isn’t a single symptom that can prove “this is only anxiety” — and it’s important not to assume that, because high readings (even if stress-related) may still signal increased future risk.

That said, there are patterns that make anxiety more likely:

Patterns that suggest anxiety-related elevation

  • Normal readings at home, but higher readings in the clinic.
  • Blood pressure drops after 5–10 minutes of quiet rest and repeat measurement (especially if the first reading was taken right after rushing in). (This aligns with recommended technique: rest, then recheck.)
  • Anxiety symptoms occur alongside the high reading (racing heart, sweating, trembling, feeling panicky), while repeat readings taken calmly are lower.

How clinicians check

  • Home monitoring over several days/weeks or ambulatory monitoring over 24 hours can help separate sustained hypertension from situational spikes.

A safety note: High blood pressure usually causes no symptoms, but very high readings with concerning symptoms need urgent evaluation. If a reading is around 180/120 or higher and you have symptoms like chest pain, shortness of breath, severe headache, weakness, confusion, or vision changes, seek emergency care.

6) What lifestyle changes can improve blood pressure?

Lifestyle changes can make a meaningful difference—sometimes comparable to medication —especially when several changes are combined.

Here are the best-supported steps:

Eat in a blood-pressure-friendly pattern (DASH-style)

  • Emphasize vegetables, fruits, whole grains, beans, nuts, and low-fat dairy, and limit saturated fat and highly processed foods.

Cut back on sodium (salt)

  • Many people improve blood pressure by reducing sodium—especially from packaged/restaurant foods.

Be physically active most weeks

  • A widely recommended target is at least 150 minutes per week of moderate activity (like brisk walking), plus muscle strengthening on 2+ days every week.

Reach and maintain a healthy weight

  • Even modest weight loss can improve blood pressure for many people.

Limit alcohol and avoid tobacco

  • Reducing alcohol and not smoking support healthier blood pressure and lower cardiovascular risk.

Sleep and stress management

  • Stress doesn’t always cause long-term hypertension by itself, but it can trigger spikes and can lead to habits that worsen blood pressure (poor diet, more alcohol, less sleep). Stress-management skills (activity, sleep routines, relaxation training) can help.