Blood pressure spikes due to anxiety - SSRI medication or natural methods?

I have been suffering with blood pressure spikes for about one year and I believe it is due to being anxious. I get nervous at the doctors office and it is very high. Last reading was 198/90. I got home and did deep breathing and relaxed and it was 122/70. I am on three different bp medications and have a new doctor who wants to put be on Lexapro and send me to a cardiologist. I take it at home and meter was checked to be accurate in her office. I can get readings at home from 165/90 down to 115/72 but spikes every day. The doctor is new for me and insists that they have to get a blood pressure reading in their chart for me that is textbook - 130/80 no higher. I have told her that I am too anxious. I do have Zanax for when i need it and take one .50 tablet when I am under extreme anxiety. Do I try to do natural ways of reducing the anxiety? What has worked for people the best? SSRI medications or exercise, yoga, meditation deep breathing? My PCP doctor says that all natural sounds good but this is putting my heart at risk. I am a 61 year old female; no other health issues. Walk 30 minutes every day. Could lose 30 pounds. Do have anxiety for sure and have had for most of my life. I am at a loss as to what to do? I do have an appointment with a cardiologist as my PCP is insisting. What have others done in this situation to reduce blood pressure spikes. What have you been told by your doctors and what if any tests have they done - stress test? echo or nothing?

18 Replies

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  • Sounds like you suffer 'white coat syndrome' to me. Ask for a 24 hour monitor at gps it will show how you are throughout your normal day, then the dr can decide from there. I had many instances like yourself until they confirmed wcs. The other thing is to note any of your home readings to take to the drs.

    Also no two of us are the same and there must be an allowable variation in our readings, not just what the book says. Also age, and as you know lifestyle can also play a part.

    When does it spike? After a meal or hot drink? Or when 'relaxing'?

  • Thanks for your reply. About 15 years ago I did a 24 monitor and was very stressed during the entire time and gave up on it. My readings are pretty good almost 70% of the time at home; but just thinking about taking my bp at home or at the doctor's office gets me stressed. When I calm down; it usually is in a good range. It spikes when I get my first reading normally and then when I relax it goes down very well unless under extreme aniexty. Working at trying to relax as much as possible. It's a hard thing to get under good control .

  • perhaps if you can get your anxiety under control that will benefit the blood pressure, like Lisahelen said, it's probably the white coat syndrome, which I also have, I take a full weeks readings at home, day and evenings, and take them to my surgery. I often wonder if patients are put on b/pressure meds unnecessarily after visiting the Dr's surgery with W.C.Syndrome.

  • Thanks for your reply and I totally agree with you. My doctor feels that if I can get stressed taking by b/p in her office; how do I do when I am stressed at other times and this is a concern for her. I am going to take readings three times a day for at least a month and see what they are. I agree that some patients are put on meds when maybe they don't need to be.

    I just need to try to get anxiety under control... working on it.

  • I agree! My life is VERY stressful with uncontrolable circumstances coming up ! That is why I go to Florida for a couple of months in the winter just to get away from stress..I am good while away.

    So I guess the answer is that we have to get some tough skin on us or maybe get numb to negativity!

  • yes..some people are on pb meds that do not need them. Its all about the $ and the kick backs the drug companies pay the DR.s...we are $ to the these people!

  • You are a carbon copy of me..I have anxiety just knowing I have to go to the DR. my bp goes up! It is a visciouse circle..we tend to be zoomed in on our BP and worry to much about it, the worry causes anxiety and fear, in the back of our mind the DR,s stress us out by saying the word "your going to have a stroke" !! I am 140/80 when i leave home for the Dr.s visit but as soon as the Dr. reaches for that dreaded pb cuff I can shoot up to 190/90. in a second.when i get home it is back down. Which means we have to learn coping skills in certain situations try to think more positive. I believe with me my pb is from nerves, like you I have been nervouse and too sensative all my life also am a type A personality where I feel everything has to be right..I have been working on trying not to be a worry wart..I am learning worry does not fix anything, so why worry.

    Bp does not stay at one certain number, it fluctuates all day so being at 120/80 constantly is impossible, maybe if we were 20yrs. old ya. ( I am 67 female.) 5ft. 123 lbs. am active but have anxiety caused by stress which in turn causes my bp to go up. I stopped worring about my numbers because the worry was making me literally sick! I was taking my reading every few hr. a day was switching from one of 2 bp monitors a day, I was driving myself crazy. Now 4 yrs. later I take my reading once a day, sometimes every other day.

    The guidlines were 140/80 , recently read for people 60 and over those numbers were changed to 150/80.

    Losing weight most likely get your numbers down and try to stop worring about your bp so much..tell yourself "it is what it is"!

    Have you had any blood work? Have you had your thyroid checked? Kidney function?

    I have had stess test with my cardiologist a few monts ago. I had a nuclear stress test where they inject nuclear medication into you , followed up by pictures that show if there are any blockages in any of the arteries of the heart. Guess that is ok because i was not put on any meds,

    I wish you the best of luck . Please do post what is going on with your testing.

  • Hello and thank you for your helpful response. It is SO NICE to see someone else understands and has very similar issues. To answer a few of your questions; my blood work is fine; thyroid checked last year and was completely normal as it has been for years. Kidney function being checked next week; but in December was fine. She ordered a test to check for a rare adrenal tumor which would cause high blood pressure and anxiety.

    As I said she is new to me and clearly thinks this is a high risk for me to spike.

    I see a cardiologist in mid June and in my mind I hope he does not order anything as that will shoot up my anxiety.

    Are you on blood pressure medications? If so, what kind and dosage? My doctor seems concerned that with three medications I should be in better control; but in her setting at the doctor's office - now way. She said that if this is a normal response to stress; then clearly a problem for my heart and need to be on Lexapro or someother SSRI medication.

    I am working to get the excess pounds off; but its interesting that with your good weight that you struggled. Glad to hear that you are getting this under control and you are releasing the stress about it. Sounds like you are doing great and your heart test came out wonderful.

    I am learning yoga and doing some mediation; but at age 61 retraining my brain will take time. I too am a Type A and can be very nervous.

    Let's keep in touch. I am so appreciative of your reply.

    I will let you know how I progress and I too am not taking my bp that often. I did the same drill as you and was driving me crazy.

    Thanks again!

  • Hi...it was a pleasure talking to you also! I read your Dr. agrees on the white coat syndrome..my Dr. does not! That gives me anxiety and he wants to always up my med and that stresses me out big time! On my last visit of course my bp was up as it is every visit with him ..I finally spoke up and said NO for a month, except for one day out of the month and only when i come to see him it is high and the rest of the 29 days of the month it is fine so for only one day I am not letting you up my dose! I have documented my readings on paper for him to see ..he does not believe the numbers!

    Yes, I am on a pb med..right now I am on Verapamil 180 and will have to go onto something else next week..my Gastrointerologist wants me to get of this med and said it is causing me to bloat and have constipation and nausea.

    I am having a difficult time on meds, in the past 4 years, they have messed up my blood work numbers or the side affects are bad, one med caused me itch like crazy , one med felt like someone hit me in the forhead with a hammer, that was a bata blocker. Lisinopril after 2 yrs. caused my throat to close up and cough and choke so bad that i couldnt breath , gastr Dr. did an upper endoscopy which showed a beet red throat and stomach . The Gastro Dr.s diagnosis was " severe gastritus " caused from the lisinopril.

    I will tell my Dr. to test me for an adrenal gland disorder..how is that tested?

    With your being on 3 meds you should be in a good bp range. Does your bp only go up at the Dr.s office? How are your numbers at home?

    The cardiologist will be the best one to help you with the best meds that you should be on. Also it is a good idea to have the kidneys tested as they can trigger bp numbers also. If one of the tubes in your kidneys are narrowed that could make your bp high . I am seeing a kidney specialist next week also.

    It sounds like your Dr. is doing a great job by trying to get to the bottom as to why your numbers are up...that is a good DR.

    I once had a emergency room Dr. tell me that there is an underlying reason why people have high pb. however most Dr.s don't want to take the time to send their patients for testing to rule it out. You are on the right track and have a good Dr. that is taking the time to help get to the bottom of why.

    My email address is : maxyz3@aol.com if you would like to email me personally.

    Please keep me posted as to your testing.

    wishing you good luck, Maxine

  • Hi Maxine,

    Thanks for your information and your email address. I will email you soon so we can connect personally.

    I did have the adrenal test done which was 2 - 24 hour urine collections to measure Catecholamines - 24 hour fractionated and Metanephrine fractionated - 24 hour. Both test for an adrenal tumor; which is rare. My tests came back normal.

    This new doctor I am seeing ( as my old one retired) added so much stress on me and she is young and only saw her two times; but she had me come in twice to have BP taken. I also had to pay a co-pay. I told her over and over again that I have anxeity and that it is better at home but since now I am so stressed about taking it; it can be high at home.

    I have gotten good readings when I do not think about going in.

    She referred me to a cardiologist who I see in mid June and I decided to switch doctors. She made my stress levels climb and has no idea about anxiety other than to say I am at risk of heart attacks and strokes. All my other tests like lipid profile are fine and I have no trouble getting screenings for other things like bone density, mammagrams. It is just talking about BP that scares me.

    What I have learned is that we have to find a primary care doctor who will listen to us; and trust that we are taking our blood pressure and wil let them know if elevated. I am amazed how high it can spike; but then I am equally amazed how good it can be when I am relaxed. I am going to be working very hard at letting it go....

    Everyone - take a deep breath, relax and just do the best you can in that moment.

  • I was seen by a Nephrologist ( Kidney Specialist) yeasterday , He is ordering special blood work for the kidneys ,also an extensive urin analasis. Waiting for a kit to be delivered by mail for this. When finishes I have to call Fedex to pick it up, can take a few weeks to get results.

    Physician said he doesn't think I have kidney disease but need to see my primary care about my liver function...GREAT ..always something! I wish you the best in your testing!

  • hello Maxyz3

    You mentioned a test for Adrenals. it's called a "Synachen test" I have had the test done twice and now been told both my adrenals have packed up due to taking long term steroids, and waiting to see an Edocronologist I also have stage 3 kidney disease, so I need to keep my blood pressure in check, and like I said in my last post I always take my own blood pressure at home as I have the white coat syndrome . I am now taking Ramipril I did take Lisinopril but they made my potassium go way up, I also had a very dry cough with those.

  • Last month i have episodes of panic attacks, i think bcuz of that i developed "white coat syndrome".everytime i went to doctor's office i feel very nervous,wheb the nurse come to check my bp -my heart racing!so i know the result and yeah it so high.the highest is 190/100 im so scared!.im just 24 yrs old,so i don't take my bo meds since i hav hbp only when they'll take my bp.

  • Do you take your blood pressure at home? Hopefully you do and you know for sure that you do not need medication! I have worked very hard to get good readings at home; but still get anxious at the doctor's office. You are young; so try to get this under control as best you can. It will help your overall health. I am happy to say that I am doing very well at home with the medications that I am on. Best of luck to you!

  • clmgoal135 thanks! and yes my doc gave me 24hr bp monitoring.but everytime the machine start to take my bp i feel anxious i dont know why! i hate myself!. my bp goes to normal only when im relaxed and sleeping. i saw it on the result.

  • I did that too and it was a horrible 24 hours. Try not to worry about it as know that when you are relaxed and sleeping it is ok. Try as hard as you can not to focus on your BP and try to keep your aniexty in check as much as you can. Don't beat yourself up!!!! Find ways to reduce your stress and know that you are ok!!

  • yes im trying still when i went to my doctors office my bp always spikes! i dont know why its really hard to relax or calm my mind. maybe i have anxiety, some of my cousins have it but they are lowblood. different with me im always anxious of my bp and im high blood. also i have episodes of panic attacks last month. really scared. my doc always says im highblood, im goin to stroke blah blah that makes me more anxious! though all my medical test is normal, even my doc dont know the cause of my hbp. positve and negative thoughts always running in my mind. very confusing what is really true..

  • So many things can cause a inaccurate BP reading that most doctors aren't even aware of are choose to ignore such as:

    Blood Pressure Cuff is too Small

    Blood Pressure Cuff Used Over Clothing - When having your blood pressure measured, the cuff should always be placed directly on your arm. Studies have shown that clothing can impact a systolic blood pressure from 10 to 50 mmHg.

    Not Resting 3-5 minutes before BP Taken - To obtain an accurate blood pressure measurement, it is important that you relax and rest quietly in a comfortable chair for 3 to 5 minutes before a reading is taken. Any activities such as exercise or eating can affect your systolic blood pressure measurement 10 to 20 mmHg.

    Arm/Back/Feet Unsupported - When having your blood pressure measured, you should always be seated in a comfortable chair, legs uncrossed, with your back and arm supported...The positioning of your upper arm below your heart level will also result in higher measurements, whereas positioning your upper arm above your heart level will give you lower measurements

    Emotional State- Stress or anxiety can cause large increases in blood pressure. If you are having your blood pressure taken while thinking about something that causes you to tense up or become stressed, your blood pressure levels could significantly increase.

    Talking - If you are talking to the nurse/doctor while having your blood pressure taken, studies have shown that your systolic blood pressure measurement may increase 10 to 15mmHg.

    Smoking Tobacco products (cigarettes, cigars, smokeless tobacco) all contain nicotine which will temporarily increase your blood pressure, so refrain from smoking at least 30 minutes before having a blood pressure measurement taken.

    Alcohol/Caffeine - Alcohol and caffeine (sodas, coffee, tea, etc) consumption causes blood pressure levels to spike so stay away from alcohol/caffeine at least 30 minutes before having a blood pressure measurement taken.

    Temperature - Blood pressure tends to increase when you are cold. Therefore, if you are at the doctor's office and the room temperature is "chilly" to you, be aware that your blood pressure readings may be higher than expected.

    Full bladder- Your blood pressure is lower when your bladder is empty. As your bladder gradually fills, your blood pressure increases. Studies have shown that your systolic blood pressure measurements could increase 10 to 15mmHg when you have a full bladder.

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