Stress doesn’t just make you “feel bad,” mentally. It also has very tangible negative effects on the physical body. In our article Can Stress Cause Illness?, we listed over six major diseases that can be triggered or exacerbated by unmanaged stress levels. High blood pressure, or hypertension, which is dangerous in and of itself and can also precipitate a host of other cardiovascular diseases, is one of the disorders that can be affected by deleterious stress levels. Fortunately, stress is one of a handful of lifestyle factors that can be better controlled if you adopt and adhere to one or more recommended practices that we explore in this report. Here are 7 ways to reduce stress and keep your blood pressure down.

What is blood pressure and why does it matter? 

Let’s first back up a bit and talk about what blood pressure is, and why it’s important. (And for broader context regarding all cardiovascular diseases, see Cardiovascular Disease Prevention: What You Need To Know.) Blood pressure is, according to The American Heart Association, “a measure of how much pressure your blood is exerting against your artery walls.” When blood pressure is measured, there are two numbers that are recorded. The first number (the bigger one) is Systolic Blood Pressure, which tells you how much pressure blood is exerting against artery walls when the heart beats. The second number is Diastolic Blood Pressure, which tells you how much pressure the blood is exerting against artery walls when the heart is in between beats.

Blood pressure, and specifically Systolic Blood Pressure, is one of 5 parameters that are key in evaluating metabolic health. The other four factors are blood sugar, waist circumference, cholesterol, and triglyceride levels.

When your blood pressure is too high, your arteries experience an abnormally high level of force from the blood being pumped through them. If your blood pressure stays abnormally high for too long (chronically), you are put at risk for many medical disorders, including cardiovascular disease (CVD), cerebrovascular diseases (e.g., stroke), kidney diseases and type 2 diabetes.

In fact, hypertension (high blood pressure) and type 2 diabetes are frequently comorbid. Patients with diabetes are twice as likely to have hypertension as non-diabetics. If you already have diabetes, your doctor will probably recommend that you monitor your blood pressure at home, especially if you already have high blood pressure, as hypertension puts you at risk for numerous cardiovascular diseases, including coronary heart disease, heart attack, stroke, heart failure and arrhythmia. Reducing risk factors for cardiovascular disease is considered “crucial for effective diabetes mellitus management,” according to a 2016 meta-analysis. 

What causes hypertension (high blood pressure)?

Some people have high blood pressure caused by an underlying condition, such as obstructive sleep apnea; kidney disease; adrenal gland tumors; thyroid problems; certain defects you're born with (congenital) in blood vessels; certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs; or illegal drugs, such as cocaine and amphetamines. This type of high blood pressure is called secondary hypertension, and tends to appear suddenly. But for most adults, there's no identifiable cause of high blood pressure, which tends to develop gradually over many years. Clinicians call this primary (essential) hypertension, and while genetic (and inherited) factors may play a role in its onset, what’s increasingly clear is that environmental (aka “lifestyle”) factors also play a big role. These other risk factors for hypertension include: 

1. An unhealthy diet: Diets too high in sodium and too low in potassium can increase blood pressure.
   
   
2. Physical inactivity: Without regular physical activity, the heart and blood vessels weaken, which can increase blood pressure.
   
   
3. Obesity: The excess body fat associated with obesity means that the heart has to work harder to pump blood and oxygen through the body, which stresses the heart and blood vessels, leading to high blood pressure.
   
   
4. Excess alcohol and tobacco use.
   
   
5. Stress: In a community-based cohort study, higher perceived stress correlated with increased risk of developing high blood pressure. Similarly, in a 2017 meta-analysis, researchers concluded that psychosocial stress is associated with an increased risk of high blood pressure and that patients with this condition also had a higher incidence of psychosocial stress compared to normotensive patients.
   

Readers should note that all of the above lifestyle factors are “elective,” meaning that you can either choose to ignore them or attempt to better manage them. Your stress level is one of the lifestyle factors that is at least partially within your control, and if you succeed at better managing it, you can reduce your risk for high blood pressure and protect yourself from CVD and other health conditions, as well.  

7 ways to reduce stress and keep blood pressure down

1. Exercise and lose weight: Cortisol, commonly known as “the stress hormone,” is often correlated with obesity and weight gain. In fact, a study found that increased cortisol sensitivity likely plays a role in predicting weight gain in girls. Another study found that cortisol levels in children were associated with being overweight. Exercising regularly to lose weight can be effective in reducing risk of CVD: one study found that exercise and stress management training were able to reduce emotional distress and improve markers of cardiovascular risk in patients with ischemic heart disease.
   
   
2. Practice breathing techniques, such as Pranayama: Based on an ancient science that originated in India, Pranayama, a breathing technique, holds that the flow of vital force (or prana) throughout the body is critical for reducing stress and maintaining health. Researchers have found that stress levels in participants reduced after two months of pranayama. Sympathetic drive to the heart was decreased and parasympathetic output to the heart increased. (The Sympathetic Nervous System, or SNS, is the aspect of our nervous system that is associated with the “fight-or-flight” response. The Parasympathetic Nervous System, or PNS, is associated with “rest-and-digest”). Another study found that practicing slow pranayama techniques such as Nadishodhana, Savitri, and Pranav Pranayama reduced perceived stress and also had beneficial effects on cardiovascular parameters such as heart rate, diastolic blood pressure and mean arterial pressure (a type of average of systolic and diastolic blood pressure). For advice on getting started with Pranayama, check out this article from The Art of Living Foundation.
   
   
3. Sleep better: Sleep is essential for our minds and bodies to unwind, rejuvenate and replenish themselves. In fact, poor sleep quality has been significantly associated with stress levels. In another study, researchers found that self-reported sleep duration and perceived stress were correlated, with those who slept for five or less hours per night having higher stress awareness. The Sleep Foundation offers great tips on how you can sleep better — including choosing quality bedding, avoiding light disruption, cultivating a quiet and peaceful atmosphere and using pleasant aromas to relax your mind and prepare for sleep.
   
   
4. Meditate: Did you know that the words “meditate” and “medicate” actually come from the same Latin root? Meditation has long been proven to be a safe and effective way to deal with a variety of chronic health conditions, including stress. In an 8-week study of Alzheimer’s patients and their caregivers, a twice-daily meditation program reduced perceived stress and improved sleep, mood, memory and blood pressure. In a review paper, 16 of 17 mindfulness meditation studies demonstrated that meditation induced positive psychological and/or physiological outcomes related to anxiety and stress. One very effective meditation practice, Heartfulness Meditation, was found to significantly reduce perceived stress and improve sleep quality in a 2021 study. Another study found that Heartfulness Meditation lowered numerous perceived stress scores and increased perceived joy scores. To try this program, download the HeartsApp app and connect virtually with a trainer for free.
   
   
5. Journal: Writing can be a stress-relieving activity, allowing us to process our thoughts and emotions and take a step back from our hectic lives and look at things from a healthier perspective. A study found that one month of expressive writing significantly reduced systolic and diastolic blood pressure. Similarly, another study showed that Positive Affect Journaling decreased mental distress, depressive symptoms and anxiety; and the journaling also increased overall feelings of well-being after one month.
   
   
6. Eat better: A poor diet can contribute to feelings of stress as well as elevated blood pressure. In particular, watch your sodium intake. A joint review found that, overall, excessive sodium intake is associated with several negative health outcomes such as elevated blood pressure, death from kidney disease and CVD. Avoiding excess sodium will go a long way in moderating the overall stress on your body and keeping blood pressure in healthy range. Other food recommendations include avoiding excess caffeine and alcohol and increasing intake of stress-reducing foods such as whole grains (e.g., quinoa) and other high-fiber foods, nuts, foods rich in Vitamin D (e.g., mushrooms), foods rich in B6 vitamins and folic acid (e.g., dark, leafy greens like spinach), foods high in Omega-3 fatty acids (e.g., salmon), foods rich in magnesium (all the aforementioned foods) and fermented foods (e.g. kefir, sauerkraut, yogurt).
   

7. Build strong relationships with friends and family: We are social creatures, meant to interact and relate with others. Many studies show the positive effects of strong relationships on numerous stress-related measures. In a study of low-socioeconomic-status youth, those with supportive role models showed lower interleukin-6 counts, a measure of inflammation that is tied to overall stress levels. Another study showed that greater perceived social support and frequent hugging protected against viral infection. Finally, supportive close relationships such as high-quality marriages and parental warmth have been associated with “lower scores on multi-system indices of biological risk, which include aggregate assessments of the HPA axis, SNS (Sympathetic Nervous System), cardiovascular, metabolic and immune systems.” Building great relationships takes time and effort. Luckily, Harvard Health has put together a list of quick, simple tips that you can apply to create strong relationships such as:
   
8. Being an empathetic listener
9. Sharing the spotlight
10. Keeping calm during discussions
11. Interacting in person when possible
12. Focusing on the positive

Key takeaways

Hopefully these 7 ways to reduce stress and keep blood pressure down will help manage stress levels. The world is a crazy place, after all, and it’s really easy to feel stressed and overwhelmed. If left unchecked, stress can have serious long-term effects on many dimensions of your health — including your blood pressure, risk for diabetes, risk for cardiovascular disease and much more. Luckily, there are many ways to manage and eliminate feelings of stress, such as regularly exercising, practicing pranayama, sleeping better, meditating, journaling, eating better and building strong relationships. Take the time to incorporate as many of these methods into your life as you can, and your heart and health will thank you.