Blood Pressure and Psyche

Hypertension is a health challenge that encompasses not only physical but also psychological aspects. Even a certain expectation from the affected individuals or just a doctor's visit can change blood pressure values or influence the effect of a therapeutic measure (Placebos, White Coat Hypertension). The interplay between psyche and hypertension is thus a fascinating field of study. It shows how psychological states influence the onset, course, and management of elevated blood pressure and vice versa.

The psychosomatics of hypertension examines how thoughts and feelings can influence our bodies. Many are aware that stress can be a significant cause of hypertension. However, stress can often be caused by psychological issues such as depression, anxiety, or eating disorders. If a person suffers from such problems, they may later develop hypertension. In the current guidelines of the ESH, depression is mentioned as a risk factor for hypertension in certain groups of people.

The occurrence of panic attacks is also significantly increased in people with hypertension, with a frequency of up to 39%. A panic attack is a sudden state of intense fear, accompanied by rapid heartbeat, shortness of breath, and dizziness. Whether panic attacks lead to hypertension or vice versa is still unclear. One suspicion regarding this is the "labeling effect." This means that the diagnosis or treatment of hypertension can trigger anxiety in some individuals. These anxieties could then lead to panic attacks. It can also happen that individuals with hypertension who suffer from panic attacks stop taking their blood pressure medications. The reason for this could be that they misinterpret the signs of panic as side effects of the medication. Therefore, it is necessary to correctly recognize and treat panic in people with hypertension.

Not only stress but also other emotions are an essential part of our daily lives. Studies have shown that strong negative emotions such as anger can increase blood pressure. In contrast, positive emotions (e.g., calmness, serenity) can lower blood pressure. It is important to recognize one's own feelings correctly in order to regulate them well.

Sometimes, however, it happens that one does not notice their feelings at all or cannot express them well. This is called alexithymia. It complicates communication between one's inner self and the body. Alexithymia occurs more frequently in people with hypertension, with frequencies ranging from 16% to 55%. This "emotional blindness" can mean a lot of tension and stress for those affected. This means that alexithymia could contribute to the development and persistence of hypertension.

A person's personality also plays a special role in hypertension. Certain personality traits can lead someone to exhibit risk behaviors, such as smoking. They can also influence how one copes with the illness, for example, whether they take medication or how they handle stress. In particular, traits such as strong ambition, impatience, aggressiveness, and the tendency to suppress stress reactions and anger are repeatedly observed in many people with hypertension.

On the other hand, a high level of compassion may contribute to lower diastolic and systolic blood pressure. It may even protect individuals with a family predisposition to hypertension.

When dealing with hypertension, it is also important to consider the psyche of the individual. This includes relaxation techniques, such as progressive muscle relaxation according to Jacobson and meditation. These can have a calming effect and reduce stress.

When it comes to hypertension, it is important to understand that the psyche plays a significant role. The relationship between our emotional world and our physical health is complex. A comprehensive approach that includes not only medical treatment but also our feelings can help manage hypertension better. In case of concerns about your mental health, it is advisable to seek professional help.

• https://doi.org/10.26719/2010.16.7.740
• https://doi.org/10.1016/s0002-9343(99)00237-5
• https://doi.org/10.1007/s11886-023-01894-7
• https://doi.org/10.1073/pnas.2105573118
• https://doi.org/10.1016/j.pmedr.2021.101477
• https://doi.org/10.1161/hypertensionaha.110.156257
• https://doi.org/10.1007/s12529-020-09886-5
• https://doi.org/10.1016/j.genhosppsych.2013.11.002

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