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Thursday, April 17, 2014
High Blood Pressure
Anxiety and high blood pressure
Dear Doctor Rief, I have had high blood pressure for 20 years. I have tried at least 14 different medications during all these years. In all this time I have never been able to get my pressure down to normal limits. My diastolic is always in the 90`s and the systolic in the 140`s. I am now 54 and worrying as time passes I am at risk of stroke or heart attack. I`ve had a stress/echo 18 months ago and it was normal. What can I do to get my pressure under control? I also suffer from GAD and currently take 5 mg. valium TID. I am under a lot of stress in my life and have been since first being diagnosed with high blood pressure. Problems with my marriage and relationship with parents and kids. I just want to be normal as now I am not able to drive due to the anxiety. Thank you for any advice you can offer
It is difficult to give specific advice without having complete data in an individual patient. However, a few points can be made:
Anxiety can cause or aggravate hypertension, and hypertension can cause anxiety. Some patients respond to counseling, while others respond to antidepressants.
At any rate, your blood pressure should be 130 systolic or lower. You can safely ignore the diastolic number, as it is not indicative of cardiovascular risk.
Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati