This interview navigates the complexities of stress induced hypertension. Dr Kashyap Dakshini, General Physician, Office Bearer, Treasurer and Member of the Indian Medical Association and also of IAOHGPA, Mumbai speaks with us on this matter. You can follow the link below to access the whole interview.
Q. How does chronic stress contribute to the development of hypertension?
Chronic stress would lead to a persistent elevation or a spike elevation in blood pressure. This is because of job pressure, emotional trauma, emotional stress, loss of a loved one or any kind of reputational stress or any form of insecurity. Now this may lead to anxious situations or constant preoccupation and lead to perceptive stress and hence may lead to elevation in high blood pressure.
Q. Are changes in our lives a factor of stress and hypertension?
In today’s age, the first factor is sleep. Diet, excessive salt intake, a high calorie diet can be another factor. Then inactivity or lack of exercise or obesity, or excessive consumption of alcohol or any form of tobacco, whether it is smoking or vaping or chewable tobacco or any kind of stress at work or in relationships. All of these are aggravating factors, lifestyle factors which may lead to elevation of blood pressure.
Q. How does chronic work-related stress affect blood pressure?
Work related stress or any kind of stress will lead to a neurological response from the brain, and that would lead to release of stress hormones such as epinephrine, non-epinephrine and cortisol. Now, these hormones are typically released in fight or flight situations, which leads to high blood pressure. Persistent high blood pressure will definitely damage the arteries, the elasticity of these arteries, and also will reduce the blood flow, and hence the oxygen supply to the heart and various vital organs. Lastly, this makes it much harder for the heart to pump blood and may lead to complications of the heart, of the brain, of the eyes, or of the kidneys, which are typically complications of hypertension.
Hence, if it’s related to the heart, it means increased chances of heart attack or coronary artery disease or heart failure. Then if it’s related to the brain, then it could be a chance of a brain stroke or radical kidney. Then the chances of chronic kidney disease because of high blood pressure, or if it’s related to the eye, then it’s hypertensive retinopathy. So, all these are complications of high blood pressure.
Q. Can technology identify the warning signs?
Stress does have a huge impact on the heart and can lead to silent cardiac deaths. There are other factors that elevate high blood pressure, such as diet, inactivity, lack of exercise, obesity, tobacco or alcohol, family history of heart disease, age or gender or high stress. All of these can lead to silent cardiac, that’s even during sleep or even a sudden cardiac death.
Warning signs and symptoms include chest discomfort or chest pain, or typical heaviness in the chest, or even any discomfort or pain in the jaw or in the neck or in the back or any kind of shortness of breath. Now, these are typical symptoms of a heart attack. So, anything from the jaw to the umbilicus, any kind of pain there can lead to a heart attack.
A heart attack can be detected with the help of an ECG machine and also through blood tests. Now, a lot of smart watches or wearables can do the job too. They have sensors which can predict the level of proponent or troponin eye or even obstruction in the artery with a reasonable amount of accuracy and in a matter of minutes.
Q. How does a healthy work life balance affect blood pressure and heart health?
A healthy work life balance will definitely lead to low levels of stress. Because focusing on exercise, on sleep, on diet and other things will reduce stress levels automatically. Neurological response from the brain, in turn, reduces the release of stress hormones such as epinephrine, non-epinephrine, and I cortisol. This would reduce the amount of blood pressure and hence the hypertensive response. Now, a healthy work life balance can easily be achieved for the management of stress and hypertension.
Q. Are there any strategies to manage stress?
There has been increasing evidence or methods of managing stress by way of either mindfulness-based chest reduction or through cognitive behavioral therapy. So, mindfulness is basically breathing and concentrating in your breath, doing meditation through either body scan techniques or through yoga through exercises.
Q. Can mindfulness and CBT replace conventional medications for hypertension?
Before starting with regular medication, one should try both of these because this is a natural way of controlling your hypertensive response through your body mechanism and brain. So, once tried it should reduce the requirement of medicines. If the blood pressure remains high, then one must consult a physician, monitor the blood pressure, and definitely a conventional antihypertensive medication, depending on the level.
Q. What are the preventive measures of high blood pressure brought on by stress?
Some of the risk factors should definitely be controlled. So, a healthy work life balance and managing that is a way of setting your targets, setting your manageable goals, concentrating on work, improving your efficiency, improving communication, taking regular breaks.
Precisely, unplug yourself, digital detox, diet, exercise, quit tobacco, quit smoking, watch your alcohol and finally a lot of relaxation techniques. But some of these preventative methods will definitely have an impact and reduce risk even if your stress and hypertension is genetic.
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