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Hi, The Past 6 Months Have Been The Most Stressful

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Posted on Sun, 3 Nov 2019
Question: Hi, the past 6 months have been the most stressful of my life. It has resulted in a ton of anxiety and lots of bodily symptoms that linger. One thing that has never been a problem until this past month is blood pressure. It remains high even though the acute stress has started to pass. I am now very anxious all the time, I feel on edge... and it's hard to calm my body down. I get random bouts of breathlessness, random sweating, random aches and pains, random shivers or hot flashes and my digestion is unpredictable and I have bad reflux.

This is how it feels often: I’ll get myself ready to start my day, as normal... I’ll go around gather my things and go, and even that makes me feel like I am running a marathon..... but while I walk around doing my errands (I live in NYC, no car) my heart rate will increase, I’ll start to sweat... as if I’m on a treadmill... but I’m just power walking... Feels like just out of shape exercising... then, when it gets uncomfortable is when I try to relax after, I don't “come down” for awhile so the sensations stick around... high heart rate, sweating... and high bp... and it stays high for probably 20-30 min until I start to calm down somewhat. But even then it comes down slowly. But it will stay up if I get anxious about something... because when I’ve taken my bp and not feeling all stimulated, it’s been ok, but right now, I always feel stimulated and on edge. It feels like every little physical thing I do causes a lot of adrenaline and cortisol to pour into my body. Like my nerves are extra sensitive to any stress.

Do you think this is sudden essential hypertension (I've never had issues before) or can stress and anxiety create strong bouts of high blood pressure?
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Follow up: Dr. Ilir Sharka (0 minute later)
Hi, the past 6 months have been the most stressful of my life. It has resulted in a ton of anxiety and lots of bodily symptoms that linger. One thing that has never been a problem until this past month is blood pressure. It remains high even though the acute stress has started to pass. I am now very anxious all the time, I feel on edge... and it's hard to calm my body down. I get random bouts of breathlessness, random sweating, random aches and pains, random shivers or hot flashes and my digestion is unpredictable and I have bad reflux.

This is how it feels often: I’ll get myself ready to start my day, as normal... I’ll go around gather my things and go, and even that makes me feel like I am running a marathon..... but while I walk around doing my errands (I live in NYC, no car) my heart rate will increase, I’ll start to sweat... as if I’m on a treadmill... but I’m just power walking... Feels like just out of shape exercising... then, when it gets uncomfortable is when I try to relax after, I don't “come down” for awhile so the sensations stick around... high heart rate, sweating... and high bp... and it stays high for probably 20-30 min until I start to calm down somewhat. But even then it comes down slowly. But it will stay up if I get anxious about something... because when I’ve taken my bp and not feeling all stimulated, it’s been ok, but right now, I always feel stimulated and on edge. It feels like every little physical thing I do causes a lot of adrenaline and cortisol to pour into my body. Like my nerves are extra sensitive to any stress.

Do you think this is sudden essential hypertension (I've never had issues before) or can stress and anxiety create strong bouts of high blood pressure?
doctor
Answered by Dr. Ilir Sharka (3 hours later)
Brief Answer:
I would recommend performing some tests:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

Regarding your concern, I would explain that your symptoms are suggestive of a metabolic disorder ( possible thyroid gland dysfunction or adrenal gland dysfunction).

I don't think that this is just essential arterial hypertension.

For this reason, I would recommend consulting with your attending physician for a physical exam and some tests:

- a resting ECG
- complete blood count, PCR ,ESR for inflammation
- thyroid hormone levels
- cortisol and aldosterone plasma levels for possible adrenal gland dysfunction
- kidney and liver function tests
- fasting glucose.

Further tests may be needed, based on the above test results.

You should discuss with your doctor on the above mentioned tests.

I hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Wishing all the best,

Dr.Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would recommend performing some tests:

Detailed Answer:
Hello!

Welcome to Ask a Doctor service!

Regarding your concern, I would explain that your symptoms are suggestive of a metabolic disorder ( possible thyroid gland dysfunction or adrenal gland dysfunction).

I don't think that this is just essential arterial hypertension.

For this reason, I would recommend consulting with your attending physician for a physical exam and some tests:

- a resting ECG
- complete blood count, PCR ,ESR for inflammation
- thyroid hormone levels
- cortisol and aldosterone plasma levels for possible adrenal gland dysfunction
- kidney and liver function tests
- fasting glucose.

Further tests may be needed, based on the above test results.

You should discuss with your doctor on the above mentioned tests.

I hope you will find this answer helpful!

I remain at your disposal for any further questions whenever you need!

Wishing all the best,

Dr.Ilir Sharka, Cardiologist
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ilir Sharka (21 minutes later)
Ok thank you. I will say, I do have many known anxiety disorders. Panic and Social Anxiety. My doctor doesn't want to do tests, I just had some recently this year, maybe 2 months ago? and everything was fine. Most recently, I had an ECG a few weeks ago and blood work related to my heart, everything was normal. She wants to wait a month and see if it gets better. All this came on fairly quickly while I was away in California... the longer I was there and staying stressed out and anxious, the worse I got. and my body is just having a tough time calming down... and it doesn't help that I'm worried about all the symptoms.

But, maybe I can ask another doctor to do the tests.



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Follow up: Dr. Ilir Sharka (0 minute later)
Ok thank you. I will say, I do have many known anxiety disorders. Panic and Social Anxiety. My doctor doesn't want to do tests, I just had some recently this year, maybe 2 months ago? and everything was fine. Most recently, I had an ECG a few weeks ago and blood work related to my heart, everything was normal. She wants to wait a month and see if it gets better. All this came on fairly quickly while I was away in California... the longer I was there and staying stressed out and anxious, the worse I got. and my body is just having a tough time calming down... and it doesn't help that I'm worried about all the symptoms.

But, maybe I can ask another doctor to do the tests.



doctor
Answered by Dr. Ilir Sharka (8 hours later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Persistent anxiety and psychological pressure can mimic all this clinical situation.

As your previous blood lab tests resulted normal, it is very likely that even the new tests will result normal, considering the short period of time since your last performed tests.

For this reason, I would recommend trying magnesium supplements, which can help calm your anxiety and stabilize your nervous system and also try to practise Yoga and meditation, which can help improve your situation.

In the meantime, I would not recommend performing further tests within 6 months, as it is very likely that they will result normal.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello again!

Persistent anxiety and psychological pressure can mimic all this clinical situation.

As your previous blood lab tests resulted normal, it is very likely that even the new tests will result normal, considering the short period of time since your last performed tests.

For this reason, I would recommend trying magnesium supplements, which can help calm your anxiety and stabilize your nervous system and also try to practise Yoga and meditation, which can help improve your situation.

In the meantime, I would not recommend performing further tests within 6 months, as it is very likely that they will result normal.

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Ilir Sharka (4 hours later)
Thanks..do you think stress and constant anxiety can cause blood pressure to stay high so often? I feel like I get triggered into anxiety even thinking about my BP being high... so I can't even take a blood pressure recording without being anxious...
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Follow up: Dr. Ilir Sharka (0 minute later)
Thanks..do you think stress and constant anxiety can cause blood pressure to stay high so often? I feel like I get triggered into anxiety even thinking about my BP being high... so I can't even take a blood pressure recording without being anxious...
doctor
Answered by Dr. Ilir Sharka (3 hours later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

You should know that persistent anxiety can mimic this situation.

It can be explained by the persistent activation of the sympathetic nervous system, leading to high adrenaline levels, which are responsible for high blood pressure and the high heart rate.

For this reason, I would recommend trying to focus on your anxiety and manage it.

In this regard, Yoga and meditation can help. Regular physical exercise can help improve your situation too. But I would recommend avoiding straining physical activity.

Consulting with a specialist of this field (psychiatrist or psychotherapist) can help too.

Wishing all the best,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

You should know that persistent anxiety can mimic this situation.

It can be explained by the persistent activation of the sympathetic nervous system, leading to high adrenaline levels, which are responsible for high blood pressure and the high heart rate.

For this reason, I would recommend trying to focus on your anxiety and manage it.

In this regard, Yoga and meditation can help. Regular physical exercise can help improve your situation too. But I would recommend avoiding straining physical activity.

Consulting with a specialist of this field (psychiatrist or psychotherapist) can help too.

Wishing all the best,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ilir Sharka (49 minutes later)
Thank you Doctor!

I just want to ask / clarify one thing then I'll close the discussion.

Can adrenaline and cortisol levels remain high for a long time after months of constant anxiety? Like I trained the hormones to be at a higher level, because I have been stressed at a high level constantly? I guess the one thing I am noticing, especially after I went to run errands today, is that it feels like exercise intolerance. When I'm power walking in NYC, the longer I do it.. I start to feel tense and my heart rate increasing etc... then, after awhile, when I settle down to rest, I start to sweat, my heart rate stays high and my BP doesn't go back to normal for quite awhile. I'll also get easily dizzy, anxious and nauseous if I have to talk or have a conversation after exercise... it's like my body needs extra time to calm down, and it doesn't really calm down completely. Could that all be from elevated cortisol and adrenaline?

If so, is the remedy rest and thinking not anxiously? Will the body recover from chronic stress and hopefully go back to a calmer "homeostatis".
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Follow up: Dr. Ilir Sharka (0 minute later)
Thank you Doctor!

I just want to ask / clarify one thing then I'll close the discussion.

Can adrenaline and cortisol levels remain high for a long time after months of constant anxiety? Like I trained the hormones to be at a higher level, because I have been stressed at a high level constantly? I guess the one thing I am noticing, especially after I went to run errands today, is that it feels like exercise intolerance. When I'm power walking in NYC, the longer I do it.. I start to feel tense and my heart rate increasing etc... then, after awhile, when I settle down to rest, I start to sweat, my heart rate stays high and my BP doesn't go back to normal for quite awhile. I'll also get easily dizzy, anxious and nauseous if I have to talk or have a conversation after exercise... it's like my body needs extra time to calm down, and it doesn't really calm down completely. Could that all be from elevated cortisol and adrenaline?

If so, is the remedy rest and thinking not anxiously? Will the body recover from chronic stress and hopefully go back to a calmer "homeostatis".
doctor
Answered by Dr. Ilir Sharka (11 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

It seems that your sympathetic nervous system is over sensitive, and thus over reactive due to continuous stress.

This means that your adrenaline and cortisol levels are persistently high, as they are being produced continuously.

Anyway , if you try to manage your anxiety, your body is going to react differently to stressful situations and you will feel better.

Regular physical activity like Yoga, recreational sports, etc. are recommendable.

Anxiolytic therapy ( given by psychiatrist prescription) can help too.

I remain at your disposal for any further questions whenever you need!

Let me know about everything!

Regards,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

It seems that your sympathetic nervous system is over sensitive, and thus over reactive due to continuous stress.

This means that your adrenaline and cortisol levels are persistently high, as they are being produced continuously.

Anyway , if you try to manage your anxiety, your body is going to react differently to stressful situations and you will feel better.

Regular physical activity like Yoga, recreational sports, etc. are recommendable.

Anxiolytic therapy ( given by psychiatrist prescription) can help too.

I remain at your disposal for any further questions whenever you need!

Let me know about everything!

Regards,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ilir Sharka (34 hours later)
hi there. i ended up having blood work done. all tests were normal but:

ESR: 19 when range is 0-15
Glucose: 106 when should be under 90 (i think thats definitely from high cortisol / stress. it always makes my sugar a bit higher)
CO2: one point lower than it should be.

tests done: CBC, basic metaboolic, thyroid, DIF.

what do you think?
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Follow up: Dr. Ilir Sharka (0 minute later)
hi there. i ended up having blood work done. all tests were normal but:

ESR: 19 when range is 0-15
Glucose: 106 when should be under 90 (i think thats definitely from high cortisol / stress. it always makes my sugar a bit higher)
CO2: one point lower than it should be.

tests done: CBC, basic metaboolic, thyroid, DIF.

what do you think?
doctor
Answered by Dr. Ilir Sharka (7 hours later)
Brief Answer:
I agree with you.

Detailed Answer:
Hello again!

I am glad that your blood lab tests have resulted OK in general.

I agree with you on the fact that anxiety can lead to higher fasting glucose levels and higher ESR levels.

In my opinion, you should try to focus on your anxiety and manage it.

Let me know about everything!

Wishing all the best,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I agree with you.

Detailed Answer:
Hello again!

I am glad that your blood lab tests have resulted OK in general.

I agree with you on the fact that anxiety can lead to higher fasting glucose levels and higher ESR levels.

In my opinion, you should try to focus on your anxiety and manage it.

Let me know about everything!

Wishing all the best,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ilir Sharka (17 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Regarding your concern, I would like to explain that individuals suffering from arterial hypertension, have high blood pressure values all the time.

While spikes on blood pressure values during physical activity or anxiety are normal, even in healthy individuals.

In hypertensive individuals, blood pressure values tend to remain high all the time and even higher during physical activity or anxiety.

But, spikes in blood pressure values during physical activity or anxiety, do not cause any harm to the body and do not need to be treated.

While persistent high blood pressure values, even when resting can cause damage to the heart and blood vessels, and thus increase the cardio-vascular risk. So, they should be treated with anti-hypertensive therapy.

Hope you will find this information helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Regarding your concern, I would like to explain that individuals suffering from arterial hypertension, have high blood pressure values all the time.

While spikes on blood pressure values during physical activity or anxiety are normal, even in healthy individuals.

In hypertensive individuals, blood pressure values tend to remain high all the time and even higher during physical activity or anxiety.

But, spikes in blood pressure values during physical activity or anxiety, do not cause any harm to the body and do not need to be treated.

While persistent high blood pressure values, even when resting can cause damage to the heart and blood vessels, and thus increase the cardio-vascular risk. So, they should be treated with anti-hypertensive therapy.

Hope you will find this information helpful!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Ilir Sharka (15 minutes later)
thanks! i actually thought of a question that may help alleviate my anxiety about blood pressure. which is counter productive.

how does actual hypertension work? if someone has high blood pressure, is it always high? like even at rest, real hypertension patients would show a higher number?

so like, if i exercise or have a panic attack or get really nervous and my bp during or right after is like 160/100... thats ok becsuse its like exercise, it will go back down... where someone with hypertension stays high?

so a high bp isnt always dangerous?

thanks.
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Follow up: Dr. Ilir Sharka (0 minute later)
thanks! i actually thought of a question that may help alleviate my anxiety about blood pressure. which is counter productive.

how does actual hypertension work? if someone has high blood pressure, is it always high? like even at rest, real hypertension patients would show a higher number?

so like, if i exercise or have a panic attack or get really nervous and my bp during or right after is like 160/100... thats ok becsuse its like exercise, it will go back down... where someone with hypertension stays high?

so a high bp isnt always dangerous?

thanks.
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Follow up: Dr. Ilir Sharka (2 hours later)
thanks! and eill blood pressure ususlly stay reised as long as youre nervous?

is it even possible to be really anxious and have normal blood pressure?

i notice that i cant really calm myself down sometimes until i get home... and my bp will be somewhat high the whole time im nervous.
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Follow up: Dr. Ilir Sharka (0 minute later)
thanks! and eill blood pressure ususlly stay reised as long as youre nervous?

is it even possible to be really anxious and have normal blood pressure?

i notice that i cant really calm myself down sometimes until i get home... and my bp will be somewhat high the whole time im nervous.
doctor
Answered by Dr. Ilir Sharka (12 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Individuals suffering from arterial hypertension have higher blood pressure values during rest ( mean blood pressure values) and even higher during physical activity or anxiety.

In such cases antihypertensive therapy is needed.

While in your case, when high blood pressure is only during physical exercise or anxiety, there is no need for treatment. You should know that every load of adrenaline in blood, needs 10minutes to go down by your metabolism.

If the person is continuously anxious, adrenaline keeps being produced and it doesn't go down until you relax. This is just a normal physiological reaction ( also called fight or flight response).

Wishing all the best,

Dr.Iliri
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Individuals suffering from arterial hypertension have higher blood pressure values during rest ( mean blood pressure values) and even higher during physical activity or anxiety.

In such cases antihypertensive therapy is needed.

While in your case, when high blood pressure is only during physical exercise or anxiety, there is no need for treatment. You should know that every load of adrenaline in blood, needs 10minutes to go down by your metabolism.

If the person is continuously anxious, adrenaline keeps being produced and it doesn't go down until you relax. This is just a normal physiological reaction ( also called fight or flight response).

Wishing all the best,

Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9536 Questions

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Hi, The Past 6 Months Have Been The Most Stressful

Hi, the past 6 months have been the most stressful of my life. It has resulted in a ton of anxiety and lots of bodily symptoms that linger. One thing that has never been a problem until this past month is blood pressure. It remains high even though the acute stress has started to pass. I am now very anxious all the time, I feel on edge... and it's hard to calm my body down. I get random bouts of breathlessness, random sweating, random aches and pains, random shivers or hot flashes and my digestion is unpredictable and I have bad reflux. This is how it feels often: I’ll get myself ready to start my day, as normal... I’ll go around gather my things and go, and even that makes me feel like I am running a marathon..... but while I walk around doing my errands (I live in NYC, no car) my heart rate will increase, I’ll start to sweat... as if I’m on a treadmill... but I’m just power walking... Feels like just out of shape exercising... then, when it gets uncomfortable is when I try to relax after, I don't “come down” for awhile so the sensations stick around... high heart rate, sweating... and high bp... and it stays high for probably 20-30 min until I start to calm down somewhat. But even then it comes down slowly. But it will stay up if I get anxious about something... because when I’ve taken my bp and not feeling all stimulated, it’s been ok, but right now, I always feel stimulated and on edge. It feels like every little physical thing I do causes a lot of adrenaline and cortisol to pour into my body. Like my nerves are extra sensitive to any stress. Do you think this is sudden essential hypertension (I've never had issues before) or can stress and anxiety create strong bouts of high blood pressure?