Can anxiety cause significant fluctuations in blood pressure?

Anxiety disorders can cause significant fluctuations in blood pressure. During an anxiety attack, blood pressure may rise sharply within a short time and then quickly return to normal once the emotional distress subsides. In some patients, systolic blood pressure may vary by as much as 30–50 mmHg. Such dramatic swings can have a considerable impact on the cardiovascular system. If frequent blood pressure fluctuations are accompanied by chest pain or headache, prompt medical evaluation is recommended.

From a physiological standpoint, anxiety triggers strong activation of the sympathetic nervous system, prompting a surge in stress hormones such as adrenaline. This leads to rapid vasoconstriction and increased heart rate, causing blood pressure to rise quickly within minutes. As anxiety diminishes, sympathetic activity decreases, blood vessels dilate, heart rate slows, and blood pressure rapidly returns to baseline levels—creating a characteristic "sudden rise and sudden drop" pattern.

It's important to note that long-term, repeated episodes of large blood pressure fluctuations continuously stress the blood vessel walls, damage vascular endothelial cells, and increase the risk of cardiovascular diseases such as atherosclerosis and coronary artery disease. These fluctuations may also disrupt the body’s blood pressure regulation mechanisms, potentially leading to sustained hypertension. The health risks associated with such instability are far greater than those posed by isolated, temporary increases in blood pressure.

In daily life, stress can be managed through regular physical activities such as yoga and jogging. Avoiding stimulating information before bedtime, maintaining emotional stability, and routinely monitoring blood pressure at different times of day can help track fluctuations. Adopting a healthy lifestyle can reduce the frequency of anxiety episodes and support overall cardiovascular health.