Physics/Physical Activity (Stress Management/Prevention)

Physical activity reduces stress by lowering cortisol, improving mood, and supporting HTN/edema control via improved circulation and weight management.

1. Aerobic exercise: 150 min/week (brisk walking, cycling); lowers cortisol, BP; supports edema reduction.

2. Yoga: 2–3 sessions/week (60 min); reduces stress, BP; improves flexibility, circulation.

3. Tai Chi: 2 sessions/week; calms mind, lowers BP; enhances balance, reduces swelling.

4. Strength training: 2 days/week; boosts endorphins, supports weight loss; aids HTN control.

5. Stretching: 10 min/day; relieves muscle tension, improves circulation; supports edema management.

Interventional (Stress Management/Prevention)

Interventional strategies involve structured, non-pharmacologic techniques, often guided, to reduce stress and its impact on HTN/edema.

1. Biofeedback: Weekly sessions; monitors HR, BP; teaches stress control, reduces HTN.

2. Acupuncture: 1–2 sessions/week; lowers stress, BP; may reduce edema-related inflammation.

3. Massage therapy: Weekly 30-min sessions; reduces cortisol, improves circulation; aids edema.

4. Guided imagery: 15 min/day; visualizes calm, lowers BP; reduces stress response.

5. Progressive muscle relaxation: 10 min/day; tenses/relaxes muscles, reduces stress, supports BP control.

Medical/Metabolic (Stress Management/Prevention)

Medical/metabolic strategies address stress via physiologic interventions, including medications and dietary approaches, supporting HTN/edema goals.

1. SSRIs: Prescribed (e.g., sertraline); manage chronic stress, anxiety; monitor for HTN effects.

2. Beta-blockers: Prescribed (e.g., propranolol); reduce stress-induced BP spikes; monitor edema.

3. DASH diet: Low sodium (<1,500 mg/day), high potassium; lowers BP, stress.

4. Omega-3 supplements: 1 g/day (fish oil); reduce inflammation, stress; support HTN control.

5. Magnesium: 300–400 mg/day; calms nervous system, lowers BP; may reduce edema.

Psychological (Stress Management/Prevention)

Psychological strategies focus on cognitive and behavioral techniques to manage stress, preventing anxiety/depression and supporting HTN/edema.

1. CBT: Weekly therapy; reframes stress thoughts; reduces anxiety, BP; improves coping.

2. Mindfulness meditation: 10–20 min/day; lowers cortisol, BP; enhances stress resilience.

3. Deep breathing: 5 min/day; slows HR, reduces BP; calms stress response.

4. Journaling: 10 min/day; processes emotions, reduces stress; supports mental clarity.

5. Support groups: Weekly; share experiences, reduce isolation; lower stress, BP.

1. Dental Caries ~90% → sugar poor hygiene; Prev: brush floss fluoride; Tx: filling; → pain infection.
   
   

2. LBP ~80% → strain disc OA; Prev: strengthening ergonomics; Tx: NSAIDs PT; → chronic disability.
   
   

3. HTN 48% → obesity salt genetics; Prev: wt loss low Na; Tx: ACEi ARB thiazide; → stroke MI CKD.
   
   

4. Obesity 42% → diet inactivity meds; Prev: calorie ctrl exercise; Tx: GLP1 lifestyle surgery; → DM CAD CA.
   
   

5. Dyslipidemia 38% → diet genetics DM; Prev: diet exercise; Tx: statin ezetimibe PCSK9; → MI stroke.
   
   

6. Chronic Pain 21% → injury OA neuropathy; Prev: ergonomics activity; Tx: PT meds; → depression disability.
   
   

7. GERD 20% → LES dysfx obesity; Prev: wt loss meal timing; Tx: PPI lifestyle; → esophagitis stricture Barrett.
   
   

8. Anxiety 19% → stress genetics; Prev: mindfulness exercise; Tx: SSRIs CBT; → impairment depression.
   
   

9. Hearing Loss 15% → age noise; Prev: hearing protection; Tx: aids; → isolation depression.
   
   

10. CKD 14% → DM HTN; Prev: BP A1c ctrl ACEi; Tx: SGLT2 nephrology; → ESRD CV death.
    
    

11. OA 13% → age obesity injury; Prev: wt ctrl strengthening; Tx: NSAIDs inj PT; → pain disability.
    
    

12. DM (T1/T2) 11.5% → obesity inactivity autoimmunity; Prev: diet wt loss; Tx: metformin GLP1 SGLT2 insulin; → CKD neuropathy retinopathy.
    
    

13. Depression 8% → stress genetics illness; Prev: exercise therapy; Tx: SSRIs therapy; → suicide disability.
    
    

14. CAD 8% → HTN DM HLD; Prev: diet exercise; Tx: statin antiplatelet; → MI death.
    
    

15. Asthma 7.5% → allergy irritants; Prev: trigger avoidance; Tx: ICS LABA rescue; → exacerbations.
    
    

16. Anemia 5.6% → iron/B12 def loss chronic dz; Prev: diet; Tx: iron B12; → fatigue heart strain.
    
    

17. COPD 6% → smoking; Prev: quit vacc; Tx: bronchodilators steroids rehab O2; → resp failure.
    
    

18. Osteoporosis 5% → age menopause steroids; Prev: Ca D exercise; Tx: bisphosphonate denosumab; → fracture disability.
    
    

19. AFib 2-4% → HTN age heart dz; Prev: BP ctrl ↓alcohol; Tx: rate/rhythm ctrl anticoag; → stroke.
    
    

20. Dementia 2.6% → Alzheimer vascular; Prev: BP ctrl activity; Tx: cholinesterase memantine; → injury burden.
    
    

21. HF 2.5% → CAD HTN; Prev: BP lipid ctrl; Tx: ACEi ARNI beta blocker SGLT2; → hosp death.
    
    

22. PAD 2.5% → atherosclerosis smoking DM; Prev: quit; Tx: statin antiplatelet exercise; → limb loss MI.
    
    

23. OSA 2.3% → obesity airway anatomy; Prev: wt loss; Tx: CPAP oral surg; → HTN arrhythmia.
    
    

24. Stroke 2% (795k/yr) → HTN AF smoking; Prev: BP ctrl anticoag; Tx: thrombolysis thrombectomy rehab; → disability.
    
    

25. Cancer 1 in 3 lifetime → tobacco genetics; Prev: screening quit vacc; Tx: surg chemo RT; → metastasis death.

Style #1 

HTN: 47.7%; normal (<120/80), elevated, stage 1 (130–139/80–89), stage 2 (≥140/90); risks stroke, CKD.

Obesity: 40.3%; Class I (BMI 30–34.9), II (35–39.9), III (≥40); risks DM, HTN.

Chronic Pain: 24.3%; acute (<3 months), subacute, chronic (>6 months); risks disability, depression.

Dental Caries: 21.3% (untreated); initial (enamel), moderate (dentin), severe (pulp); risks abscess, tooth loss.

GERD: 20%; mild (occasional reflux), moderate (frequent), severe (esophagitis, Barrett’s); risks stricture.

Anxiety: 19%; mild (manageable), moderate (impairs function), severe (debilitating); risks panic disorder.

Hearing Loss: 15.5%; mild (26–40 dB), moderate (41–55), severe (>56); risks isolation.

CKD: 14%; stage 1 (GFR ≥90), 2 (60–89), 3 (30–59), 4–5 (ESRD); risks CV death.

Depression: 13.1%; mild (few symptoms), moderate (impairment), severe (suicidal ideation); risks disability.

OA: 12.6%; grade 1 (mild), 2 (moderate), 3 (severe), 4 (end-stage); risks disability.

DM2: 11.6%; prediabetes (A1c 5.7–6.4%), diabetes, complicated (neuropathy, CKD); risks amputation.

Sleep Apnea: 10%; mild (AHI 5–14), moderate (15–29), severe (≥30); risks HTN.

Asthma: 8.2%; intermittent, mild persistent, moderate, severe persistent; risks exacerbations.

Anemia: 7.8%; mild (Hb 11–12 g/dL), moderate (8–10.9), severe (<8); risks fatigue.

COPD: 6.5%; GOLD 1 (FEV1 ≥80%), 2 (50–79%), 3–4 (<50%); risks respiratory failure.

Cancer: 5%; stage 0 (in situ), I–II (local), III–IV (metastatic); risks death.

CAD: 4.6%; stable angina, unstable, non-STEMI, STEMI; risks MI, heart failure.

AF: 4.5%; paroxysmal, persistent (>7 days), long-standing, permanent; risks stroke.

Osteoporosis: 4%; normal (T-score ≥-1), osteopenia, osteoporosis (≤-2.5), severe (fractures).

PAD: 3%; asymptomatic, claudication, critical ischemia, tissue loss; risks amputation, MI.

Stroke: 3% (survivors); TIA, ischemic (mild, moderate, severe), hemorrhagic; risks disability.

Dementia: 2.9%; mild cognitive impairment, mild, moderate, severe dementia; risks injury.

HF: 2.7%; stage A (risk), B (asymptomatic), C (symptomatic), D (refractory); risks death.

LBP: ~28% (chronic); acute (<6 weeks), subacute, chronic (>12 weeks); risks disability.

Dyslipidemia: 35%; borderline (LDL 130–159), high (160–189), very high (≥190); risks CAD.

Style #2 

1. Dental Caries: Demineralization → enamel cavity → dentin cavity → pulp involvement → abscess → tooth loss

2. LBP: Acute strain → subacute (6wks) → chronic (>12wks) → severe disability → surgical candidate

3. Obesity: Overweight (BMI 25-29.9) → Class I (30-34.9) → Class II (35-39.9) → Class III (≥40) severe

4. HTN: Normal (<120/80) → elevated (120-129/<80) → Stage 1 (130-139/80-89) → Stage 2 (≥140/90) → crisis (>180/120)

5. Dyslipidemia: Borderline high → high → very high LDL; combined hyperlipidemia → severe familial forms

6. OA: Joint space narrowing → osteophytes → subchondral sclerosis → bone-on-bone → joint replacement needed

7. GERD: Intermittent symptoms → weekly symptoms → daily symptoms → erosive esophagitis → Barrett's → adenocarcinoma

8. Anxiety: Mild situational → moderate GAD → severe panic disorder → agoraphobia → complete avoidance

9. COPD: At-risk → mild (FEV1 ≥80%) → moderate (50-79%) → severe (30-49%) → very severe (<30%)

10. CKD: Stage 1 (GFR >90) → 2 (60-89) → 3a (45-59) → 3b (30-44) → 4 (15-29) → 5 (<15) ESRD

11. Depression: Mild episode → moderate → severe without psychosis → severe with psychosis → treatment-resistant

12. PAD: Asymptomatic → claudication → rest pain → tissue loss → amputation risk

13. AF: Paroxysmal → persistent → long-standing persistent → permanent → with complications (stroke/HF)

14. HF: Stage A (at-risk) → B (structural disease) → C (symptomatic) → D (refractory/end-stage)

15. Dementia: MCI → mild → moderate → severe → end-stage requiring total care

16. CAD: Subclinical atherosclerosis → stable angina → unstable angina → NSTEMI → STEMI → cardiogenic shock

17. Stroke: TIA → minor stroke → major stroke → massive stroke → brain death

18. DM2: Prediabetes (A1c 5.7-6.4%) → early DM → established DM → complications → end-organ failure

19. Asthma: Intermittent → mild persistent → moderate persistent → severe persistent → life-threatening exacerbation

20. Anemia: Mild (Hgb 10-12) → moderate (8-10) → severe (6.5-8) → life-threatening (<6.5) → transfusion-dependent

21. Osteoporosis: Normal → osteopenia (T-score -1 to -2.5) → osteoporosis (<-2.5) → severe with fractures

22. Hearing Loss: Mild (26-40dB) → moderate (41-55dB) → moderate-severe (56-70dB) → severe (71-90dB) → profound (>90dB)

23. Sleep Apnea: Mild (AHI 5-15) → moderate (15-30) → severe (>30) → life-threatening complications

24. Chronic Pain: Acute → subacute → chronic → severe refractory → disability/bedridden

25. Cancer: In situ → Stage I (localized) → II (regional) → III (extensive regional) → IV (metastatic)

HTN: 47.7%; normal (<120/80), elevated, stage 1 (130–139/80–89), stage 2 (≥140/90); risks stroke, CKD.

Obesity: 40.3%; Class I (BMI 30–34.9), II (35–39.9), III (≥40); risks DM, HTN.

Chronic Pain: 24.3%; acute (<3 months), subacute, chronic (>6 months); risks disability, depression.

Dental Caries: 21.3% (untreated); initial (enamel), moderate (dentin), severe (pulp); risks abscess, tooth loss.

GERD: 20%; mild (occasional reflux), moderate (frequent), severe (esophagitis, Barrett’s); risks stricture.

Anxiety: 19%; mild (manageable), moderate (impairs function), severe (debilitating); risks panic disorder.

Hearing Loss: 15.5%; mild (26–40 dB), moderate (41–55), severe (>56); risks isolation.

CKD: 14%; stage 1 (GFR ≥90), 2 (60–89), 3 (30–59), 4–5 (ESRD); risks CV death.

Depression: 13.1%; mild (few symptoms), moderate (impairment), severe (suicidal ideation); risks disability.

OA: 12.6%; grade 1 (mild), 2 (moderate), 3 (severe), 4 (end-stage); risks disability.

DM2: 11.6%; prediabetes (A1c 5.7–6.4%), diabetes, complicated (neuropathy, CKD); risks amputation.

Sleep Apnea: 10%; mild (AHI 5–14), moderate (15–29), severe (≥30); risks HTN.

Asthma: 8.2%; intermittent, mild persistent, moderate, severe persistent; risks exacerbations.

Anemia: 7.8%; mild (Hb 11–12 g/dL), moderate (8–10.9), severe (<8); risks fatigue.

COPD: 6.5%; GOLD 1 (FEV1 ≥80%), 2 (50–79%), 3–4 (<50%); risks respiratory failure.

Cancer: 5%; stage 0 (in situ), I–II (local), III–IV (metastatic); risks death.

CAD: 4.6%; stable angina, unstable, non-STEMI, STEMI; risks MI, heart failure.

AF: 4.5%; paroxysmal, persistent (>7 days), long-standing, permanent; risks stroke.

Osteoporosis: 4%; normal (T-score ≥-1), osteopenia, osteoporosis (≤-2.5), severe (fractures).

PAD: 3%; asymptomatic, claudication, critical ischemia, tissue loss; risks amputation, MI.

Stroke: 3% (survivors); TIA, ischemic (mild, moderate, severe), hemorrhagic; risks disability.

Dementia: 2.9%; mild cognitive impairment, mild, moderate, severe dementia; risks injury.

HF: 2.7%; stage A (risk), B (asymptomatic), C (symptomatic), D (refractory); risks death.

LBP: ~28% (chronic); acute (<6 weeks), subacute, chronic (>12 weeks); risks disability.

Dyslipidemia: 35%; borderline (LDL 130–159), high (160–189), very high (≥190); risks CAD.

Dietary Principles to Reduce HTN and Feet Swelling

1. Reduce Sodium Intake (HTN & Edema):

   • Why: Excess sodium increases blood pressure by causing fluid retention, which also worsens edema.

   • How: Limit to 1,500–2,300 mg/day (AHA/CDC). Avoid processed foods (e.g., canned soups, deli meats, chips), which account for 70% of sodium intake.

   • Foods to Choose: Fresh vegetables, fruits, unsalted nuts, and home-cooked meals.

   • Practical Tip: Use herbs (e.g., basil, rosemary) or spices (e.g., turmeric, ginger) instead of salt for flavor. Check labels for sodium content (<140 mg/serving is low).

2. Increase Potassium-Rich Foods (HTN & Edema):

   • Why: Potassium balances sodium, relaxes blood vessels, and promotes fluid excretion, reducing both BP and swelling.

   • How: Aim for 3,500–4,700 mg/day (DASH guidelines).

   • Foods to Choose: Bananas (422 mg/cup), sweet potatoes (541 mg/medium), spinach (839 mg/cup cooked), avocados (708 mg/medium), and beans (e.g., white beans, 1,000 mg/cup).

   • Practical Tip: Add a banana to breakfast or a baked sweet potato to dinner. Pair with low-sodium preparation.

3. Adopt a DASH-Style Diet (HTN):

   • Why: DASH reduces systolic BP by 6–11 mmHg (JAMA, 2021) by emphasizing nutrient-dense, anti-inflammatory foods.

   • How: Focus on whole grains (6–8 servings/day), vegetables (4–5 servings/day), fruits (4–5 servings/day), lean proteins (e.g., fish, poultry, <6 oz/day), and low-fat dairy (2–3 servings/day).

   • Foods to Choose: Oatmeal, quinoa, broccoli, berries, salmon, and skim milk.

   • Practical Tip: Plan meals with half your plate as vegetables/fruits, a quarter lean protein, and a quarter whole grains.

4. Limit Refined Carbs and Sugars (HTN):

   • Why: High sugar intake is linked to obesity and HTN (Circulation, 2020); refined carbs spike BP and inflammation.

   • How: Avoid sugary drinks, white bread, and desserts. Choose complex carbs (e.g., brown rice, whole-grain pasta).

   • Practical Tip: Swap soda for water or herbal tea; use fruit for natural sweetness.

5. Increase Anti-Inflammatory Foods (HTN & Edema):

   • Why: Inflammation contributes to HTN and fluid retention. Anti-inflammatory foods (e.g., omega-3s, antioxidants) support vascular health.

   • How: Include fatty fish (salmon, mackerel, 2 servings/week), nuts (almonds, walnuts, 1 oz/day), olive oil, and colorful produce (berries, leafy greens).

   • Practical Tip: Add a handful of walnuts to salads or use olive oil in cooking. Try a salmon dish weekly.

6. Reduce Caffeine and Alcohol (HTN & Edema):

   • Why: Excess caffeine can raise BP in sensitive individuals; alcohol increases BP and fluid retention.

   • How: Limit caffeine to 200–300 mg/day (1–2 cups coffee) and alcohol to 1 drink/day (women) or 2 (men).

   • Practical Tip: Switch to decaf coffee or herbal teas (e.g., hibiscus, shown to lower BP in studies).

7. Stay Hydrated, but Monitor Fluid Intake (Edema):

   • Why: Proper hydration prevents dehydration-induced fluid retention, but excessive fluids can worsen edema in some cases (e.g., heart or kidney issues).

   • How: Aim for 6–8 cups/day unless restricted by a doctor. Spread intake evenly.

   • Practical Tip: Sip water throughout the day; avoid chugging large amounts at once.

8. Limit Foods That Worsen Edema:

   • Why: High-sodium and processed foods exacerbate fluid retention.

   • How: Avoid fast food, frozen meals, and salty snacks. Limit red meat, which can increase inflammation.

   • Practical Tip: Prepare homemade soups with low-sodium broth and fresh vegetables.

Sample Daily Meal Plan

• Breakfast: Oatmeal (1 cup) with berries (1 cup), 1 tbsp chia seeds, and skim milk (1 cup). Potassium: ~600 mg, Sodium: <100 mg.

• Snack: Banana (1 medium) and 10 unsalted almonds. Potassium: ~450 mg.

• Lunch: Grilled salmon (4 oz), quinoa (1 cup), steamed spinach (1 cup) with olive oil drizzle. Potassium: ~1,200 mg, Sodium: <200 mg.

• Snack: Greek yogurt (low-fat, 3/4 cup) with sliced kiwi (1). Potassium: ~400 mg.

• Dinner: Baked chicken breast (4 oz), roasted sweet potato (1 medium), and broccoli (1 cup) with garlic and turmeric. Potassium: ~1,000 mg, Sodium: <200 mg.

• Total: ~3,650 mg potassium, <1,500 mg sodium, anti-inflammatory focus.

1 Capsaicin (topical) 0.025–0.075% cream, apply 3–4x/day Effective for neuropathic/musculoskeletal pain [1]

2 Omega-3 fatty acids (fish oil) 1–3 g EPA/DHA daily Reduces inflammatory musculoskeletal pain [2-4]

3 Curcumin (turmeric extract) 500–2000 mg/day Anti-inflammatory, reduces arthritis pain [4-6]

4 Devil’s claw (Harpagophytum) 600–1200 mg extract/day Reduces low back and osteoarthritis pain [1]

5 Willow bark (Salix alba) 120–240 mg salicin/day Analgesic for low back/osteoarthritis pain [1]

6 Comfrey root (topical) Cream/ointment, 2–3x/day Reduces acute back and joint pain [1, 7] 

7 Boswellia serrata 100–250 mg extract 2–3x/day Reduces osteoarthritis pain [5-6]

8 Lavender oil (topical/aroma) Topical or aromatherapy Modest effect on neuropathic pain [1, 7]

9 Vitamin D (for deficiency) 800–2000 IU/day May reduce musculoskeletal pain if deficient [2, 5]

10 Magnesium 250–500 mg/day May help with migraine, muscle pain  [5]

For dietary approaches, plant-based Mediterranean and vegan/vegetarian diets show fair evidence for reducing musculoskeletal pain, likely via anti-inflammatory effects.[2][4]

Intermittent fasting (IF) may modestly reduce chronic pain and improve inflammation, but evidence is mixed and not yet definitive.[8-9] IF and continuous caloric restriction are comparably effective for weight loss and cardiometabolic health; alternate day fasting may provide slightly greater short-term weight loss than other IF regimens.[10-12] For weight loss, both IF and traditional calorie restriction are effective, and the choice should be individualized based on patient preference and comorbidities.[10-12]

In summary, several natural substances and dietary strategies have moderate evidence for pain relief, but should be used as adjuncts to standard care, with attention to safety and individual patient factors.

1.

Herbal Medicine for Low Back Pain: A Cochrane Review.

Gagnier JJ, Oltean H, van Tulder MW, et al.

Spine. 2016;41(2):116-33. doi:10.1097/BRS.0000000000001310.

2.

Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review.

Mendonça CR, Noll M, Castro MCR, Silveira EA.

Nutrients. 2020;12(10):E3075. doi:10.3390/nu12103075.

3.

Does Diet Play a Role in Reducing Nociception Related to Inflammation and Chronic Pain?.

Bjørklund G, Aaseth J, Doşa MD, et al.

Nutrition (Burbank, Los Angeles County, Calif.). 2019;66:153-165. doi:10.1016/j.nut.2019.04.007.

4.

Diet Composition's Effect on Chronic Musculoskeletal Pain: A Narrative Review.

Kurapatti M, Carreira D.

Pain Physician. 2023;26(7):527-534.

5.

Non-Drug Pain Relievers Active on Non-Opioid Pain Mechanisms.

Marchesi N, Govoni S, Allegri M.

Pain Practice : The Official Journal of World Institute of Pain. 2022;22(2):255-275. doi:10.1111/papr.13073.

6.

Recent Development in Antihyperalgesic Effect of Phytochemicals: Anti-Inflammatory and Neuro-Modulatory Actions.

Singh AK, Kumar S, Vinayak M.

Inflammation Research : Official Journal of the European Histamine Research Society ... [Et Al.]. 2018;67(8):633-654. doi:10.1007/s00011-018-1156-5.

 Leading Journal 

7.

A Comprehensive Review on Clinically Proven Natural Products in the Management of Nerve Pain, With Mechanistic Insights.

Dewanjee S, Sohel M, Hossain MS, et al.

Heliyon. 2023;9(5):e15346. doi:10.1016/j.heliyon.2023.e15346.

8.

The Effectiveness of Intermittent Fasting, Time Restricted Feeding, Caloric Restriction, a Ketogenic Diet and the Mediterranean Diet as Part of the Treatment Plan to Improve Health and Chronic Musculoskeletal Pain: A Systematic Review.

Cuevas-Cervera M, Perez-Montilla JJ, Gonzalez-Muñoz A, Garcia-Rios MC, Navarro-Ledesma S.

International Journal of Environmental Research and Public Health. 2022;19(11):6698. doi:10.3390/ijerph19116698.

9.

Intermittent Fasting: Potential Utility in the Treatment of Chronic Pain Across the Clinical Spectrum.

Caron JP, Kreher MA, Mickle AM, et al.

Nutrients. 2022;14(12):2536. doi:10.3390/nu14122536.

10.

Intermittent Fasting Strategies and Their Effects on Body Weight and Other Cardiometabolic Risk Factors: Systematic Review and Network Meta-Analysis of Randomised Clinical Trials.

Semnani-Azad Z, Khan TA, Chiavaroli L, et al.

BMJ (Clinical Research Ed.). 2025;389:e082007. doi:10.1136/bmj-2024-082007.

 Leading Journal  New Research

11.

Longer-Term Effects of Intermittent Fasting on Body Composition and Cardiometabolic Health in Adults With Overweight and Obesity: A Systematic Review and Meta-Analysis.

Khalafi M, Maleki AH, Ehsanifar M, Symonds ME, Rosenkranz SK.

Obesity Reviews : An Official Journal of the International Association for the Study of Obesity. 2025;26(2):e13855. doi:10.1111/obr.13855.

 Leading Journal  New Research

12.

Effects of Intermittent Fasting on Health, Aging, and Disease.

de Cabo R, Mattson MP.

The New England Journal of Medicine. 2019;381(26):2541-2551. doi:10.1056/NEJMra1905136.

 Leading Journal 

Evidence & Typical Range

• Transient rise: Most studies show systolic blood pressure (SBP) increases by ~10–30 mmHg and diastolic blood pressure (DBP) by ~5–15 mmHg during acute anxiety, stress testing, or panic attacks.

• White coat hypertension: Patients with clinical anxiety in medical settings often show SBP increases of 10–40 mmHg compared to home values.

• Mechanism: Anxiety → ↑ sympathetic outflow → ↑ heart rate, cardiac output, and vasoconstriction → acute BP elevation.

Important Notes

• These increases are temporary; anxiety does not cause sustained hypertension, but in people with existing hypertension, repeated spikes may worsen vascular risk.

• Chronic anxiety can contribute indirectly to hypertension through poor sleep, alcohol, and reduced exercise.