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Get Smart on Blood Pressure with CBT

Cognitive Behavioral Therapy (CBT) was recently shown to have a significant positive effect on health outcomes for people with hypertension in a new systematic review and meta-analysis published by Preventive Medicine Reports. These results are good news as preventing and treating hypertension is of great importance. Addressing the psychological factors underlying high blood pressure gives people an additional way to address their cardiovascular health.

According to the Mayo Clinic, for people who are not taking blood pressure medication, the following readings apply:

Normal blood pressure. Ranges from 120/80 mm Hg or lower.

Elevated blood pressure. Ranges from 120 to 129 mm Hg, the bottom number is below 80 mm Hg.

Stage 1 hypertension. Ranges from 130 to 139 mm Hg or the bottom number is between 80 and 89 mm Hg.

Stage 2 hypertension. Ranges from 140/90 mm Hg or higher.

Blood pressure higher than 180/120 mm Hg is considered a hypertensive emergency. Seek emergency medical help.

In most people, primary essential hypertension results from the interaction of genetic (inherited) and lifestyle factors, while in a smaller proportion of people, blood pressure is higher due to an underlying medical condition, known as secondary high blood pressure. Currently, hypertension affects approximately one third of the adults in the United States. Due to the medical problems that hypertension can cause, it can pose a heavy burden on the person, their family, and on society.

Effectively preventing and treating hypertension is an important goal. Treatment requires a medical diagnosis and is always treated by a medical professional. It is important for people with hypertension to make effective lifestyle changes such as: taking prescribed blood pressure lowering medications, exercising, eating a healthy diet, and quitting smoking and limiting alcohol use. Hypertension is a chronic condition and it’s understandable that people would be prone to negative emotions such as anxiety and depression during treatment.

CBT is a psychological therapy that aims to integrate thoughts, feelings, and behaviors to help the person change perceptions to enhance their quality of life. Thoughts, feelings, and behavior are all related and affect each other. When a person is highly anxious or depressed, their thoughts, feelings, and behaviors tend to work against them in a vicious cycle. CBT helps a person break out of this cycle. As better thinking and more helpful behaviors are practiced, thoughts and actions begin to reinforce each other in a positive and healthy direction.

If your doctor has recommended blood pressure management after higher blood pressure readings in the office, also focusing on the contributing psychological factors would offer a more holistic approach. The thoughts we think can affect our blood pressure, the feelings we feel can affect our thoughts, both can influence how we treat ourselves, how we behave toward ourselves affects our blood pressure. Interrupting this cycle by learning new ways to put a positive focus on thoughts feelings and behavior can be efficacious in reducing systolic pressure, diastolic pressure, total cholesterol level, anxiety symptoms, depressive symptoms and improving the quality of sleep for patients with hypertension. CBT can have a profound impact on the prevention and management of hypertension. You can start by thinking positively about your heart and all it does for you. Begin to care for your heart by taking a more proactive outlook.

If you are interested in a course of CBT as an addition to a healthy heart plan, please contact my office. Therapy is always delivered in an inviting, compassionate office setting.

Lauren A. Salani, LCSW, BCB, Stress Relief Services, Atlantic Executive Center, 107 Monmouth Road, Suite 104, West Long Branch, NJ 07764 Phone: 732.542.2638, Website:,


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