Imagine your body as a bustling city, with arteries serving as highways that deliver vital supplies to various neighbourhoods of your organs. Now, picture rush hour traffic congestion: cars piling up, roads narrowing, movement slowing. Eventually, frustration builds, accidents happen, and the city’s functionality suffers. That’s what hypertension does to your body. It disrupts blood flow, straining the heart and affecting circulation to the brain, which can also have far-reaching consequences for mental health (1).
For decades, the focus of hypertension management has been physical: lower salt intake, exercise more, and take medication if needed. But what if we’ve been missing a crucial piece of the puzzle? Research suggests that sugar, not salt, may significantly contribute to high blood pressure (13). And what if the state of your mind plays just as big a role as the state of your arteries? Chronic stress, anxiety, and poor mental health can all exacerbate hypertension, highlighting the need for a more holistic approach to prevention and care (1-4)
Hypertension can also take a toll on well-being, contributing to mood instability, cognitive decline, and even depression. The connection runs so deep that some researchers argue we should treat hypertension like we treat mental health disorders, with a focus on emotional well-being, stress regulation, and brain health, not just cardiovascular function (1,5,6).
One of the culprits in this cycle is cortisol, the infamous stress hormone. When life throws challenges your way, work deadlines, financial worries, even daily traffic, your body releases cortisol to help you “soldier on.” In small doses, it’s helpful. But when stress is constant, cortisol remains elevated, raising blood pressure and increasing inflammation. Over time, this leads to hypertension, and ironically, those with high blood pressure often feel more anxious, exhausted, or mentally drained because their brain isn’t getting the oxygen and nutrients it needs (6,7).
And here’s where Lifestyle comes in. What you eat affects both your blood pressure and your mental resilience, and the Low-Carb, High-Fat (LCHF) approach has shown promise in balancing both. A well-formulated LCHF diet stabilizes blood sugar, which reduces stress spikes and anxiety, lowers inflammation (a hidden driver of both hypertension and depression), and supports brain function by fuelling it with ketones instead of glucose. Think of ketones as premium fuel: more stable, longer-lasting, and associated with improved mental clarity and cognitive performance (8-11).
Emerging evidence suggests that reducing refined carbohydrates and sugar can significantly lower blood pressure, independent of salt intake. One study found that cutting added sugars led to greater improvements in systolic and diastolic blood pressure than simply reducing sodium (13). Moreover, individuals who opt for a nutrient-dense LCHF diet often report more mental sharpness, reduced anxiety, and even better sleep, which in turn helps regulate blood pressure naturally. Without the blood sugar spikes and crashes associated with processed foods, the body remains in a more balanced metabolic rhythm, promoting both cognitive and cardiovascular health (11,12).
Managing hypertension requires a deeper look at how we live, especially what we eat and how we handle stress. Food plays a powerful role in this equation. Diets high in refined carbs and sugars can fuel inflammation, spike blood sugar, and trigger mood instability, setting off a cycle of stress and elevated blood pressure. On the other hand, nutrient-dense, low-carb diets help stabilize energy levels, reduce inflammation, and support both cardiovascular and mental health. Stress compounds the issue. Chronic cortisol elevation from daily pressures, whether emotional, environmental, or nutritional, can strain the heart and impair brain function. But integrating daily movement, restorative sleep, deep breathing, and mindfulness can lower cortisol, improve mental clarity, and help regulate blood pressure naturally. (1,8,10). At its core, hypertension isn’t just about numbers, it’s about how we live, how we process stress, and how we fuel our bodies. Recognizing the deep connection between mind and heart could transform how we manage hypertension, not just as a physical condition but as an emotional and mental one, too. By aligning diet and lifestyle to support both heart and brain, we move from simply managing disease to cultivating lasting vitality, balance, and resilience.
References
- Shahimi, N. H., Lim, R., Mat, S., Goh, C. H., Tan, M. P., & Lim, E. (2022). Association between mental illness and blood pressure variability: a systematic review. Biomedical engineering online, 21(1), 19. https://doi.org/10.1186/s12938-022-00985-w
- An, E., Irwin, M., Doering, L., Brecht, M., Watson, K., Corwin, E., & Macey, P. (2021). Mindfulness effects on lifestyle behavior and blood pressure: A randomized controlled trial. Health Science Reports, 4(2). https://escholarship.org/uc/item/9hj10943#author
- Kretchy, I. A., Owusu-Daaku, F. T., & Danquah, S. A. (2014). Mental health in hypertension: assessing symptoms of anxiety, depression and stress on anti-hypertensive medication adherence. International journal of mental health systems, 8, 25. https://doi.org/10.1186/1752-4458-8-25
- Hussein, M. S., Albadi, A. A., Alsuhaibani, A. S., Alsameen, R. M., Alsaedi, B. M. B., Alzaher, H. A., Almomen, M. A., Alqurashi, F. A. E., Mohamed, R. H. A., Aldera, S. A., & Alshehri, M. A. M. (2024). Psychological interventions in the treatment of hypertension: Efficacy and applications. Revista Iberoamericana de Psicología del Ejercicio y el Deporte, 19(6), 641–646. https://www.riped-online.com/articles/psychological-interventions-in-the-treatment-of-hypertension-efficacy-and-applications.pdf
- Sparacino J. (1982). Blood pressure, stress, and mental health. Nursing research, 31(2), 89–94. https://pubmed.ncbi.nlm.nih.gov/6764659/
- Schaare, H. L., Blöchl, M., Kumral, D., Uhlig, M., Lemcke, L., Valk, S. L., & Villringer, A. (2023). Associations between mental health, blood pressure and the development of hypertension. Nature communications, 14(1), 1953. https://doi.org/10.1038/s41467-023-37579-6
- Whitworth, J. A., Williamson, P. M., Mangos, G., & Kelly, J. J. (2005). Cardiovascular consequences of cortisol excess. Vascular health and risk management, 1(4), 291–299. https://doi.org/10.2147/vhrm.2005.1.4.291
- Mayo Clinic. (2023). High Blood Pressure (Hypertension). https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410
- Nutrition Network. (2023). Dietary Interventions in Hypertension. https://nutrition-network.org/the-importance-of-understanding-hypertension/
- Paoli, A., Rubini, A., Volek, J. S., & Grimaldi, K. A. (2013). Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. European Journal of Clinical Nutrition, 67(8), 789-796.
https://doi.org/10.1038/ejcn.2013.116 - Taylor, M. K., Sullivan, D. K., Mahnken, J. D., Burns, J. M., & Swerdlow, R. H. (2018). Feasibility and efficacy data from a ketogenic diet intervention in Alzheimer’s disease. Alzheimer’s & Dementia, 14(7), 1030-1037.
https://doi.org/10.1016/j.jalz.2018.01.012 - Cunnane, S. C., Courchesne-Loyer, A., St-Pierre, V., Vandenberghe, C., Pierotti, T., Fortier, M., … & Castellano, C. A. (2016). Can ketones compensate for deteriorating brain glucose uptake during aging? Implications for the risk and treatment of Alzheimer’s disease. Annals of the New York Academy of Sciences, 1367(1), 12-20.
https://doi.org/10.1111/nyas.12999 - DiNicolantonio, J. J., Lucan, S. C., & O’Keefe, J. H. (2014). The wrong white crystals: Not salt but sugar as aetiological in hypertension and cardiometabolic disease. Open Heart, 1(1), e000167. https://doi.org/10.1136/openhrt-2014-000167
Lisa Marashula, The Noakes Foundation Research Assistant
