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The Impact of Blood Pressure on Wellness: Insights from WHOOP Research

Research suggests higher blood pressure may affect various aspects of health and well-being.

  • It can have a long-term effect on your cognitive performance: Sustained high blood pressure, especially during mid-life, consistently predicted decline in cognitive performance later in life, notably affecting memory, executive functioning, and attention, read more here. Lowering blood pressure, particularly when initiated during mid-life, improves cognitive outcomes, read more here
  • Well-being and Quality of Life: It can affect how you feel day-to-day (energy, comfort, mood):  Effective blood pressure management generally improved QoL across physical, mental, and emotional health domains (sources: Masyuko et al., 2021; Schmieder RE et al., 2017; Trevisol DJ et al., 2011). Demographic factors (age, frailty, baseline health) and treatment intensity significantly influences outcomes (sources: Berlowitz et al., 2017; Taft  et al., 2018; Sugimoto  & Yamamoto, 2022), underscoring the importance of individualized strategies.
  • Resilience: Research shows that individuals with sustained higher blood pressure have impaired baroreflex sensitivity, autonomic regulation, lower HRV and RHR adaptability while increasing stress on the heart, read more here and here. Elevated resting heart rate (≥80 bpm) correlates with increased sympathetic tone and poorer outcomes, see Grassi et al., 2023. Overall, evidence highlights a complex interaction between autonomic nervous system function and higher blood pressures, characterized by positive correlations with resting heart rate, negative associations with heart rate variability and baroreflex sensitivity, and variable sympathetic nervous system activity correlations across different populations.
  • Exercise performance: People who have higher blood pressure for a long time often have reduced exercise capacity, linked to stiffer carotid arteries and lower oxygen reserves, which are connected to decreased artery flexibility, read more here and here . Resistance training regularly leads to lowered blood pressure after exercise in both individuals with normal and higher blood pressure; however, people with higher blood pressure often have a greater drop in blood pressure after exercising, indicating an imbalanced heart and blood vessel responses following physical activity, read more here. Consistent exercise can normalize these responses by improving the autonomic nervous system response, read more here
  • Sleep and blood pressure have a two-way relationship.This means that not getting enough good sleep can affect your blood pressure, and having higher blood pressure can in turn make it harder to sleep well.  In some cases, a higher blood pressure may be an indicator for poor sleep, read more here.
    • Sleep Quality: Across five studies, people with higher blood pressure had significantly worse self-reported sleep quality than those with blood pressure less than 120/80 mmHg. Read more here
    • Sleep Fragmentation: In a recent review investigating the relationship between sleep features and higher blood pressure, researchers reported that people with sustained higher blood pressure experienced alterations to their sleep duration, sleep stages, and fragmentation compared to people with blood pressure less than 120/80 mmHg, with individuals with higher BP experiencing higher sleep fragmentation, read more here
    • Sleep Architecture: Same review by Kanclerska and colleagues (2023) has concluded that higher blood pressure is associated with lower duration of REM sleep, another longitudinal study has found that the rate of decline in REM sleep over time is higher for individuals with higher blood pressure. 
    • Sexual Function: Individuals with sustained high blood pressure show higher rates of sexual dysfunction compared to individuals with normal blood pressure (sources: Manolis & Doumas, 2008; Lou et al., 2023). 

It is worth noting that many of these studies have limitations based on the populations they recruited to participate in the study and other design limitations.  So there remains much to learn and WHOOP intends to be part of the effort to better understand the impacts and uses of blood pressure information.  Also, many observed associations (higher blood pressure with sleep etc.) are bidirectional or confounded by common causes, making it challenging to parse cause and effect. Untangling these requires longitudinal studies and ideally interventional studies (e.g. see if treating one improves the other). In any case, it is important to note that the information provided here represents general insights into the potential relationships between blood pressure and various aspects of health and well-being. However, individual responses can vary significantly based on factors such as genetics, sex, ethnicity,  overall lifestyle, pre-existing conditions, and medication use. Readers are encouraged to interpret these findings as broad information rather than definitive rules and to consult qualified healthcare professionals for personalized advice or treatment.

References

Elias, M. F., Goodell, A. L., & Dore, G. A. (2012). Hypertension and Cognitive Functioning: A Perspective in Historical Context. Hypertension, 60(2), 260–268. https://doi.org/10.1161/HYPERTENSIONAHA.111.186429

Grassi G, Dell’Oro R, Bombelli M, Cuspidi C, & Quarti-Trevano F. (2023). High blood pressure with elevated resting heart rate: A high risk “Sympathetic” clinical phenotype. Hypertension Research : Official Journal of the Japanese Society of Hypertension, 46(10), 2318–2325. https://doi.org/10.1038/s41440-023-01394-9

Gupta A, Perdomo S, Billinger S, Beddhu S, Burns J, & Gronseth G. (2020). Treatment of hypertension reduces cognitive decline in older adults: A systematic review and meta-analysis. BMJ Open, 10(11), e038971. https://doi.org/10.1136/bmjopen-2020-038971

Kanclerska J, Szymańska-Chabowska A, Poręba R, Michałek-Zrąbkowska M, Lachowicz G, Mazur G, & Martynowicz H. (2023). A Systematic Review of Publications on the Associations Between Sleep Architecture and Arterial Hypertension. Medical Science Monitor : International Medical Journal of Experimental and           Clinical Research, 29, e941066. https://doi.org/10.12659/MSM.941066

Liu, D., Yu, C., Huang, K., Thomas, S., Yang, W., Liu, S., & Kuang, J. (2022). The Association between Hypertension and Insomnia: A Bidirectional Meta-Analysis of Prospective Cohort Studies. International Journal of Hypertension, 2022, 4476905. https://doi.org/10.1155/2022/4476905

Lo, K., Woo, B., Wong, M., & Tam, W. (2018). Subjective sleep quality, blood pressure, and hypertension: A meta-analysis. The Journal of Clinical Hypertension, 20(3), 592–605. https://doi.org/10.1111/jch.13220

Lou IX, Chen J, Ali K, & Chen Q. (2023). Relationship Between Hypertension, Antihypertensive Drugs and Sexual Dysfunction in Men and Women: A Literature Review. Vascular Health and Risk Management, 19, 691–705. https://doi.org/10.2147/VHRM.S439334

Manolis, A., & Doumas, M. (2008). Sexual dysfunction: The ‘prima ballerina’ of hypertension-related quality-of-life complications. Journal of Hypertension, 26(11), 2074–2084. https://doi.org/10.1097/HJH.0b013e32830dd0c6

Masyuko, S., Ngongo, C. J., Smith, C., & Nugent, R. (2021). Patient-reported outcomes for diabetes and hypertension care in low- and middle-income countries: A scoping review. PLOS ONE, 16(1), e0245269. https://doi.org/10.1371/journal.pone.0245269

Mazic, S., Suzic Lazic, J., Dekleva, M., Antic, M., Soldatovic, I., Djelic, M., Nesic, D., Acimovic, T., Lazic, M., Lazovic, B., & Suzic, S. (2015). The impact of elevated blood pressure on exercise capacity in elite athletes. International Journal of Cardiology, 180, 171–177. https://doi.org/10.1016/j.ijcard.2014.11.125

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Moon, C., Hagen, E. W., Johnson, H. M., Brown, R. L., & Peppard, P. E. (2021). Longitudinal sleep characteristics and hypertension status: Results from the Wisconsin Sleep Cohort Study. Journal of Hypertension, 39(4), 683. https://doi.org/10.1097/HJH.0000000000002692

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Ooi JH, Lim R, Seng H, Tan MP, Goh CH, Lovell NH, Argha A, Beh HC, Md Sari NA, & Lim E. (2024). Non-invasive parameters of autonomic function using beat-to-beat cardiovascular variations and arterial stiffness in hypertensive individuals: A systematic review. Biomedical Engineering Online, 23(1), 23. https://doi.org/10.1186/s12938-024-01202-6

Sayk, F., Becker, C., Teckentrup, C., Fehm, H.-L., Struck, J., Wellhoener, J. P., & Dodt, C. (2007). To Dip or Not to Dip: On the Physiology of Blood Pressure Decrease During Nocturnal Sleep in Healthy Humans. Hypertension, 49(5), 1070–1076. https://doi.org/10.1161/HYPERTENSIONAHA.106.084343

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Sugimoto K & Yamamoto K. (2022). Hypertension, the decline of activities of daily living (ADL) and frailty. Hypertension Research : Official Journal of the Japanese Society of Hypertension, 45(4), 629–634. https://doi.org/10.1038/s41440-021-00846-4

Taft C, Hallberg I, Bengtsson U, Manhem K, & Kjellgren K. (2018). Links between blood pressure and medication intake, well-being, stress, physical activity and symptoms reported via a mobile phone-based self-management support system: A cohort study in primary care. BMJ Open, 8(8), e020849. https://doi.org/10.1136/bmjopen-2017-020849

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