Do benzodiazepine drugs lower blood pressure?

Written by Brandon Okey. Mina Draskovic, B.Psy., reviewed this content for accuracy.

Benzodiazepines are among the most widely prescribed medications for anxiety and insomnia, but they can jeopardize your cardiovascular health. These medications lower your blood pressure by relaxing your blood vessels and calming your nervous system.

A 2023 study suggests that the unpredictable effects of benzodiazepines on blood pressure can trigger dangerous cardiovascular events, especially in older adults or those with heart conditions.

At Ardu, we monitor your heart health closely during benzo tapering to prevent dangerous cardiovascular complications. Our medication management service addresses the harmful blood pressure fluctuations caused by benzodiazepines to reduce the risk of sudden drops or spikes that often occur during withdrawal.

Reach out to our benzo rehab center when you’re ready to free your mind and protect your heart.

Are benzos good for blood pressure?

Benzodiazepines lower blood pressure in most patients, but this doesn’t make them beneficial for cardiovascular health. They enhance the effects of gamma-aminobutyric acid (GABA) in your brain. GABA works as your brain’s natural calming chemical, and when benzos amplify its action, they create a cascade of relaxing effects throughout your body. This relaxation extends to your blood vessels, causing them to dilate and reduce peripheral resistance. One of the consequences is a drop in your blood pressure.

A blood pressure reduction might seem beneficial, but it creates unpredictable cardiovascular responses. A 2020 study found that benzodiazepines interfere with your body’s natural ability to stabilize blood pressure after standing, causing your blood pressure to continue dropping when it should be recovering. This delayed recovery often leads to orthostatic hypotension, a dangerous drop in blood pressure when you stand up.

An Australian national study identified a series of harmful effects of benzodiazepines on blood pressure.

Here’s why benzos aren’t good for managing blood pressure:

Long-term benzodiazepine use reduces blood pressure in older adults, dropping systolic and diastolic readings. This effect appears minimal in younger patients but still carries risks for hypertensive patients on other medications.
Benzodiazepines block sympathetic nerve activity, preventing the typical blood pressure recovery and prolonging dangerous hypotensive effects when standing. Blood pressure plummets most dramatically 10 seconds after standing, with gaps of up to 21 mmHg between benzodiazepine-treated patients and untreated patients.
Short-term benzodiazepine consumption triggers temporary spikes in blood pressure, which contradicts long-term effects.
Apart from suppressing blood pressure through GABA, benzodiazepines also directly relax blood vessels through their muscle-relaxing properties. Both pathways drive the hypotensive effects regardless of the specific type of benzodiazepine a person takes.

Benzodiazepines don’t target your cardiovascular system with precision. Instead, they produce cardiovascular effects as a secondary consequence of their primary action on your central nervous system. Your cardiovascular system adapts to benzodiazepines over time, becoming less responsive to their blood pressure-lowering effects.

Meanwhile, your brain still craves the drug, which increases your dependency risk even when the cardiovascular benefits fade.

We specialize in treating benzodiazepine dependence while we monitor your overall health throughout the tapering process. Our medical team creates personalized treatment plans that address the physical withdrawal symptoms of benzodiazepine use and the underlying anxiety that led to it.

How benzodiazepines may indirectly affect blood pressure

Beyond their direct action on blood vessels, benzodiazepines reshape blood pressure regulation through lifestyle and health behavior changes. Long-term use creates a complex web of indirect cardiovascular effects beyond immediate pharmacological actions.

Benzodiazepines disrupt normal sleep-wake cycles that regulate blood pressure patterns throughout the day and night. This disruption worsens existing sleep disorders and forces your cardiovascular system to work harder during periods when it should be recovering.
Your eating habits change under the influence of benzodiazepines, often leading to increased sodium consumption. This dietary shift directly elevates blood pressure in patients with essential hypertension.
Benzodiazepines alter social patterns, increasing isolation that worsens anxiety in patients who already have hypertension.
Cognitive function declines with benzodiazepine use. Patients often forget medication doses and miss appointments with healthcare professionals. This poor adherence allows blood pressure to rise unchecked.
Some patients combine benzodiazepines with alcohol. This is a dangerous combination that impacts heart function and disrupts normal blood pressure regulation.
Many patients experience rebound anxiety between doses. Anxiety spikes trigger temporary blood pressure elevations, which creates a roller-coaster effect on cardiovascular health.
Benzodiazepines’ effects mask symptoms that would otherwise alert you to underlying cardiovascular disease. This delays the diagnosis and treatment of serious conditions.

Despite these cardiovascular concerns, many patients take benzodiazepines to manage their mental health issues, especially different types of anxiety disorders.

Ardu’s dual diagnosis program addresses substance dependence and underlying mental health issues simultaneously. Our approach treats anxiety with evidence-based therapies that protect your heart while healing your mind—no benzodiazepines required.

Do benzodiazepines lower heart rate?

Benzodiazepines can lower heart rate, although their effects are typically mild. Heart rate and blood pressure function in a connected system. When benzos relax blood vessels and lower pressure, your heart responds by slowing its pace. This effect poses particular risks for older adults and those with existing heart conditions. Because of their relaxing, anxiolytic properties, benzodiazepines decrease systolic and diastolic blood pressure, especially in anxious patients with hypertension.

According to a 2024 study, taking large amounts of benzodiazepines and zolpidem rarely causes a low heart rate. Lowering heart rate isn’t their primary purpose, but this effect depends on your metabolism, overall health, underlying medical conditions, and even age.

Who should avoid benzodiazepines?

Benzodiazepines are risky for certain people because of their cardiovascular, cognitive, and addictive properties. The following groups should avoid benzodiazepine use or approach it with extreme caution:

People with heart failure or a history of heart attack.
Diabetic patients who may not recognize hypoglycemic symptoms.
Those taking calcium channel blockers or other antihypertensive medications.
People with sleep disorders. like sleep apnea.
Those with bipolar disorder.
Anyone with a personal or family history of substance use disorders.
Pregnant or breastfeeding women.
People with severe liver disease.

If you fall into any of these categories, discuss safer alternatives with your healthcare provider.

Contact Ardu and explore safe, effective alternatives to benzodiazepines that support your mental health and cardiovascular wellbeing.

Break free from benzodiazepine dependence with Ardu

Overcoming benzodiazepine dependence requires a personalized approach that addresses withdrawal management and cardiovascular health restoration. Our treatment journey begins with medically supervised detox, your first step toward normalized blood pressure and heart function.

Our detox program prioritizes your cardiovascular safety during the challenging withdrawal period. We employ gradual tapering protocols under 24/7 medical supervision to minimize withdrawal symptoms while carefully monitoring your blood pressure and heart rate.

Since withdrawal can trigger dangerous blood pressure spikes, we complement our medical care with holistic approaches including gentle yoga therapy, mindfulness-based stress reduction, and nutritional therapy that help regulate your cardiovascular system naturally.

Dual diagnosis treatment

Many people struggling with benzodiazepine dependence started taking these medications for anxiety. Our integrated dual diagnosis approach addresses dependency and underlying anxiety, breaking the cycle where stress and blood pressure fluctuations reinforce each other.

We combine evidence-based treatment with individual therapy, CBT for anxiety management, and relaxation practices to help you develop natural ways to maintain healthy blood pressure without medication.

Comprehensive rehabilitation

Following detox, our rehabilitation program offers inpatient and outpatient options to support your cardiovascular recovery. Our residential program provides a controlled environment where we can closely monitor your heart health as your body adjusts to functioning without benzodiazepines. For those needing more flexibility, our outpatient program includes regular cardiovascular checkups while you learn to implement lifestyle changes that support heart health.

Family support facilitates lasting recovery. Through family therapy sessions, we help rebuild relationships while educating loved ones about addiction risks and how to support your ongoing health and recovery.

Contact Ardu online or call at 801-872-8480 to learn how our personalized treatment approach can help you achieve cardiovascular stability without benzodiazepines. Our expert team is ready to guide you through every step of your recovery journey.

Brandon Okey is the co-founder of Ardu Recovery Center and is dedicated to empowering people on their journey to sobriety.

Benzodiazepines effects on blood pressure FAQ

Is Xanax a beta blocker?

Xanax (alprazolam) is not a beta blocker. It’s a benzodiazepine that enhances GABA in the brain to produce feelings of calmness and reduce anxiety. Beta blockers, like propranolol and metoprolol, act on the heart and blood vessels by blocking adrenaline effects. While both medications reduce anxiety symptoms, they work through different mechanisms. Beta blockers mainly address physical symptoms of anxiety such as rapid heartbeat and trembling, while Xanax affects the central nervous system directly.

What is better than Xanax for anxiety?

Several medications often work better than Xanax for anxiety without the addiction risk.

SSRIs (like Lexapro and Zoloft) and SNRIs (like Cymbalta) treat anxiety disorders more effectively long-term without causing dependence or cardiovascular risks.
Buspirone offers anxiety relief without sedation or addiction potential.
For physical symptoms, beta blockers help with performance anxiety without affecting cognitive function.
Pregabalin manages anxiety with less abuse potential than benzodiazepines.

Beyond medications, cognitive behavioral therapy shows superior long-term outcomes than Xanax, with lasting benefits and no side effects. The best approach often combines non-addictive medications with therapy for comprehensive treatment.

Do benzos lower serotonin?

Benzodiazepines don’t directly lower serotonin but can indirectly affect serotonin systems. They primarily work on GABA receptors, not serotonin pathways. Long-term benzodiazepine use may reduce serotonin production through complex brain adaptations. Benzos can diminish the efficacy of SSRIs, medications that increase serotonin levels. Patients who take both may experience reduced benefits from their antidepressants. This interaction explains why benzodiazepines aren’t recommended as first-line treatments for depression.

If you’re taking medications affecting serotonin, talk to your healthcare provider before starting or stopping benzodiazepines to avoid complications with your treatment regimen.

Do benzos reduce cortisol?

Benzodiazepines do reduce cortisol levels. These medications suppress the hypothalamic-pituitary-adrenal axis, decreasing stress hormone production. Research shows benzodiazepines lower cortisol in healthy subjects and patients with anxiety disorders. This cortisol-lowering effect contributes to their anxiety-reducing properties and explains their effectiveness for stress-related conditions.

This suppression can become problematic with long-term use because your body may develop abnormal cortisol responses. After stopping benzodiazepines, patients often experience cortisol rebound, with levels temporarily spiking higher than before. This hormonal fluctuation contributes to withdrawal symptoms and can stress your cardiovascular system.

What is the most common side effect of benzodiazepines?

Drowsiness and sedation are the most common side effects of benzodiazepines and they affect about 70% of patients. This sedation results from how benzodiazepines enhance GABA’s inhibitory effects throughout the brain. Beyond sleepiness, patients frequently report cognitive impairment, including confusion, memory problems, and slurred speech. Muscle relaxation effects cause coordination problems and increase fall risk, especially in older adults.

Cardiovascular side effects include mild drops in blood pressure and heart rate. Longer-acting benzodiazepines such as diazepam (Valium) produce more persistent sedation than shorter-acting ones such as alprazolam (Xanax). These effects typically worsen when combined with alcohol or other central nervous system depressants.

Resources

Solanki B, Goel R, Gupta LK. Benzodiazepines Reduce Blood Pressure in Short Term: A Systematic Review and Meta-analysis. Curr Hypertens Rep. 2023 Oct;25(10):335-341. doi: 10.1007/s11906-023-01256-2. Epub 2023 Aug 15. PMID: 37581768.

Giulia Rivasi, Rose Anne Kenny, Andrea Ungar, Roman Romero-Ortuno, Effects of benzodiazepines on orthostatic blood pressure in older people, European Journal of Internal Medicine, Volume 72, 2020, Pages 73-78, ISSN 0953-6205, https://doi.org/10.1016/j.ejim.2019.10.032.

Begum M, Gonzalez-Chica D, Bernardo C, Stocks N. Impact of long-term management with sleep medications on blood pressure: An Australian national study. Brain Behav. 2023 May;13(5):e2943. doi: 10.1002/brb3.2943. Epub 2023 Apr 3. PMID: 37013365; PMCID: PMC10175978.

Ivanov I, Kirzhner R, Sokup B, Sun Y. Benzodiazepine and Zolpidem-Induced Bradycardia: A Case Report. Cureus. 2024 Jan 12;16(1):e52178. doi: 10.7759/cureus.52178. PMID: 38344520; PMCID: PMC10859173.

Manthey L, Giltay EJ, van Veen T, Neven AK, Vreeburg SA, Penninx BW, Zitman FG. Long-term benzodiazepine use and salivary cortisol: the Netherlands Study of Depression and Anxiety (NESDA). J Clin Psychopharmacol. 2010 Apr;30(2):160-8. doi: 10.1097/JCP.0b013e3181d41f41. PMID: 20520289.