Do Compression Socks Raise Your Blood Pressure?

Do Compression Socks Raise Your Blood Pressure?

Compression socks apply pressure to your lower limbs, and they boost the velocity of the blood in your veins. They affect your blood by applying pressure, so it might seem logical to assume that compression garments raise your blood pressure. Strictly speaking, this is not true. People with healthy blood pressure do not develop hypertension (high blood pressure) when they wear compression stockings or socks. Knee-high compression garments have no sustained impact on your blood pressure.

Interestingly, some studies suggest that other types of compression garments aid in the treatment of orthostatic hypotension (low blood pressure) by limiting sudden changes in systolic blood pressure; however, knee-high compression socks are not recommended for this purpose. Again, most research suggests that knee-high compression socks and stockings have little impact on blood pressure. 

What Are Compression Socks Designed to Do?

By gently putting pressure on your lower legs, compression socks decrease the diameter of your blood vessels. Not only does this allow the valves inside your vessels to fully close, preventing leakage of blood in the wrong direction, but the smaller diameter also improves the velocity of your blood flow. Think of putting your thumb over half of the mouth of a water hose. By reducing the size of the opening, the spray would become stronger. The same thing happens inside your arteries and veins when you wear compression socks. Increased blood flow leads to a stronger circulatory system, healthier vessels, and less stress on the heart.  

How Do Compression Socks Prevent and Treat Deep Vein Thrombosis?

Some populations are particularly at risk for developing deep vein thrombosis. DVT occurs when blood clots form in the deep veins. Not only can DVT be uncomfortable, but deep vein blood clots sometimes break off and cause blockages elsewhere in the body. When that happens, the resulting blockages, called embolisms, can be fatal.

The following conditions and behaviors increase a person's risk of developing DVT:

  • Pregnancy
  • Age over 60
  • An inherited blood-clotting disorder
  • Bed rest, paralysis, or surgery
  • Injury to veins
  • Oral contraceptives or hormone replacement therapy
  • Obesity
  • Smoking
  • Cancer
  • Heart failure
  • Crohn's disease or ulcerative colitis
  • A family history of deep vein thrombosis or pulmonary embolism
  • Sitting for long periods of time, as on a long-haul flight

Evidence suggests that compression therapy decreases the risk of developing deep vein blood clots for pregnant women ("Deep Vein"), hospital inpatients (Cayley), and airline passengers (Clarke). The increased velocity of blood flow helps to prevent blood from becoming stagnant and clotting in the deep veins. Even when blood clots have already developed, doctors recommend compression socks as a therapy to help treat the symptoms of existing DVT (Blättler), post thrombotic syndrome (Appelen), and pulmonary embolism ("Recovery"). 

Sudden high blood pressure is a symptom of DVT, and someone experiencing this symptom should seek immediate medical attention. Instead of causing hypertension, compression stockings help reduce your likelihood of developing DVT and its affiliated symptoms, which can include spikes in blood pressure. 

How Do Compression Socks Prevent and Treat Varicose Veins?

Varicose veins result from a condition called chronic venous insufficiency (CVI). Normally, blood flows through the veins from the feet to the heart; however, chronic venous insufficiency causes a failure of the one-way valves within the veins. As a result, fluid leaks back down towards the feet, causing enlarged, discolored, and bulbous veins. Not only are the resulting varicose and spider veins unsightly, but they can also cause pain, swelling, and sensations of heaviness in the lower limbs. 

Risk factors for varicose veins include:

  • Old age
  • Sex
  • Pregnancy
  • Family history of varicose veins
  • Obesity
  • Sitting or standing for long periods

Graduated compression socks, like the ones we sell, are fitted with more compression at the ankle and less compression at the calf, so they support the veins as they work against gravity. Furthermore, by constricting the diameter of the veins, they prevent valves from leaking. A large number of studies have shown the positive impact of graduated compression therapy for the prevention and treatment of varicose veins. (Lim) While compression therapy can help to relieve the symptoms of varicose veins, it cannot repair failed venous valves. Short of vascular surgeries and expensive medical procedures, compression socks provide the most convenient and cost-effective way to manage existing varicose and spider veins caused by CVI.

How Do Compression Socks Reduce Swelling ?

We've already discussed how compression socks can reduce swelling for patients suffering from DVT and CVI. Even for those without existing venous conditions, long periods of sitting or standing can cause edema—and compression therapy can help. To learn more about how graduated compression therapy can prevent swelling, stretched and shiny skin, and ulcers, take a look at my previous article on the topic, "Do Compression Socks Help With Swelling?"

Does Compression Therapy Have Any Influence on Blood Pressure?

Because compression socks remove excess fluid from the veins, in certain circumstances, they may have a short-term influence on blood pressure. As Dr. Gregg A. Reger explains, "If you were fluid overloaded, then you may have a mild temporary increase in blood pressure as any excess fluids (edema) enters the systemic circulation and is excreted, but this is gradual and should not produce significant hypertension." For most people, this change in blood pressure isn't a problem, and, for some people with orthostatic hypotension, eliminating the buildup of fluid serves to prevent sudden variations in blood pressure.

Hypertension

Hypertension, or high blood pressure, is a condition that affects over one million Americans. It occurs when the pressure against the arterial walls becomes dangerously high. Most people will develop high blood pressure eventually, according to the Mayo Clinic.

Risk factors include:

  • Old age
  • Obstructive sleep apnea
  • Kidney problems
  • Adrenal gland tumors
  • Thyroid problems
  • Congenital defect
  • Certain medications—birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs
  • Illegal drugs

Dr. Stephen F. Daugherty confirms that compression socks should be safe for most patients with hypertension, explaining, "Compression stockings are unlikely to cause an elevated arterial blood pressure." 

Hypotension

In contrast, low blood pressure (hypotension) occurs when the pressure against the arterial walls becomes dangerously low. Symptoms sometimes include lightheadedness and fainting. Research suggests that compression therapy benefits patients with orthostatic hypotension. One study concludes, "The application of hydrostatic counterpressure by the use of an elasticized garment is helpful in the management of orthostatic hypotension..." (Sheps) Another experiment used a tilting maneuver to induce lightheadedness in test subjects. The researchers describe the process, writing, "Ten elderly people with orthostatic hypotension and a history of falls were studied by continuous recording of blood pressure and heart rate during passive tilting from supine to 90° head-up tilt. Compression hosiery significantly decreased the change in systolic blood pressure." (Henry)

It's important to note that the form of compression therapy found to be most effective for decreasing fluctuations in blood pressure was waist-length hosiery. That said, it's unlikely that knee-length compression socks would negatively impact a patient with hypotension. 

What Are the Contraindications for Compression Socks?

Some of the contraindications for compression therapy include: 

  • Ischemia
  • Peripheral neuropathy
  • Congestive heart failure
  • Diabetes
  • Cellulitis
  • Other skin conditions that limit sensation

If you have one of the above conditions, you may still be able to benefit from wearing compression socks. Be sure to seek guidance from a physician. For instance, even though congestive heart failure is a contraindicated condition, some doctors recommend compression therapy for certain patients with heart failure. Consult with a doctor to find out what's appropriate for you, as he or she may have recommendations about safe levels of compression for your body. 

Talk to Your Doctor About Compression Socks

By reducing leg swelling and removing excess fluid from your leg veins, compression socks work to improve your circulatory health. For someone suffering from hypertension or hypotension, a healthy circulatory system should serve to improve your overall health. As you would with any medical condition, you should consult your doctor to ensure that you're making safe choices and selecting the appropriate compression level for your body. Over-the-counter compression socks, like the ones Comrad sells, offer compression levels that are safe for most body types. 

To learn more about the different levels of compression on the market, check out our article, "What Level of Compression Socks Do I Need?" Your health care provider can give you more personalized advice regarding the optimal way to introduce compression socks into your self-care routine. 

To answer the question plainly—do compression socks raise your blood pressure?—we can confirm that compression socks should be safe for most people with hypotension and hypotension. Although they may cause a small, gradual increase in blood pressure as excess fluid flushes from the lower extremities, the overall impact on vascular health remains beneficial for most people. Compression socks, by reducing the risk of DVT, CVI, and swelling, are a great choice, even for people with a history of mild-to-moderate hypertension. 

Sources: 

Appelen D, van Loo E, Prins MH, Neumann MHAM, and Kolbach DN. "Compression therapy for prevention of post-thrombotic syndrome." Cochrane Database of Systematic Reviews, Issue 9, 2017, https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004174.pub3/epdf/abstract.

Blättler, W., and H. Partsch. “Leg Compression and Ambulation Is Better than Bed Rest for the Treatment of Acute Deep Venous Thrombosis.” Int Angiol, Vol. 4, 22 Dec. 2003, pp. 393–400. PubMed, https://www.ncbi.nlm.nih.gov/pubmed.

Cayley, William E. “Preventing deep vein thrombosis in hospital inpatients.” Clinical Review, Midlands Business Journal, Jul 19, 2007, https://www.bmj.com/content/335/7611/147.

Clarke, M. J., Broderick, C., Hopewell, S., Juszczak, E.,Eisinga, A. “Compression stockings for preventing deep vein thrombosis in airline passengers” Cochrane Database Syst Rev, December 19, 2016, https://discover.dc.nihr.ac.uk/content/signal-000351/long-haul-flyers-could-reduce-risk-of-leg-blood-clots-with-compression-stockings.

“Deep Vein Thrombosis (DVT) in Pregnancy.” NHS Choices, NHS, 27 Mar. 2018, www.nhs.uk/conditions/pregnancy-and-baby/dvt-blood-clot-pregnant/.

Henry, R., Rowe, J., O'Mahony, D. "Haemodynamic analysis of efficacy of compression hosiery in elderly fallers with orthostatic hypotension," The Lancet, Vol. 354, Iss. 9172, 1999, pp. 45-46, https://www.sciencedirect.com/science/article/abs/pii/S0140673699021327.

“High Blood Pressure (hypertension).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Mar. 2018, https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410.

“Recovery & Support for Pulmonary Embolism.” Patient Care at NYU Langone Health, NYU Langone Health, nyulangone.org/conditions/pulmonary-embolism-in-adults/support.

Lim, Chung Sim and Alun H. Davies. “Graduated compression stockings.” CMAJ  Vol. 186, Iss. 10 pp. E391-E398. July 08, 2014, https://www.cmaj.ca/content/cmaj/186/10/E391.full.pdf.

Reger, G. A. "How do compression stockings affect blood pressure?" DoctorQA.com, 2013, http://www.doctorqa.com/qa/compression-stockings-lead-to-high-blood-pressure

Sheps, S G. “Use of an elastic garment in the treatment of orthostatic hypotension.” Cardiology vol. 61 suppl. 1, 1976, pp. 271-279, https://pubmed.ncbi.nlm.nih.gov/975141/