Stress and hypertension

Essential hypertension is thought to be multifactorial in origin, with approximately equal contributions from genetic and environmental sources. Its prevalence is influenced by lifestyle factors, which could be nutritional or behavioral. Both factors have been implicated in the rise of blood pressure that accompanies acculturation to a modern urbanized way of life. Acute exposure to psychological stress can produce a transient rise of blood pressure, and it has been suggested that individuals who show increased reactivity to standardized challenges are at increased risk of becoming hypertensive as a result of repeated exposure to brief stressors. Evidence supporting this is fragmentary. Several population studies have indicated that blood pressure may be higher in people for whom there is a mismatch between their environment and their aspirations. A well-studied example is men employed in jobs characterized by “high strain”, that is combining high demands with a low level of perceived control. Several cross-sectional studies have shown an association between job strain and ambulatory blood pressure, which is independent of other risk factors for hypertension. Furthermore, the increased blood pressure is seen not only during working hours, but throughout the day and night. There is also evidence from one prospective study (the Cornell Worksite Study) that exposure to job strain over a three year period is associated with an increase of ambulatory blood pressure.