Hypertension: Psychological factors in aetiology and management

High blood pressure is the result of the interaction of many factors. Evidence from many different sources and species suggests that among these factors are various health behaviours and stress related processes. It is likely that obesity, over-consumption of alcohol and salt and lack of exercise all contribute to reversible elevations in pressure. The role of stress and various personality factors is more contentious but it is probable that stress elevates blood pressure in individuals rendered vulnerable through the operation of either constitutional or behavioural factors. The control of raised blood pressure through forms of stress management has been vigorously studied but it is hard to draw flIlll conclusions about its effectiveness. It is does not appear helpful in lowering blood pressure in patients who are well used to blood pressure measurement but may lower pressure in patients whose blood pressure is elevated in response to such measurement.