Stress and Hypertension

Hypertension develops and progresses in people with hypertensive diathesis triggered by environmental factors such as stress and obesity. Granted that stress response in the cardiovascular system is induced by interactions between environmental stimuli and situational cognition of an individual, the development of hypertension depends on differences in situational cognition among individuals. This paper examines this issue by way of case study. A 53-year-old man with a 28- year history of labile and mild hypertension experienced abnormal elevation in blood pressure levels at ages 41 and 47 when he faced intractable problems. These abnormal blood pressure elevations did not respond to increase in antihyperten- sive drugs, but were able to be lower by changes in his life environment. However, severity of hypertension advanced following these two episodes. During his second hospitalization, physicians instructed the patient to confront problems with his wife that he had avoided, and he received treatment (autogenic training, fasting therapy, and group therapy) designed to help him become aware of his avoiding behavior. Although he has had white coat hypertension after the first abnormal BP elevation, his blood pressure has been stable for six years since discharge with no increase in dosage of antihypertensive drugs.