Hypertension

Essential hypertension is the chronic elevation in blood pressure of unknown origin, which is prevalent in 15-25% of the adult population and estimated to cause 4.5% of current global disease burden. The fundamental question of whether psychosocial stress (including subacute and chronic stressors and chronic psychological states such as depression) causes hypertension has been investigated using observational studies, natural experiments, and laboratory studies to show whether acute stress modifies disease relevant biological processes. There is consistent evidence for an association between psychosocial factors and hypertension, and biologically plausible mechanisms have been established. Acute and enduring stressors directly impact on blood pressure control. However, one intriguing question that remains partly unanswered is why a similar level of stress exposure might lead to the development of sustained hypertension in some individuals but not in others. In summary, lifestyle approaches that encompass stress reduction and health behaviour promotion should therefore be considered in the treatment of hypertension and identifying those at high risk.