Behavioral and environmental aspects of hypertension.

Relationships of behavioral and environmental influences on the development and maintenance of hypertension have been reviewed. The evidence for such influences arises from studies in five areas, namely, retrospective correlations between emotional events and hypertensive disease; acute changes in blood pressure with stress in animals and man; chronic blood pressure change following stress in animals and man; changes in blood pressure produced by behavioral modifications; and the personality patterns and particular behaviors of hypertensive subjects. Data from these studies have been briefly but critically reviewed with emphasis on the interreactive nature of the environmental, behavioral, genetic and other biological factors which eventuate in hypertension. It is emphasized that the issue for the future is not whether behavioral factors play any role in hypertension but rather to what extent, under what circumstances, and in which individuals behavioral factors are acting as important pressor stimuli in the overall homeostatic distortions that result in hypertension.