Abstract
In susceptible persons emotional stress results in immediate sympathetic stimulation, with a vasomotor response that results in a high-output state and elevated blood pressure; the vasopressor response seems to be transient. There seems to be no longitudinal epidemiologic validation of the attractive hypothesis that transiently elevated blood pressures are the prelude to fixed hypertension, however. The acquisition of hypertension by populations abandoning their traditional mode of living has been attributed to the sociocultural stress inherent in westernization, but these studies usually have not taken into account concomitants of this type of acculturation, such as dietary changes and increased body weight. The inverse relationship of blood pressure levels to education could explain the development of hypertension when aspiration to upward mobility is thwarted. The severity of perceived occupational stress relates inversely to blood pressure, suggesting that familiarity with a job renders the demands made by the work environment more predictable and less threatening in terms of vasopressor response.
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Selected References
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- Aro S., Hasan J. Occupational class, psychosocial stress and morbidity. Ann Clin Res. 1987;19(2):62–68. [PubMed] [Google Scholar]
- BROD J., FENCL V., HEJL Z., JIRKA J. Circulatory changes underlying blood pressure elevation during acute emotional stress (mental arithmetic) in normotensive and hypertensive subjects. Clin Sci. 1959 May;18:269–279. [PubMed] [Google Scholar]
- Baum A., Gatchel R. J., Schaeffer M. A. Emotional, behavioral, and physiological effects of chronic stress at Three Mile Island. J Consult Clin Psychol. 1983 Aug;51(4):565–572. doi: 10.1037//0022-006x.51.4.565. [DOI] [PubMed] [Google Scholar]
- Baumann R., Ziprian H., Gödicke W., Hartrodt W., Naumann E., Läuter J. The influence of acute psychic stress situations on biochemical and vegetative parameters of essential hypertensives at the early stage of the disease. Psychother Psychosom. 1973;22(2):131–140. doi: 10.1159/000286484. [DOI] [PubMed] [Google Scholar]
- Beaglehole R., Salmond C. E., Hooper A., Huntsman J., Stanhope J. M., Cassel J. C., Prior I. A. Blood pressure and social interaction in Tokelauan migrants in New Zealand. J Chronic Dis. 1977 Dec;30(12):803–812. doi: 10.1016/0021-9681(77)90008-x. [DOI] [PubMed] [Google Scholar]
- Booze C. F. Morbidity experience of air traffic control personnel--1967--77. Aviat Space Environ Med. 1979 Jan;50(1):1–8. [PubMed] [Google Scholar]
- Boutelle R. C., Epstein S., Ruddy M. C. The relation of essential hypertension to feelings of anxiety, depression and anger. Psychiatry. 1987 Aug;50(3):206–217. doi: 10.1080/00332747.1987.11024353. [DOI] [PubMed] [Google Scholar]
- Brodsky C. M. Long-term work stress in teachers and prison guards. J Occup Med. 1977 Feb;19(2):133–138. doi: 10.1097/00043764-197702000-00007. [DOI] [PubMed] [Google Scholar]
- Brody M. J., Natelson B. H., Anderson E. A., Folkow B., Levy M. N., Obrist P. A., Reis D. J., Rosenman R. H., Williams R. B., Jr Behavioral mechanisms in hypertension. Circulation. 1987 Jul;76(1 Pt 2):I95–100. [PubMed] [Google Scholar]
- Brunner H. R., Waeber B., Nussberger J. Blood pressure monitoring for quality assessment of antihypertensive therapy. J Cardiovasc Pharmacol. 1986;8 (Suppl 6):S55–S59. doi: 10.1097/00005344-198608006-00013. [DOI] [PubMed] [Google Scholar]
- Cassel J. Hypertension and cardiovascular disease in migrants: a potential source of clues? Int J Epidemiol. 1974 Sep;3(3):204–206. doi: 10.1093/ije/3.3.204. [DOI] [PubMed] [Google Scholar]
- Clamage D. M., Sanford C. S., Vander A. J., Mouw D. R. Effects of psychosocial stimuli on plasma renin activity in rats. Am J Physiol. 1976 Oct;231(4):1290–1294. doi: 10.1152/ajplegacy.1976.231.4.1290. [DOI] [PubMed] [Google Scholar]
- Cobb S. Physiologic changes in men whose jobs were abolished. J Psychosom Res. 1974 Aug;18(4):245–258. doi: 10.1016/0022-3999(74)90005-1. [DOI] [PubMed] [Google Scholar]
- Cobb S., Rose R. M. Hypertension, peptic ulcer, and diabetes in air traffic controllers. JAMA. 1973 Apr 23;224(4):489–492. [PubMed] [Google Scholar]
- Conway J. Blood pressure and heart rate variability. J Hypertens. 1986 Jun;4(3):261–263. doi: 10.1097/00004872-198606000-00001. [DOI] [PubMed] [Google Scholar]
- Cottington E. M., Matthews K. A., Talbott E., Kuller L. H. Occupational stress, suppressed anger, and hypertension. Psychosom Med. 1986 Mar-Apr;48(3-4):249–260. doi: 10.1097/00006842-198603000-00010. [DOI] [PubMed] [Google Scholar]
- Dimsdale J. E., Pierce C., Schoenfeld D., Brown A., Zusman R., Graham R. Suppressed anger and blood pressure: the effects of race, sex, social class, obesity, and age. Psychosom Med. 1986 Jul-Aug;48(6):430–436. doi: 10.1097/00006842-198607000-00005. [DOI] [PubMed] [Google Scholar]
- Drummond P. D. Cardiovascular reactivity in borderline hypertensives during behavioural and orthostatic stress. Psychophysiology. 1985 Nov;22(6):621–628. doi: 10.1111/j.1469-8986.1985.tb01656.x. [DOI] [PubMed] [Google Scholar]
- Duijkers T. J., Drijver M., Kromhout D., James S. A. "John Henryism" and blood pressure in a Dutch population. Psychosom Med. 1988 Jul-Aug;50(4):353–359. doi: 10.1097/00006842-198807000-00004. [DOI] [PubMed] [Google Scholar]
- Dyer A. R., Stamler J., Shekelle R. B., Schoenberger J. The relationship of education to blood pressure: findings on 40,000 employed Chicagoans. Circulation. 1976 Dec;54(6):987–992. doi: 10.1161/01.cir.54.6.987. [DOI] [PubMed] [Google Scholar]
- FLYNN J. T., KENNEDY M. A. K., WOLF S. Essential hypertension in one of identical twins; an experimental study of cardiovascular reactions in the Y twins. Res Publ Assoc Res Nerv Ment Dis. 1949 Dec;29:954–961. [PubMed] [Google Scholar]
- Falkner B., Kushner H., Onesti G., Angelakos E. T. Cardiovascular characteristics in adolescents who develop essential hypertension. Hypertension. 1981 Sep-Oct;3(5):521–527. doi: 10.1161/01.hyp.3.5.521. [DOI] [PubMed] [Google Scholar]
- Falkner B., Onesti G., Angelakos E. T., Fernandes M., Langman C. Cardiovascular response to mental stress in normal adolescents with hypertensive parents. Hemodynamics and mental stress in adolescents. Hypertension. 1979 Jan-Feb;1(1):23–30. doi: 10.1161/01.hyp.1.1.23. [DOI] [PubMed] [Google Scholar]
- Falkner B., Onesti G., Hamstra B. Stress response characteristics of adolescents with high genetic risk for essential hypertension: a five year follow-up. Clin Exp Hypertens. 1981;3(4):583–591. doi: 10.3109/10641968109033685. [DOI] [PubMed] [Google Scholar]
- Folkow B. Physiological aspects of primary hypertension. Physiol Rev. 1982 Apr;62(2):347–504. doi: 10.1152/physrev.1982.62.2.347. [DOI] [PubMed] [Google Scholar]
- Forsyth R. P. Blood pressure responses to long-term avoidance schedules in the restrained rhesus monkey. Psychosom Med. 1969 Jul-Aug;31(4):300–309. doi: 10.1097/00006842-196907000-00003. [DOI] [PubMed] [Google Scholar]
- Fouriaud C., Jacquinet-Salord M. C., Degoulet P., Aimé F., Lang T., Laprugne J., Main J., Oeconomos J., Phalente J., Prades A. Influence of socioprofessional conditions on blood pressure levels and hypertension control. Epidemiologic study of 6,665 subjects in the Paris district. Am J Epidemiol. 1984 Jul;120(1):72–86. doi: 10.1093/oxfordjournals.aje.a113876. [DOI] [PubMed] [Google Scholar]
- Frankenhaeuser M., Gardell B. Underload and overload in working life: outline of a multidisciplinary approach. J Human Stress. 1976 Sep;2(3):35–46. doi: 10.1080/0097840X.1976.9936068. [DOI] [PubMed] [Google Scholar]
- GAMPEL B., SLOME C., SCOTCH N., ABRAMSON J. H. Urbanization and hypertension among Zulu adults. J Chronic Dis. 1962 Jan;15:67–70. doi: 10.1016/0021-9681(62)90102-9. [DOI] [PubMed] [Google Scholar]
- Gentry W. D., Chesney A. P., Gary H. E., Jr, Hall R. P., Harburg E. Habitual anger-coping styles: I. Effect on mean blood pressure and risk for essential hypertension. Psychosom Med. 1982 May;44(2):195–202. doi: 10.1097/00006842-198205000-00005. [DOI] [PubMed] [Google Scholar]
- Goldstein H. S., Edelberg R., Meier C. F., Davis L. Relationship of resting blood pressure and heart rate to experienced anger and expressed anger. Psychosom Med. 1988 Jul-Aug;50(4):321–329. doi: 10.1097/00006842-198807000-00001. [DOI] [PubMed] [Google Scholar]
- HILL A. B. THE ENVIRONMENT AND DISEASE: ASSOCIATION OR CAUSATION? Proc R Soc Med. 1965 May;58:295–300. doi: 10.1177/003591576505800503. [DOI] [PMC free article] [PubMed] [Google Scholar]
- HOKANSON J. E., BURGESS M., COHEN M. F. EFFECTS OF DISPLACED AGGRESSION ON SYSTOLIC BLOOD PRESSURE. J Abnorm Psychol. 1963 Sep;67:214–218. doi: 10.1037/h0047125. [DOI] [PubMed] [Google Scholar]
- Harburg E., Blakelock E. H., Jr, Roeper P. R. Resentful and reflective coping with arbitrary authority and blood pressure: Detroit. Psychosom Med. 1979 May;41(3):189–202. doi: 10.1097/00006842-197905000-00002. [DOI] [PubMed] [Google Scholar]
- Harburg E., Erfurt J. C., Chape C., Hauenstein L. S., Schull W. J., Schork M. A. Socioecological stressor areas and black-white blood pressure: Detroit. J Chronic Dis. 1973 Sep;26(9):595–611. doi: 10.1016/0021-9681(73)90064-7. [DOI] [PubMed] [Google Scholar]
- Harburg E., Erfurt J. C., Hauenstein L. S., Chape C., Schull W. J., Schork M. A. Socio-ecological stress, suppressed hostility, skin color, and Black-White male blood pressure: Detroit. Psychosom Med. 1973 Jul-Aug;35(4):276–296. doi: 10.1097/00006842-197307000-00003. [DOI] [PubMed] [Google Scholar]
- Harlan L. C., Polk B. F., Cooper S., Blaszkowski T. P., Ignatius-Smith J., Stromer M., Mull H. Effects of labeling and treatment of hypertension on perceived health. Am J Prev Med. 1986 Sep-Oct;2(5):256–261. [PubMed] [Google Scholar]
- Harris A. H., Gilliam W. J., Findley J. D., Brady J. V. Instrumental conditioning of large-magnitude, daily, 12-hour blood pressure elevations in the baboon. Science. 1973 Oct 12;182(4108):175–177. doi: 10.1126/science.182.4108.175. [DOI] [PubMed] [Google Scholar]
- Havlik R. J., Garrison R. J., Katz S. H., Ellison R. C., Feinleib M., Myrianthopoulos N. C. Detection of genetic variance in blood pressure of seven-year-old twins. Am J Epidemiol. 1979 May;109(5):512–516. doi: 10.1093/oxfordjournals.aje.a112708. [DOI] [PubMed] [Google Scholar]
- Haynes S. G., Levine S., Scotch N., Feinleib M., Kannel W. B. The relationship of psychosocial factors to coronary heart disease in the Framingham study. I. Methods and risk factors. Am J Epidemiol. 1978 May;107(5):362–383. doi: 10.1093/oxfordjournals.aje.a112556. [DOI] [PubMed] [Google Scholar]
- Henry J. P., Cassel J. C. Psychosocial factors in essential hypertension. Recent epidemiologic and animal experimental evidence. Am J Epidemiol. 1969 Sep;90(3):171–200. doi: 10.1093/oxfordjournals.aje.a121062. [DOI] [PubMed] [Google Scholar]
- Henry J. P., Cassel J. C. Psychosocial factors in essential hypertension. Recent epidemiologic and animal experimental evidence. Am J Epidemiol. 1969 Sep;90(3):171–200. doi: 10.1093/oxfordjournals.aje.a121062. [DOI] [PubMed] [Google Scholar]
- Henry J. P., Ely D. L. Physiology of emotional stress: specific responses. J S C Med Assoc. 1979 Nov;75(11):501–509. [PubMed] [Google Scholar]
- Henry J. P. Stress, salt and hypertension. Soc Sci Med. 1988;26(3):293–302. doi: 10.1016/0277-9536(88)90393-0. [DOI] [PubMed] [Google Scholar]
- Herd J. A., Morse W. H., Kelleher R. T., Jones L. G. Arterial hypertension in the squirrel monkey during behavioral experiments. Am J Physiol. 1969 Jul;217(1):24–29. doi: 10.1152/ajplegacy.1969.217.1.24. [DOI] [PubMed] [Google Scholar]
- Horowitz M. J. Intrusive and repetitive thoughts after experimental stress. A summary. Arch Gen Psychiatry. 1975 Nov;32(11):1457–1463. doi: 10.1001/archpsyc.1975.01760290125015. [DOI] [PubMed] [Google Scholar]
- Horowitz M. J. Stress and the physician. Trans Assoc Life Insur Med Dir Am. 1979;62:43–60. [PubMed] [Google Scholar]
- House J. S., Strecher V., Metzner H. L., Robbins C. A. Occupational stress and health among men and women in the Tecumseh Community Health Study. J Health Soc Behav. 1986 Mar;27(1):62–77. [PubMed] [Google Scholar]
- James S. A., Hartnett S. A., Kalsbeek W. D. John Henryism and blood pressure differences among black men. J Behav Med. 1983 Sep;6(3):259–278. doi: 10.1007/BF01315113. [DOI] [PubMed] [Google Scholar]
- James S. A., Kleinbaum D. G. Socioecologic stress and hypertension related mortality rates in North Carolina. Am J Public Health. 1976 Apr;66(4):354–358. doi: 10.2105/ajph.66.4.354. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jenkins C. D., Somervell P. D., Hames C. G. Does blood pressure usually rise with age? . . . Or with stress? J Human Stress. 1983 Sep;9(3):4–12. doi: 10.1080/0097840X.1983.9936124. [DOI] [PubMed] [Google Scholar]
- Julius M., Harburg E., Cottington E. M., Johnson E. H. Anger-coping types, blood pressure, and all-cause mortality: a follow-up in Tecumseh, Michigan (1971-1983). Am J Epidemiol. 1986 Aug;124(2):220–233. doi: 10.1093/oxfordjournals.aje.a114380. [DOI] [PubMed] [Google Scholar]
- Julius S. Transition from high cardiac output to elevated vascular resistance in hypertension. Am Heart J. 1988 Aug;116(2 Pt 2):600–606. doi: 10.1016/0002-8703(88)90557-1. [DOI] [PubMed] [Google Scholar]
- King H. O., Bleaney A. A. The low prevalence of hypertension in Falkland Islands men. J R Coll Gen Pract. 1984 Feb;34(259):95–96. [PMC free article] [PubMed] [Google Scholar]
- LEVI L. THE STRESS OF EVERYDAY WORK AS REFLECTED IN PRODUCTIVENESS, SUBJECTIVE FEELINGS AND URINARY OUTPUT OF ADRENALINE AND NOR-ADRENALINE UNDER SALARIED AND PIECE-WORK CONDITIONS. J Psychosom Res. 1964 Dec;8:199–202. doi: 10.1016/0022-3999(64)90042-x. [DOI] [PubMed] [Google Scholar]
- Lazarus R. S., DeLongis A., Folkman S., Gruen R. Stress and adaptational outcomes. The problem of confounded measures. Am Psychol. 1985 Jul;40(7):770–785. [PubMed] [Google Scholar]
- Light K. C., Koepke J. P., Obrist P. A., Willis P. W., 4th Psychological stress induces sodium and fluid retention in men at high risk for hypertension. Science. 1983 Apr 22;220(4595):429–431. doi: 10.1126/science.6836285. [DOI] [PubMed] [Google Scholar]
- Mann A. H. Psychiatric morbidity and hostility in hypertension. Psychol Med. 1977 Nov;7(4):653–659. doi: 10.1017/s0033291700006309. [DOI] [PubMed] [Google Scholar]
- Matthews K. A., Manuck S. B., Stoney C. M., Rakaczky C. J., McCann B. S., Saab P. G., Woodall K. L., Block D. R., Visintainer P. F., Engebretson T. O. Familial aggregation of blood pressure and heart rate responses during behavioral stress. Psychosom Med. 1988 Jul-Aug;50(4):341–352. doi: 10.1097/00006842-198807000-00003. [DOI] [PubMed] [Google Scholar]
- Mehta S., Burton P. Stress in operating theatre personnel. Anaesthesia. 1977 Oct;32(9):924–925. doi: 10.1111/j.1365-2044.1977.tb10139.x. [DOI] [PubMed] [Google Scholar]
- Monk M. Psychologic status and hypertension. Am J Epidemiol. 1980 Aug;112(2):200–208. doi: 10.1093/oxfordjournals.aje.a112985. [DOI] [PubMed] [Google Scholar]
- Morales-Ballejo H. M., Eliot R. S., Boone J. L., Hughes J. S. Psychophysiologic stress testing as a predictor of mean daily blood pressure. Am Heart J. 1988 Aug;116(2 Pt 2):673–681. doi: 10.1016/0002-8703(88)90568-6. [DOI] [PubMed] [Google Scholar]
- Nestel P. J. Blood-pressure and catecholamine excretion after mental stress in labile hypertension. Lancet. 1969 Apr 5;1(7597):692–694. doi: 10.1016/s0140-6736(69)92645-2. [DOI] [PubMed] [Google Scholar]
- Niemcryk S. J., Jenkins C. D., Rose R. M., Hurst M. W. The prospective impact of psychosocial variables on rates of illness and injury in professional employees. J Occup Med. 1987 Aug;29(8):645–652. [PubMed] [Google Scholar]
- Oberman A., Lane N. E., Harlan W. R., Graybiel A., Mitchell R. E. Trends in systolic blood pressure in the thousand aviator cohort over a twenty-four-year period. Circulation. 1967 Dec;36(6):812–822. doi: 10.1161/01.cir.36.6.812. [DOI] [PubMed] [Google Scholar]
- Oliver W. J., Cohen E. L., Neel J. V. Blood pressure, sodium intake, and sodium related hormones in the Yanomamo Indians, a "no-salt" culture. Circulation. 1975 Jul;52(1):146–151. doi: 10.1161/01.cir.52.1.146. [DOI] [PubMed] [Google Scholar]
- Oni A. High blood pressure in black populations--current perspectives of incidence, prevalence and risk factors. J Tenn Med Assoc. 1984 Mar;77(3):134–142. [PubMed] [Google Scholar]
- Oni A. Intraracial factors in blood pressure variations among the black population. J Natl Med Assoc. 1984 Jun;76(6):595–603. [PMC free article] [PubMed] [Google Scholar]
- Page I. H. Angiotensin and hypertension. JAMA. 1980 Apr 25;243(16):1631–1631. [PubMed] [Google Scholar]
- Pawson I. G., Janes C. Massive obesity in a migrant Samoan population. Am J Public Health. 1981 May;71(5):508–513. doi: 10.2105/ajph.71.5.508. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pollock K. On the nature of social stress: production of a modern mythology. Soc Sci Med. 1988;26(3):381–392. doi: 10.1016/0277-9536(88)90404-2. [DOI] [PubMed] [Google Scholar]
- Poulter N. R., Khaw K., Hopwood B. E., Mugambi M., Peart W. S., Sever P. S. Determinants of blood pressure changes due to urbanization: a longitudinal study. J Hypertens Suppl. 1985 Dec;3(3):S375–S377. [PubMed] [Google Scholar]
- Prior I. A. Cardiovascular epidemiology in New Zealand and the Pacific. N Z Med J. 1974 Sep 25;80(524):245–252. [PubMed] [Google Scholar]
- RODAHL K. Relation of diet to blood pressure in the Eskimo. Trans Am Coll Cardiol. 1955 Apr;4:273–278. [PubMed] [Google Scholar]
- Rofé Y., Goldberg J. Prolonged exposure to a war environment and its effects on the blood pressure of pregnant women. Br J Med Psychol. 1983 Dec;56(Pt 4):305–311. doi: 10.1111/j.2044-8341.1983.tb01562.x. [DOI] [PubMed] [Google Scholar]
- Rose R. J., Miller J. Z., Grim C. E., Christian J. C. Aggregation of blood pressure in the families of identical twins. Am J Epidemiol. 1979 May;109(5):503–511. doi: 10.1093/oxfordjournals.aje.a112707. [DOI] [PubMed] [Google Scholar]
- SCOTCH N. A. A preliminary report on the relation of sociocultural factors to hypertension among the Zulu. Ann N Y Acad Sci. 1960 Dec 8;84:1000–1009. doi: 10.1111/j.1749-6632.1960.tb39132.x. [DOI] [PubMed] [Google Scholar]
- Salmond C. E., Joseph J. G., Prior I. A., Stanley D. G., Wessen A. F. Longitudinal analysis of the relationship between blood pressure and migration: the Tokelau Island Migrant Study. Am J Epidemiol. 1985 Aug;122(2):291–301. doi: 10.1093/oxfordjournals.aje.a114101. [DOI] [PubMed] [Google Scholar]
- Schnall P. L., Pieper C., Schwartz J. E., Karasek R. A., Schlussel Y., Devereux R. B., Ganau A., Alderman M., Warren K., Pickering T. G. The relationship between 'job strain,' workplace diastolic blood pressure, and left ventricular mass index. Results of a case-control study. JAMA. 1990 Apr 11;263(14):1929–1935. [PubMed] [Google Scholar]
- Schneider R. H., Egan B. M., Johnson E. H., Drobny H., Julius S. Anger and anxiety in borderline hypertension. Psychosom Med. 1986 Mar-Apr;48(3-4):242–248. doi: 10.1097/00006842-198603000-00009. [DOI] [PubMed] [Google Scholar]
- Schulte W., Neus H., Thönes M., von Eiff A. W. Basal blood pressure variability and reactivity of blood pressure to emotional stress in essential hypertension. Basic Res Cardiol. 1984 Jan-Feb;79(1):9–16. doi: 10.1007/BF01935802. [DOI] [PubMed] [Google Scholar]
- Shapiro A. P. Pathophysiology of stress-induced hypertension. J S C Med Assoc. 1979 Nov;75(11):510–512. [PubMed] [Google Scholar]
- Shapiro A. P. Psychological factors in hypertension: an overview. Am Heart J. 1988 Aug;116(2 Pt 2):632–637. doi: 10.1016/0002-8703(88)90562-5. [DOI] [PubMed] [Google Scholar]
- Shapiro S., Weinblatt E., Frank C. W. Return to work after first myocardial infarction. Arch Environ Health. 1972 Jan;24(1):17–26. doi: 10.1080/00039896.1972.10666045. [DOI] [PubMed] [Google Scholar]
- Sharma J. N., Fernandez P. G., Kim B. K., Idikio H., Triggle C. R. Cardiac regression and blood pressure control in the Dahl rat treated with either enalapril maleate (MK 421, an angiotensin converting enzyme inhibitor) or hydrochlorothiazide. J Hypertens. 1983 Oct;1(3):251–256. doi: 10.1097/00004872-198310000-00009. [DOI] [PubMed] [Google Scholar]
- Silverberg D. S., Aviram A., Carel R. S. Hypertension in European immigrants to Israel: those who experienced the Holocaust and those who did not. J Hypertens Suppl. 1985 Dec;3(3):S383–S385. [PubMed] [Google Scholar]
- Stamler J., Stamler R., Riedlinger W. F., Algera G., Roberts R. H. Hypertension screening of 1 million Americans. Community Hypertension Evaluation Clinic (CHEC) program, 1973 through 1975. JAMA. 1976 May 24;235(21):2299–2306. doi: 10.1001/jama.235.21.2299. [DOI] [PubMed] [Google Scholar]
- Steptoe A., Melville D., Ross A. Behavioral response demands, cardiovascular reactivity, and essential hypertension. Psychosom Med. 1984 Jan-Feb;46(1):33–48. doi: 10.1097/00006842-198401000-00006. [DOI] [PubMed] [Google Scholar]
- Strayhorn G. Social supports, perceived stress, and health: the black experience in medical school--a preliminary study. J Natl Med Assoc. 1980 Sep;72(9):869–881. [PMC free article] [PubMed] [Google Scholar]
- Syme S. L., Oakes T. W., Friedman G. D., Feldman R., Siegelaub A. B., Collen M. Social class and racial differences in blood pressure. Am J Public Health. 1974 Jun;64(6):619–620. doi: 10.2105/ajph.64.6.619. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Syme S. L., Oakes T. W., Friedman G. D., Feldman R., Siegelaub A. B., Collen M. Social class and racial differences in blood pressure. Am J Public Health. 1974 Jun;64(6):619–620. doi: 10.2105/ajph.64.6.619. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Syme S. L. Social determinants of disease. Ann Clin Res. 1987;19(2):44–52. [PubMed] [Google Scholar]
- Syvälahti E., Lammintausta R., Pekkarinen A. Effect of psychic stress of examination on serum growth hormone, serum insulin, and plasma renin activity. Acta Pharmacol Toxicol (Copenh) 1976 Apr;38(4):344–352. doi: 10.1111/j.1600-0773.1976.tb03129.x. [DOI] [PubMed] [Google Scholar]
- Timio M., Verdecchia P., Ronconi M., Gentili S., Francucci B., Bichisao E. Blood pressure changes over 20 years in nuns in a secluded order. J Hypertens Suppl. 1985 Dec;3(3):S387–S388. [PubMed] [Google Scholar]
- Trowell H. C. From normotension to hypertension in Kenyans and Ugandans 1928-1978. East Afr Med J. 1980 Mar;57(3):167–173. [PubMed] [Google Scholar]
- Ulrych M. Changes of general haemodynamics during stressful mental arithmetic and non-stressing quiet conversation and modification of the latter by beta-adrenergic blockade. Clin Sci. 1969 Jun;36(3):453–461. [PubMed] [Google Scholar]
- Vingerhoets A. J., Marcelissen F. H. Stress research: its present status and issues for future developments. Soc Sci Med. 1988;26(3):279–291. doi: 10.1016/0277-9536(88)90392-9. [DOI] [PubMed] [Google Scholar]
- Vinokur A., Selzer M. L. Desirable versus undesirable life events: their relationship to stress and mental distress. J Pers Soc Psychol. 1975 Aug;32(2):329–337. doi: 10.1037//0022-3514.32.2.329. [DOI] [PubMed] [Google Scholar]
- Whitehead W. E., Blackwell B., DeSilva H., Robinson A. Anxiety and anger in hypertension. J Psychosom Res. 1977;21(5):383–389. doi: 10.1016/0022-3999(77)90046-0. [DOI] [PubMed] [Google Scholar]
- Winkleby M. A., Ragland D. R., Syme S. L. Self-reported stressors and hypertension: evidence of an inverse association. Am J Epidemiol. 1988 Jan;127(1):124–134. doi: 10.1093/oxfordjournals.aje.a114772. [DOI] [PubMed] [Google Scholar]
- van der Ploeg H. M., van Buuren E. T., van Brummelen P. The role of anger in hypertension. Psychother Psychosom. 1985;43(4):186–193. doi: 10.1159/000287878. [DOI] [PubMed] [Google Scholar]