STRESS, COPING, LIFE-STYLE AND HYPERTENSION - A PARADIGM FOR RESEARCH, PREVENTION AND NONPHARMACOLOGICAL MANAGEMENT OF HYPERTENSION

Lifestyle related factors such as obesity, drinking habits, sodium and potassium intake and physical inactivity are well established determi nants of high blood pressure. The role of psyche-social stressors, and in particular environmental work or home stress is far less clear. So me but not all studies using the Karasek 'job-strain' model have found a relationship with ambulatory blood pressure levels. Other studies u sing more 'subjective' measures of occupational stress have found no r elationship or even inverse associations with blood pressure. The poss ibility that relationships between external stressors, personality fac tors and blood pressure levels might be mediated or confounded by copi ng mechanisms influencing lifestyle factors known to directly affect b lood pressure has not been adequately studied. This paper briefly expl ores the paradigm relating environmental psychosocial stress, individu al coping mechanisms, lifestyle behaviours and blood pressure levels. The issues are critical for research methodology in this area and for the development of better behavioural strategies for the prevention an d nonpharmacological management of hypertension.