Does stress cause hypertension? A view from the real world

If you ask a doctor, they'll say that stress doesn't cause hypertension ~ or, at least, they will analyze "stress" in biomedical terms (catecholamines and what not). But every clinician has had the experience of patients who are sure that they know when they have high blood pressure: it's when they get stressed.

In a thought-provoking talk at the International Conference of Communication in Healthcare (which I return from tonight), Barbara Bokhour (from Boston) et al. helped reframe my experience with their analyses of interviews done with patients with uncontrolled hypertension. Patients have their own models for hypertension (psychological stress playing an important role in these) and they take action to self-treat, by trying to reduce their stress.

Among the researchers' interesting findings was that patients might be etymologizing hypertension into "hyper" + "tension": if you have high blood pressure you must be really tense.

I had two thoughts about this. 1. Why not co-opt these patient models, telling them that anti-hypertensives reduce stress (on the heart)? Not entirely deceptive. 2. What if we just started calling it "high blood pressure"?

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