Expert Opinions

Expert Opinions Archive
Do emotions play a key role in hypertension?

K.F., Davenport, IA

Samuel J. Mann, M.D., of New York Presbyterian Hospital-Cornell Medical Center and author of Healing Hypertension (Wiley, 1999) comments:

"This is a crucial question because medical people ignore the mind-body link, while mind-body advocates implicate this link in all cases of hypertension," he explains. "The truth is in between: Hypertension is caused by factors such as genetics and weight in some people and by emotions in others.

"I believe it's the emotions we don't feel, rather than the tension and anger we do feel, that is the culprit. Clues to this emotional basis are: a history of emotional trauma, which the person insists has no lingering effect; a personality style that rarely acknowledges emotional distress; episodic or difficult-to-control hypertension; or marked hypertension in someone who's young and thin."

Do drugs help when hypertension is driven by emotions?

"Yes," says Dr. Mann, "although facing and dealing with those emotions, through therapy or on one's own, offers an opportunity to get off medication. I've found that drugs such as ACE inhibitors and diuretics, which work via the kidneys, appear more effective when the hypertension is genetic rather than emotion-based. In the latter, drugs directed at the sympathetic nervous system, such as alpha and beta blockers, work better. In this way, understanding when hypertension is linked to emotions can help guide selection of the right drugs."

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