When the sympathetic nervous system is activated, it shunts more blood to the brain by constricting peripheral arteries, raising arterial blood pressure. In essential hypertension the nervous system seems to be reacting to an imaginary threat that never goes away. Sympathetic tone is constantly too high, arteries are constantly constricted, and blood pressure remains elevated to levels that can eventually damage the heart and arteries, kidneys, and other organs. Because the sympathetic nervous system deals with fear and uses adrenalin and nonadrenalin as its chemical messengers, it is not surprising that anxiety is a factor in essential hypertension. One of the clearest demonstrations of this is the artificial elevation that often occurs when a doctor or nurse reads a patient's blood pressure the so-called white coat syndrome.
Doctors inadvertently aggravate hypertension when they contribute to patients' anxiety about it.
The first piece of advice I will give you on this subject is to verify for yourself that your blood pressure is elevated by learning to take it yourself in your own home when you feel secure and relaxed. You may well find that the values your doctor gets in his office are much higher than your norm, in which case you can feel more confident about managing the problem on your own without medication. There is good reason to try to treat hypertension without medication, because most of the medications are toxic. Diuretics , intended to decrease fluid volume in the circulatory system by stepping up urinary excretion of sodium and water, may increase the risk of heart attack. Most other hypertensive drugs work by interfering with nerves that regulate arteries, blocking their constricting influence.