Without question, blood pressure can fluctuate transiently in response to job stress, but the development of persisting changes in blood pressure has not been established. Further, if repeated blood pressure elevation due to job stress did lead to sustained hypertension, one might similarly expect repeated elevations due to manual labor to do so as well. The repeated isometric stress of lifting heavy objects exposes manual laborers to repeated and substantial increases in blood pressure, sympathetic tone, and peripheral resistance. Yet manual labor is not associated with development of hypertension. Just as stress can transiently increase blood pressure, relaxation techniques and biofeedback can transiently lower it.
Uncontrolled studies report that various behavioral techniques also have a sustained effect.
However, reviews of controlled studies are less supportive. 30-32 One review reported a large effect when a combination of techniques was employed in individualized fashion, but did not take into account placebo effect. Two other reviews did not confirm a sustained effect on blood pressure. 30,31 Studies that assessed the effect of such interventions on ambulatory rather than clinic blood pressure reported little effect. A recent study reported a sustained 10-mm fall in systolic blood pressure with transcendental meditation.