Young diseases

Managing anger may be more important for younger men than older men, says Charles Spielberger, PhD, professor of psychology at the University of South Florida in Tampa. "I don't know of studies that look only at men under age 35, but a young man is dealing with a lifelong habit of anger," he tells WebMD.

He says anger involves feelings ranging from annoyance to rage and causes psychological and biological changes. Spielberger developed the widely used STAXI (State Trait Anger Expression Inventory) to assess anger and has studied the role of anger in hypertension. "Research shows it is people who are boiling inside but don't show it who are more likely to develop hypertension."

Anger can also be a personality trait. "Some people feel anger more often across a wider variety of situations. People who do this and hold it in, they're the ones in danger of hypertension."

Spielberger tells WebMD that a good anger management program can help someone lower or normalize blood pressure. It's a three-step process.

First, learn to recognize the anger and the situations that cause it. "A lot of people who feel anger frequently might not recognize it, especially low to moderate levels."

Second, analyze the situation. "If your supervisor frequently makes you and other employees angry, tell yourself 'It's not me. This person is supercritical. I'll listen to what he says, but I'm not going to blame myself for his bad disposition.'"

Third, reduce the anger. "Counting to 10 will distract you, or try muscle relaxation. If possible, avoid the situation."

What About 'White Coat Hypertension?'

If you have a physical exam that shows elevated blood pressure, your doctor might say it could be "white coat hypertension," meaning the stress of seeing the doctor caused the high reading.

White coat hypertension was once thought to be benign, but that may not be the case, says Ulrich Broeckel, who is assistant professor of medicine at the Medical College of Wisconsin in Milwaukee. He co-authored a study of 1,677 patients aged 25 to 74. The study, reported in the British Medical Journal, measured structural changes in the heart, which Broeckel says were probably related to stress and the response to stress. "We found a significant difference between people who had white coat hypertension and those who didn't. It suggests that if people have these increases in blood pressure when they see a doctor, they have them in other stressful situations," says Broeckel.

Don't Wait 5 Years

"The longer you have untreated hypertension, the more complications you get," says Broeckel. "We also know patients who had early onset hypertension and developed diabetes at an early age. It makes early diagnosis and treatment very important."