People with Type A personalities are bound to develop high blood pressure, right? Think again. Being stressed, competitive and impatient can have negative consequences — but high blood pressure isn't necessarily one of them.

Yet possible links between stress and high blood pressure exist. And if you've been diagnosed with high blood pressure, understanding those connections can make a long-term difference in your cardiovascular health.

Stress is often defined as a fight-or-flight response — the kind that enabled our primitive ancestors to combat a saber-toothed tiger in the wild or flee to safety. Today, we respond to perceived danger in much the same way. But instead of confronting wild animals, we face threats such as getting fired or speaking in public.

Our physical response to such events can include increased secretion of epinephrine (adrenaline) and cortisol. These hormones increase your blood pressure by causing your heart to beat faster and your blood vessels to constrict.

Even though stress involves measurable physical changes, it's a tough concept to pin down. Researchers have defined stress in various ways — for example, as job strain that results from high demands and a lack of decision-making power.

Yet not everyone agrees with this definition. And even if they did, there's not enough evidence that job strain alone causes consistent changes in blood pressure. Other factors — such as overeating or drinking alcohol in response to a demanding job — may actually be responsible for increased blood pressure.

An expert panel from the National Heart Foundation of Australia reviewed the medical literature for studies of links between stress and various forms of heart disease. The panel found strong evidence to link depression and social isolation — which are sometimes described as stress — to coronary heart disease. However, the panel concluded that the concept of stress is vague and difficult to directly link to specific diseases or conditions.

Increases in blood pressure related to distressing events and the subsequent hormonal changes can be dramatic. But once the stressor disappears, your blood pressure returns to normal. However, even temporary spikes in blood pressure — if they occur often enough — can damage your blood vessels, heart and kidneys in a way similar to persistent high blood pressure.

In addition, if you react to stress by smoking, drinking too much alcohol or eating unhealthy foods, you increase your risk of high blood pressure, heart attack and stroke.

Current research doesn't indicate that reducing stress can directly lower blood pressure. But using strategies to manage stress can help in other ways. For example, mastering stress management techniques can lead to other behavior changes — including those that reduce your blood pressure.

When looking for ways to manage stress, remember that you have many options. For example:

• Simplify your schedule. If you consistently feel rushed, take a few minutes to review your calendar and to-do lists. Look for activities that eat up your time but deliver little value. Schedule less time for such activities, or eliminate them completely.
• Breathe to relax. Making a conscious effort to deepen and slow down your breathing can help you relax.
• Exercise. Physical activity is a natural stress buster.
• Get plenty of sleep. Being sleep-deprived can make your problems seem larger than they really are.
• Shift your perspective. When dealing with problems, resist the tendency to complain. Acknowledge your feelings about the situation, then focus on finding solutions.

The goal is to discover what works for you. Be open-minded and willing to experiment. Choose your strategies, take action and start enjoying the benefits.