The heart has to pump harder and harder with a smaller and smaller supply of blood to its own muscle. This is the situation seen commonly in people with angina pectoris. The chest pain is caused by a heart that goes into spasm, partly because it is not able to keep up with the work it is being called on to do. The problem may actually become so bad that a portion of the heart muscle dies, leading to a myocardial infarction, or heart attack.

It probably comes as no news to most people that heart attacks and high blood pressure are closely associated with each other and also very much associated with the amount of tension in one's life. Those people who live in a tense home situation or have tense and demanding jobs tend to have much more cardiac and high blood pressure disease than people in more relaxed daily surroundings.

Remember the negative conditioning of the dog back in Chapter 8? If we conduct this experiment with a special instrument on the dog to measure its blood pressure, we find that each time it gets a shock, its blood pressure goes up. Actually, the pressure can increase in all of us in any time of tension or fear, because it is part of the normal response pattern. If it occurs regularly, along with a programming stimulus, it becomes negatively conditioned. Soon each time the stimulus comes along, the blood pressure goes up. Perhaps in human beings we do not see continuous elevated blood pressure very often in younger people because it takes some time for this overall mechanism to become firmly established. In addition, the greater flexibility of the walls of the blood vessels of younger people give them much more ability to absorb periodic tensions. As one grows older, however, blood pressure elevations occur repeatedly, until the conditions of high blood pressure and its unhappy results may be produced.

You're probably asking yourself, "What about all the talk of diet, exercise, and heredity as related to blood pressure and heart disease?" These are definitely important factors, and should not be ignored by anyone seeking to maintain the health of the circulatory system. But in addition to the management of diet and exercise, management of emotions is important. The more unrelieved tension and incoherent response patterns in one's life, the more rapidly the blood pressure is likely to rise through the years. A person who has a genetic predisposition to develop these problems, or who has had early warning symptoms, has an important choice to make. That person cannot change his or her heredity, but he or she can decide whether to continue to be high-strung, hurry from one appointment to another, worry, and lose his or her temper. That person can begin, one by one, to eliminate these dangerous responses. My advice is that he or she learn to become a person who can choose to remain relaxed and calm even during stressful situations in spite of how uptight he or she may have been in the past. The person who follows this advice stands a much better chance of retarding any gradual increase in blood pressure and, perhaps more important, avoiding the emotional crises that may be the cause of the acute elevation in blood pressure responsible for heart attacks, strokes, cerebral hemorrhage, and kidney disease. Whereas it might be permissible for another person to worry, get upset, or feel tense, for an individual with hypertension, it may be more dangerous than walking on a broken leg.

This is not to say that the person should avoid all his or her usual pursuits, only that the person should become aware of any stress that creeps into his or her life and alter his or her responses through deconditioning (for instance, not getting upset if he or she is late) and positive programming (becoming as "patient as Job" an, as "relaxed as a sleeping babe").