Evidence of the interaction between psychological factors and blood pressure is reviewed with a focus on stressful events and mental health. While the hypertensive personality remains an elusive and perhaps fictional entity, and indices of psychological distress, psychopathology, or poor adjustment do not correlate highly with blood pressure or hypertension, environment stressors such as the threat of unemployment and job pressures adversely affect blood pressure and mental health across groups of individuals. Recent studies suggest that the diagnosis of hypertension may elicit clinically significant psychological distress and anxiety. Adverse reactions to antihypertensive medication may interact with and exacerbate pre-existing distress. Implications for nurses dealing with hypertensive patients are discussed.