Conducted a meta-analysis of studies about blood pressure (BP) and heart rate (HR) responses to behavioral stress in essential hypertensives (HTNs), borderline HTNs, and offspring of HTNs. Essential HTNs had large BP responses during all stressors, but especially during passive stressors not requiring a behavioral response. Borderline HTNs had moderately large and more reliable BP and HR responses primarily during active stressors (ASTs). Normotensive offspring of HTNs had moderately large and more reliable BP and HR responses to ASTs. Excessive sympathetic nervous system activity during behavioral stress seems to have a pathophysiologic role in the development of hypertension. (PsycINFO Database Record (c) 2012 APA, all rights reserved)