Have you ever been fired from a job?

[zipplewrath]

6. A good first step

Acknowledging reality is a great first step.

There are physical little tricks to get a lower reading. Don't cross your legs. Your arm should be relaxed and really should be lower than your shoulder. DON'T TALK. For that matter, a bit like you describe, see if you can't stop talking a good two minutes before they take your blood pressure. Control your breathing, take a couple of deep breaths when you first sit down, then just stay very calm. It'd be nice if the room wasn't too bright either. I'd probably close my eyes too.

I say these things not so much to say that they'll "fix" things for you, but that if you can do some physical things to give you confidence and encourage you to believe that you've "got this", it can affect your mental state favorably. In golf we call it the "pre-shot routine". It's more about concentration and one's brain in general than anything to do with the body.