Adapting to a demanding stressful urban environment places emphasis on the resources and ability to cope with these demands. The brain-heart link is assessed in the award-winning Sympathetic activity and Ambulatory Blood pressure in Africans Prospective cohort study. We have demonstrated behavioural emotional resiliency albeit physiological susceptibility or “loss of control” in urban Africans, where psychological distress seems masked in a too demanding environment. We hypothesize that central neural control is challenged during stress and it may facilitate psychophysiological burnout (“losing control”). This will be evident in augmented alpha-adrenergic vascular responses coupled to hypothalamus-pituitary-adrenal axis hypo-activity, cognitive distress and endothelial dysfunction. Preliminary findings of the SABPA study sparked own initiative to conceptualize implementation of the Hypertension Research and Training clinic to integrate research and service delivery programs.