| Description |
Two nonpharmacological interventions--education for lifestyle adjustments and biobehavioral techniques--were tested on medicated and nonmedicated patients with mild essential hypertension. Blood pressure reductions and relationships between blood pressure responses and concomitant variables (changes in weight, diet, medications, exercise, stress, social support, and practice of relaxation and meditation techniques) were assessed. Previous research failed to monitor competing variables that may have produced the observed reductions in blood pressure. Few multiintervention studies on mild hypertensives showed modest blood pressure decreases, but changes in concomitant variables were incompletely reported or not related to blood pressure responses. Forty-four white hypertensives, ages 25-60 years, upper middle socioeconomic status, were matched on age, sex, medication status, and baseline blood pressure and randomized into four treatment groups: (1) education with medication (EDMD); (2) education without medication (EDOMD); (3) relaxation, meditation aided by pulse wave velocity and temperature biofeedback without medication (RMBMD); and (4) relaxation, meditation, biofeedback without medication (RMBOMD). Diagnostic studies ruled out target organ pathology. Six screening sessions across 3 weeks established baseline elevations greater than 138 mm Hg systolic and/or 88 mm Hg diastolic. Thirty-nine patients completed 10 weeks treatment and 6 months follow up. Analysis of variance with repeated measures showed no between-group differences. However, within-subjects comparisons of baseline with treatment and follow up measures demonstrated pressure reductions of 7-12 mm Hg systolic (p < .05-.001) and 3-5 mm Hg diastolic pressure (p < .05-.01) for all groups except nonsignificant diastolic decreases for EDOMD group during the last 5 weeks treatment and RMBOMD group for 6 months follow up. Efficacy rates indicated that EDMD group was most effective in reducing blood pressure below 138/88 mm Hg. For systolic decreases, RMBMD ranked second, EDOMD third, and RMBOMD fourth; ranks were EDOMD second, RMBOMD third, and RMBMD fourth in diastolic reductions. Significant within-subjects changes were observed in concomitant lifestyle variables: (1) decreased pounds overweight with moderate to large blood pressure reductions (p < .05); (2) decreased frequency of sodium intake with large blood pressure decrements (p < .05-0.1); and (3) increased stress ratings with diastolic nonreductions (p < .05). |
