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Applied Psychophysiology and Biofeedback

, Volume 31, Issue 1, pp 51–63 | Cite as

The Efficacy of Behavioral Treatments for Hypertension

  • Wolfgang LindenEmail author
  • Janine V. Moseley
WHITE PAPER REVIEW

Evidence is reviewed for the efficacy of behavioral treatments for hypertension. The format chosen here is a review of reviews given that numerous consensus committee reports and quantitative reviews on the topic have been published. Extensive evidence from over 100 randomized controlled trials indicates that behavioral treatments reduce blood pressure (BP) to a modest degree, and this change is greater than what is seen in wait-list or other inactive controls. Effect sizes are quite variable. The observed BP reductions are much greater when BP levels were high at pre-test, and behavioral studies tend to underestimate possible benefits because of floor effects in their protocols. Blood pressure measured in the office may be confounded with measurement habituation. Multi-component, individualized psychological treatments lead to greater BP changes than do single-component treatments. Among biofeedback treatments, thermal feedback and electrodermal activity feedback fare better than EMG or direct BP feedback, which tend to produce null effects. There continues to be a scarcity of strong protocols that properly control for floor effects and potential measurement confounds.

KEY WORDS:

hypertension blood pressure outcome treatment efficacy 

ABBREVIATIONS

BP

blood pressure

SBP

systolic blood pressure

DBP

diastolic blood pressure

ABPM

Ambulatory blood pressure measurement

ES

(effect size d)

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  1. 1.PsychologyThe University of British ColumbiaVancouverCanada

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