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Stress-management training for essential hypertension: A controlled study

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Abstract

Forty three patients with essential hypertension participated in a study on the effectiveness of stress-management training for essential hypertension. After 6–9 clinic and 48 self-measured readings of systolic and diastolic blood pressures (SBP and DBP), 22 patients were treated with a program based on education, relaxation, and problem-solving training; and another 21 patients were assigned to a waiting list control group. At post-treatment, mean reductions of clinic BP (17/13 mm Hg vs. 6.9/4.7 mm Hg for SBP/DBP), percentages of subjects who achieved at least a 5 mm Hg reduction (86/86% vs. 48/48% for SBP/DBP) and percentages of subjects who in addition achieved a normotensive level (59/68% vs. 29/14% for SBP/DBP) were significantly higher in the treated group than in the control group. Concerning self-measured BP, the effectiveness of the stress-management training was not so considerable (mean reductions of 3.6/2.4 mm Hg and percentages of subjects who achieved a 5 mm Hg reduction of 52/38% for SBP/DBP), but it was significant and maintained in a 4-month follow-up assessment (mean reductions of 4/2 mm Hg and percentages of subjects who achieved a 5 mm Hg reduction of 48/33% for SBP/DBP). It is suggested that stress-management training can be beneficial for treatment of essential hypertension.

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References

  • Amigo, I., Buceta, J. M., Becoña, E., & Bueno, A. (1991). Cognitive behavioural treatment for essential hypertension: A controlled study.Stress Medicine, 7, 103–108.

    Google Scholar 

  • Armitage, P., & Rose, G. A. (1966). The variability of measurement of casual blood pressure. I. A laboratory study.Clinical Science, 30, 325–335.

    PubMed  Google Scholar 

  • Baer, P. E., Collins, F. H., Bourianoff, G. G., & Ketchel, M. F. (1979). Assessing personality factors in essential hypertension with a brief self-report instrument.Psychosomatic Medicine, 41, 321–330.

    PubMed  Google Scholar 

  • Bernstein, D. A., & Borkovec, T. D. (1983).Entrenamiento en relajación progresiva [Progressive relaxation training]. Bilbao: DDB.

    Google Scholar 

  • Blanchard, E. B., & Schwarz, S. P. (1988). Clinically significant changes in behavioral medicine.Behavioral Assessment, 10, 171–188.

    Article  Google Scholar 

  • Carné, X., Moreno, V., Portaserra, M., & Vellida, E. (1989). El cálculo del número de pacientes necesarios en la planificación de un estudio clínico [The calculation of the number of patients needed to design a clinical trial].Medicina Clínica, 92, 72–77.

    PubMed  Google Scholar 

  • Cottier, C., Shapiro, K., & Julius, S. (1984). Treatment of mild hypertension with progressive muscle relaxation.Archives of Internal Medicine, 144 1954–1958.

    Article  PubMed  Google Scholar 

  • Diamond, E. L. (1982). The role of anger and hostility in essential hypertension and coronary heart disease.Psychological Bulletin, 92, 410–433.

    Article  PubMed  Google Scholar 

  • D’Zurilla, T. J. (1986).Problem-solving therapy. New York: Springer.

    Google Scholar 

  • D’Zurilla, T. J. (1990). Problem-solving training for effective stress management and prevention.Journal of Cognitive Psychotherapy: An International Quarterly, 4, 327–353.

    Google Scholar 

  • D’Zurilla, T. J., & Nezu, A. M. (1990). Development and preliminary evaluation of the Social Problem-Solving Inventory.Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2, 156–163.

    Google Scholar 

  • D’Zurilla, T. J., & Sheedy, C. F. (1991). Relation between social problem-solving ability and subsequent level of psychological stress in college students.Journal of Personality and Social Psychology, 61, 841–846.

    Article  PubMed  Google Scholar 

  • Fernández-Abascal, E. G. (1993).Hipertensión: Intervención psicológica [Hypertension: Psychological intervention]. Madrid: Eudema.

    Google Scholar 

  • Freestone, S., Silas, J. H., & Ramsay, L. E. (1982). Sample size for short-term trials of antihypertensive drugs.British Journal of Clinical Pharmacology, 14, 265–268.

    PubMed  Google Scholar 

  • García-Vera, M. P., & Labrador, F. (1991).Su salud depende de lo que usted haga Quiere ocuparse de su salud? [Your health depends on what you do. Do you want to take care of your health?] Unpublished self-help booklet. Facultad de Psicología. Universidad Complutense de Madrid.

  • García-Vera, M. P., & Labrador, F. (1996).El problema de la hipertensión ante la bata blanca en los ensayos clínicos de los tratamientos antihipertensivos [The trouble with white coat hypertension in the clinical trials on antihypertensive treatments]. Manuscript submitted for publication.

  • García-Vera, M. P., Labrador, F., & Arriba, J. Mǎ. 1993. El autorregistro de la presi/’o arterial para el diagnóstico y manejo de la hipertensión arterial [Self-recorded blood pressure for the diagnosis and management of essential hypertension]. In J. Mâ. Arribas & F. Caballero (Eds.),Manual de cirugía menor y otros procedimientos en la consulta del médico de familia [Handbook of minor surgery and other procedures in family physician’s office] (pp. 517–521). Madrid: Merck Sharp & Dohme.

    Google Scholar 

  • García-Vera, M. P., Labrador, F., & Sanz, J. (1996).Comparison of clinic, home self-measured and work self-measured blood pressures. Manuscript submitted for publication.

  • Goebel, M., Viol, G. W., & Orebaugh, C. (1993). An incremental model to isolate specific effects of behavioral treatments in essential hypertension.Biofeedback and Self-Regulation, 18, 255–280.

    Article  PubMed  Google Scholar 

  • Gould, B. A., Hornung, R. S., Kieso, H., Cashman, P. M. M., and Raftery, E. R. (1986). An evaluation of self-recorded blood pressure during drug trials.Hypertension, 8, 267–271.

    PubMed  Google Scholar 

  • Hatch, J. P., Klatt, K. D., Supik, J. D., Rios, N., Fisher, J. G., Bauer, R. L., & Shimotsu, G. W. (1985). Combined behavioral and pharmacological treatment of essential hypertension.Biofeedback and Self-Regulation, 10, 119–138.

    Article  PubMed  Google Scholar 

  • Hollon, S. D., & Flick, S. N. (1988). On the meaning and methods of clinical significance.Behavioral Assessment, 10, 197–206.

    Google Scholar 

  • Jacob, R. G., Chesney, M. A., Williams, D. M., Yijun Ding, B. S., & Shapiro, A. P. (1991). Relaxation therapy for hypertension: design effects and treatment effects.Annals of Behavioral Medicine, 13, 5–17.

    Google Scholar 

  • Jacob, R. G., Wing, R., & Shapiro, A. P. (1987). The behavioral treatment of hypertension: Long-term effects.Behavior Therapy, 18, 325–352.

    Article  Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research.Journal of Consulting and Clinical Psychology, 59, 12–19.

    Article  PubMed  Google Scholar 

  • James, G. D., Pickering, T. G., Yee, L. S., Harshfield, G. A., Riva, S., & Laragh, G. D. (1988). The reproducibility of average ambulatory, home, and clinic pressures.Hypertension, 11, 545–549.

    PubMed  Google Scholar 

  • Johnston, D. W. (1987). The behavioral control of high blood pressure.Current Psychological Research & Reviews, 6, 99–114.

    Google Scholar 

  • Jurek, I., Higgins, J. T., Jr., & McGrady, A. (1992). Interaction of biofeedback-assisted relaxation and diuretic in treatment of essential hypertension.Biofeedback and Self-Regulation, 17, 125–141.

    Article  PubMed  Google Scholar 

  • Kleinert, H. D., Harshfield, G. A., Pickering, T. G., Devereux, R. B., Sullivan, P. A., Marion, R. M., Mallory, W. K., & Laragh, J. H. (1984). What is the value of home blood pressure measurement in patients with mild hypertension?Hypertension, 6, 574–578.

    PubMed  Google Scholar 

  • Luzarus, R. S. (1978). A strategy for research on psychological and social factors in hypertension.Journal of Human Stress, 4, 35–40.

    Google Scholar 

  • Linden, W., & Chambers, L. (1994). Clinical effectiveness of non-drug treatment for hypertension: A meta-analysis.Annals of Behavioral Medicine, 16, 35–45.

    Google Scholar 

  • Linden, W., & Feuerstein, M. (1981). Essential hypertension and social coping behavior.Journal of Human Stress, 7, 28–34.

    PubMed  Google Scholar 

  • Linden, W., & Feuerstein, M. (1983). Essential hypertension and social coping behavior: Experimental findings.Journal of Human Stress, 9, 22–31.

    PubMed  Google Scholar 

  • Llabre, M. M., Ironson, G. H., Spitzer, S. B., Gellman, M. D., Weider, D. J., & Schneiderman, N. (1988). Blood pressure stability of normotensive and mild hypertensives in different setting.Health Psychology, 7, 127–137.

    PubMed  Google Scholar 

  • Markovitz, J. H., Matthews, K. A., Kannel, W. B., Cobb, J. L., & D’Agostino, R. B. (1993). Psychological predictors of hypertension in the Framingham Study: Is there tension in hypertension?Journal of the American Medical Association, 270, 2439–2443.

    Article  PubMed  Google Scholar 

  • McGrady, A. & Higgins, J. T., Jr. (1990). Effect of repeated measurements of blood pressure on blood pressure in essential hypertension: Role of anxiety.Journal of Behavioral Medicine, 13, 93–101.

    Article  PubMed  Google Scholar 

  • Ménard, J., Serrurier, D., Bautier, P., Plouin, P. E., & Corvol, P. (1988). Crossover design to test antihypertensive drugs with self-recorded blood pressure.Hypertension, 11, 153–159.

    PubMed  Google Scholar 

  • Mengden, T., Binswanger, B., Weisser, B., & Vetter, W. (1992). An evaluation of self-measured blood pressure in a study with a calcium-channel antagonist versus a β-blocker.American Journal of Hypertension, 5, 154–160.

    PubMed  Google Scholar 

  • Moon, J. R., & Eisler, R. M. (1983). Anger control: An experimental comparison of three behavioral treatments.Behavior Therapy, 14, 493–505.

    Article  Google Scholar 

  • Pickering, T. G. (1991).Ambulatory monitoring and blood pressure variability. London: Science Press.

    Google Scholar 

  • Ruoff, G. (1989). ACE inhibitors and diuretics. The benefits of combined therapy for hypertension.Postgraduate Medicine, 85(3), 127–132.

    PubMed  Google Scholar 

  • Schechter, C. B. (1990). Sequential decison making with continuous disease states and measurements. II. Applications to diastolic pressure.Medical Decision Making, 10, 256–265.

    PubMed  Google Scholar 

  • Sechrest, L. (1989). Métodos de investigación, fiabilidad y validez [Research methods, reliability and validity]. In A. S. Bellack & M. Hersen (Eds.),Métodos de investigación en psicología clínica [Research methods in clinical psychology] (pp. 35–65). Bilbao: DDB.

    Google Scholar 

  • Shapiro, A. P., Myers, T., Reiser, M. F., & Ferris, E. B. (1954). Comparison of blood pressure response to veriloid and to the doctor.Psychosomatic Medicine, 16, 478–488.

    PubMed  Google Scholar 

  • Sommers-Flanagan, J., & Greenberg, R. P. (1989). Psychosocial variables and hypertension: A new look at an old controversy.Journal of Nervous and Mental Disease, 177, 15–24.

    PubMed  Google Scholar 

  • Spiro, A., III, Aldwin, C. M., Ward, K. D., & Mroczek, D. K. (1995). Personality and the incidence of hypertension among older men: Longitudinal findings from the normative aging study.Health Psychology, 14, 563–569.

    Article  PubMed  Google Scholar 

  • Verdecchia, P., Bentivoglio, M., Provvidenza, M., Savino, K., & Corea, L. (1985). Reliability of self-recorded arterial pressure in essential hypertension in relation to the stage of the disease. In G. G. Rome (Ed.),Blood pressure recording in the clinical management of hypertension (pp. 40–42). Roma: Edizioni L. Pozzi.

    Google Scholar 

  • Waeber, G., Beck, G., Waeber, B., Bidiville, J., Nussberger, J., & Brunner, H. R. (1988). Comparison of betaxolol with verapamil in hypertensive patients: discrepancy between office and ambulatory blood pressures.Journal of Hypertension, 6, 239–245.

    Article  PubMed  Google Scholar 

  • Waeber, B., O’Brien, E., Camenzind, E., Cox, J., Nussberger, J., & Brunner, H. R. (1992). Efficacy assessment of antihypertensive therapy. In H. Brunner & B. Waeber (Eds.),Ambulatory blood pressure recording (pp. 145–168). New York: Raven.

    Google Scholar 

  • Watson, R. D. S., Lumb, R., Young, M. A., Stallard, T. J., Davies, P., & Littler, A. (1987). Variation in cuff blood pressure in untreated outpatients with mild hypertension implications for initianting antihypertensive treatment.Journal of Hypertension, 5, 207–211.

    PubMed  Google Scholar 

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  1. Universidad Complutense de Madrid, Madrid, Spain

    María Paz García-Vera, Francisco J. Labrador & Jesús Sanz

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  1. María Paz García-Vera
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  2. Francisco J. Labrador
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García-Vera, M.P., Labrador, F.J. & Sanz, J. Stress-management training for essential hypertension: A controlled study. Appl Psychophysiol Biofeed 22, 261–283 (1997). https://doi.org/10.1007/BF02438980

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