Elevated Blood Pressure

  • Craig K. Ewart
  • Susanna Cunningham
Part of the Applied Clinical Psychology book series

Abstract

Behavioral interventions to modify diet, activity, and emotional stress constitute the recommended initial treatment for mild essential hypertension in children and should accompany pharmacological therapy in more severe cases (Task Force on Blood Pressure Control in Children, 1987; referred to hereafter as the Second Task Force). The first concern is to ensure that the blood pressure evaluation process itself does not generate excessive anxiety and negative self-labeling on the part of child and family (Bloom & Monterossa, 1981; Bergman & Stamm, 1967). If, upon repeated assessment, the child’s blood pressure is found to be significantly elevated, this can usually be presented as a timely cue to start changing life-style patterns that could lead to health problems later on. Behavioral assessment and intervention efforts then focus on modifying diet habits, increasing physical activity, and reducing excessive emotional stress.

Keywords

Cholesterol Sugared Fatigue Obesity Depression 

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References

  1. Berchtold, P., Jorgens, V., Kemmer, F. W., & Berger, M. (1982). Obesity and hypertension: Cardiovascular response to weight reduction. Hypertension, 4(Suppl. III), III-50-III-55.Google Scholar
  2. Bergman, A. B., & Stamm, S. J. (1967). The morbidity of cardiac nondisease in schoolchildren. New England Journal of Medicine, 276, 1008–1013.PubMedCrossRefGoogle Scholar
  3. Bloom, J., & Monterossa, S. (1981). Hypertension labeling and sense of well-being. American journal of Public Health, 71, 1228–1232.PubMedCrossRefGoogle Scholar
  4. Boekeloo, B. O., Mamon, J. A., & Ewart, C. K. (1987). Identifying coronary-prone behavior in adolescents using the Bortner self-rating scale. Journal of Chronic Diseases 40 785–793.Google Scholar
  5. Bray, G. A. (1986). Effects of obesity on health and happiness. In K. D. Brownell & J. Foreyt (Eds.), Handbook of eating disorders(pp. 3–44 ). New York: Basic Books.Google Scholar
  6. Brownell, K. D. (1982). Obesity: Understanding and treating a serious, prevalent, and refractory disorder. Journal of Consulting and Clinical Psychology, 50, 820–840.PubMedCrossRefGoogle Scholar
  7. Brownell, K. D., Delman, J. H., Stunkard, A. J. (1983). Treatment of obese children with and without their mothers: Changes in weight and blood pressure. Pediatrics, 71, 515–523.PubMedGoogle Scholar
  8. Brownell, K. D., Marlatt, G. A., Lichtenstein, E., & Wilson, G. T. (1986). Understanding and preventing relapse. American Psychologist, 41, 765–782.PubMedCrossRefGoogle Scholar
  9. Clarke, W. R., Woolson, R. F., & Lauer, R. M. (1986). Changes in ponderosity and blood pressure in childhood: The Muscatine study. American Journal of Epidemiology, 124 195–206.PubMedGoogle Scholar
  10. Dennison, D., Frauenheim, K. A., & Izu, L. (1983). The DINE microcomputer program: An innovative curricular approach. Health Education, March—April, 44–47.Google Scholar
  11. Dietz, W. H. (1983). Childhood obesity: Susceptibility, cause and management. Journal of Pediatrics, 103, 676–686.PubMedCrossRefGoogle Scholar
  12. Epstein, L. H. (1986). Treatment of childhood obesity. In K. D. Brownell and J. P. Foreyt (Eds.), Handbook of eating disorders(pp. 159–179 ). New York: Basic Books.Google Scholar
  13. Epstein, L. H., Wing, R. R., & Valoski, A. (1986). Family-based behavioral weight control in obese young children. Journal of the American Dietetic Association, 4, 481–484.Google Scholar
  14. Epstein, L. H., Wing, R. R., Koeski, R., & Valoski, A. (1985). A comparison of lifestyle exercise, aerobic exercise, and calisthenics on weight loss in obese children. Behavior Therapy, 16, 345–356.CrossRefGoogle Scholar
  15. Ewart, C. K., Burnett, K. F., & Taylor, C. B. (1983). Communication behaviors that affect blood pressure: An A-B-A-B analysis of marital interaction. Behavior Modification, 7, 331–344.PubMedCrossRefGoogle Scholar
  16. Ewart, C. K., Harris, W. L., Iwata, M. M., Coates, T. J., Bullock, R., & Simon, B. (1987b). Feasibility and effectiveness of school-based relaxation to lower blood pressure. Health Psychology, 6, 399–416.PubMedCrossRefGoogle Scholar
  17. Ewart, C. K., Harris, W. L., Zeger, S., & Russell, G. A. (1986). Diminished pulse pressure under mental stress characterizes normotensive adolescents with parental high blood pressure. Psychosomatic Medicine, 48, 489–501.PubMedGoogle Scholar
  18. Ewart, C. K., Peyrot, M., & Harris, W. L. (1989). Cardiovascular risk in adolescents: Contributions of negative interpersonal emotion syndrome and parental high blood pressure. Johns Hopkins University, Baltimore. Unpublished manuscript.Google Scholar
  19. Ewart, C. K., Taylor, C. B., Kraemer, H. C., & Agras, W. S. (1984). Reducing blood pressure reactivity during interpersonal conflict: Effects of marital communication training. Behavior Therapy, 15, 473–484.CrossRefGoogle Scholar
  20. Falkner, B., Onesti, G., Angelakos, E. T., Fernandes. M., &Langman, C. (1979). Cardiovascular response to mental stress in normal adolescents with hypertensive parents. Hypertension, 1, 23–30.PubMedGoogle Scholar
  21. Ferguson, J. M., Marquis, J. N. & Taylor, C. B. (1977). A script for deep muscle relaxation training. Diseases of the Nervous System, 38, 703–708.PubMedGoogle Scholar
  22. Frank, G. C., Farris, R. P., Ditmarsen, P., Voors, A. W., & Berenson, G. S. (1982). An approach to primary preventive treatment for children with high blood pressure in a total community. Journal of the American College of Nutrition, 1, 357–374.PubMedGoogle Scholar
  23. Henry, J. P., & Stephens, P. M. (1977). Stress, health, and the social environment: A sociobiologic approach to edicine. New York: Springer.Google Scholar
  24. Julius, S., Weder, A. B., & Eagan, B. M. (1983). Pathophysiology of early hypertension: Implication for epidemiologic research. In F. Gross & T. Strasser (Eds.), Mild hypertension: Recent advances. New York: Raven Press.Google Scholar
  25. Martin, J. E., & Dubbert, P. M. (1982). Exercise applications and promotion in behavioral medicine: Current status and future directions. Journal of Consulting and Clinical Psychology, 50, 1004–1017.PubMedCrossRefGoogle Scholar
  26. Paffenbarger, R. S., Wing, A. L., Hyde, R. T., & Jung, D. L. (1983). Physical activity and incidence of hypertension in college alumni. American Journal of Epidemiology, 117, 245–257.PubMedGoogle Scholar
  27. Reynolds, W. M., & Coats, K. I. (1986). A comparison of cognitive behavioral therapy and relaxation training for the treatment of depression in adolescents. Journal of Consulting and Clinical Psychology, 54, 653–660.PubMedCrossRefGoogle Scholar
  28. Stamler, R., Stamler, J., Riedlinger, W. F., Algera, G., & Roberts, R. H. (1978). Weight and blood pressure: Findings in hypertension screening of 1 million Americans. Journal of the American Medical Association, 240, 1607–1610.PubMedCrossRefGoogle Scholar
  29. Task Force on Blood Pressure Control in Children. (1987). Report of the second task force on blood pressure control in Children-1987. Pediatrics, 79, 1-25.Google Scholar
  30. Voors, A. W., Berenson, G. S., Dalferes, E. R., Webber, L. S., & Shuler, S. E. (1979). Racial differences in blood pressure control. Science, 204, 1091–1094.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1990

Authors and Affiliations

  • Craig K. Ewart
    • 1
  • Susanna Cunningham
    • 2
  1. 1.Department of Public Health Psychology, School of Hygiene and Public HealthJohns Hopkins UniversityBaltimoreUSA
  2. 2.Department of Physiological Nursing, School of NursingUniversity of WashingtonSeattleUSA

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