Home vs clinic blood pressure in essential hypertension with and without behavioral therapy

Summary

Behavioral treatments of relaxation alone (RL = 13) and relaxation in combination with EMG biofeedback (RL/BF = 14) were given to uncontrolled essential hypertensives (diastolic blood pressure greater than 90 mmHg) between the ages of 35 and 62. Comparisons were made between RL, RL/BF and a control condition in which patients monitored their own blood pressures (SM = 14). These three groups of patients all receiving anti-hypertensive medications were compared with a fourth un-medicated relaxation group (RL/noD = 17). Both home and clinic laboratory blood pressure were compared during 6 weeks of baseline and 10 weeks of treatment. In the baseline period, sitting quietly for 15 min in the laboratory significantly reduced the systolic blood pressure in the anti-hypertensive drug treated patients. This effect was not apparent in the un-medicated group. Relaxation and relaxation/biofeedback were equally effective in reducing blood pressure at home in the morning and evening and produced significantly greater systolic and diastolic decreases than those seen in the SM control group. Relaxation therapy in the non-drug group was significant only for morning blood pressures. Clinic blood pressures did not reflect significant differences between the groups. It is concluded that the setting (laboratory/clinic vs home) and the condition (before or after sitting quietly) under which blood pressure measurements are made may influence the effect of medications or behavioral therapy.

This study was conducted at the Sepulveda Veterans Administration Medical Center and was supported by the American Heart Association (Greater Los Angeles Affiliate) Grant No. 701-G2-2.