Stress management versus lifestyle modification on systolic hypertension and medication elimination: a randomized trial.

Full Abstract

Isolated systolic hypertension is common in the elderly, but decreasing systolic blood pressure (SBP) without lowering diastolic blood pressure (DBP) remains a therapeutic challenge. Although stress management training, in particular eliciting the relaxation response, reduces essential hypertension its efficacy in treating isolated systolic hypertension has not been evaluated. We conducted a double-blind, randomized trial comparing 8 weeks of stress management, specifically relaxation response training (61 patients), versus lifestyle modification (control, 61 patients). Inclusion criteria were >or=55 years, SBP 140-159 mm Hg, DBP <90 mm Hg, and at least two antihypertensive medications. The primary outcome measure was change in SBP after 8 weeks. Patients who achieved SBP <140 mm Hg and >or=5 mm Hg reduction in SBP were eligible for 8 additional weeks of training with supervised medication elimination. SBP decreased 9.4 (standard deviation [SD] 11.4) and 8.8 (SD 13.0) mm Hg in relaxation response and control groups, respectively (both ps <0.0001) without group difference (p=0.75). DBP decreased 1.5 (SD 6.2) and 2.4 (SD 6.9) mm Hg (p=0.05 and 0.01, respectively) without group difference (p=0.48). Forty-four (44) in the relaxation response group and 36 in the control group were eligible for supervised antihypertensive medication elimination. After controlling for differences in characteristics at the start of medication elimination, patients in the relaxation response group were more likely to successfully eliminate an antihypertensive medication (odds ratio 4.3, 95% confidence interval 1.2-15.9, p=0.03). Although both groups had similar reductions in SBP, significantly more participants in the relaxation response group eliminated an antihypertensive medication while maintaining adequate blood pressure control.

Learn Faster Today Improve your study skills

Author information

Author/s: Dusek, Jeffery A (JA); Hibberd, Patricia L (PL); Buczynski, Beverly (B); Chang, Bei-Hung (BH); Dusek, Kathryn C (KC); Johnston, Jennifer M (JM); Wohlhueter, Ann L (AL); Benson, Herbert (H); Zusman, Randall M (RM);

Affiliation: Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital, Boston, MA 02114, USA.

Grants: H75/CCH 123424 (Agency:United States PHS) ; H75/CCH 19124 (Agency:United States PHS) ; K24AT003683 (Agency:United States NCCAM) ; R01 DP000339 (Agency:United States NCCDPHP)

Journal and publication information

Publication Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.

Journal: Journal of alternative and complementary medicine (New York, N.Y.) (J Altern Complement Med), published in United States. (Language: eng)

Reference: 2008-Mar; vol 14 (issue 2) : pp 129-38

Dates: Created 2008/03/10; Completed 2008/07/08;

PMID: 18315510, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article (including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Activities of Daily Living
Adaptation, Psychological
Aged
Antihypertensive Agents - administration & dosage
Blood Pressure
Double-Blind Method
Female
Heart Rate
Humans

Hypertension - complications; drug therapy; therapy
Life Style
Male
Middle Aged
Personal Satisfaction
Relaxation Techniques
Severity of Illness Index
Stress, Psychological - etiology; therapy
Treatment Outcome

Associated Chemicals: Antihypertensive Agents (0)

These are the highest related articles currently in the database:

See 100+ related articles.