The effects on blood pressure of regular patient and professional monitoring of blood pressure, extensive patient-involved assessment of results, relaxation, and systolic blood pressure biofeedback are analyzed by comparisons of data from two 3-month treatment periods with results from a 1-month baseline period and by comparisons among control and treatment groups. Ninety borderline hypertensive patients completed the treatments. Major findings are: A Acute effects; 1) Both relaxation and systolic blood pressure biofeedback lowered blood pressure acutely. 2) Improvement in performance of relaxation and biofeedback with practice showed that they are learned skills. 3) Acutely, relaxation and biofeedback were equally effective for lowering systolic blood pressure, but relaxation lowered diastolic blood pressure more. B. Long-term effects; 1) Blood pressure declined for at least 6 months with regular monitoring and patient-involved assessment. 2) The greatest lowering of blood pressure by behavioral intervention occurred during periods when pressures tended to be highest. 3) A combination of relaxation and biofeedback, with biofeedback preceding relaxation, was better than either used alone and slightly, but not significantly, better than relaxation preceding biofeedback. 4) The long-term effects of biofeedback were slightly greater than those of relaxation. A staged, incremental behavioral treatment of borderline hypertension is proposed.

A group of 125 patients was enrolled in a study designed to evaluate the effectiveness of two behavioral treatments of high blood pressure, "relaxation' and systolic blood pressure "biofeedback." All patients monitored their pressures three times daily and also had their pressures recorded by a health professional weekly for a one-month, baseline period. This article reports only the results form the baseline period. The main findings are: 1) extensive self-monitoring of blood pressure is feasible and practical; 2) systolic pressure rises throughout the day, but is highest in the afternoon; 3) diastolic pressure falls form morning to evening, but is highest in the afternoon; 4) intradaily range of systolic but not diastolic blood pressure is higher among women than among men; 5) both systolic and diastolic pressures fall throughout the first 3 weeks; 6) standard deviations and ranges of self-determined blood pressures are highly intercorrelated; however, changes in professionally measured blood pressures are poorly correlated with these indices of blood pressure lability; 7) systolic pressure levels, rates of decline throughout the baseline period and lability indices are correlated with age, but comparable measures of diastolic blood pressure are not correlated with age.