Long term application of behavioral treatments in essential hypertensives

Behavioral Treatment of High Blood Pressure: III. Follow-Up Results and Treatment Recommendations

“…Monitoring should be carried out three times daily to enable one to assess intradaily patterns as well as '"Response cost" is a behavioral concept derived from studies which show that the effort a subject expends in attaining a reward is aversive and competes with the reinforcing properties of the reward. 3 We have intentionally used the indefinite phrases, "sufficiently low," "still too high," and "acceptable levels" because clinicians use arbitrary criteria to treat their patients and we wished to propose a program that accurately reflected common practice. Likewise, there is evidence that morbidity or mortality is quantitatively related to blood pressure and that the relationship is continuous (i.e., there is no discrete level of blood pressure at which risk can be said to be present and below which it can be considered absent).…”

Responses to mental stress and physical provocations before and during long term treatment of hypertensive patients with beta‐adrenoceptor blockers or hydrochlorothiazide.

“…Indeed, a few studies have shown less pronounced diastolic blood pressure lowering effects of propranolol, as compared to 13l-selective antagonists, during stress (Richter-Heinrich et al, 1981;Waal-Manning, 1979).…”

Effects of home blood pressure measurement on long-term BP control.

“…[1][2][3] Two of the major areas of research involve screening programs,4-9 and the problem of maintaining patients on antihypertensive therapy which is part of a broader area regarding the maintenance of behavioral change. [10][11][12] To facilitate compliance and its correlate, blood pressure control, a number of intervention strategies have been tested including locating a hypertension specialty clinic in the community,3 6'320 locating a hypertension treatment clinic in or near the work site, 8,21-23 establishing specialty clinics within university medical clinics,2425 providing intense follow-up for hypertension patients to assure appointment keeping,2627 providing various forms of social support and education,28-32 and providing patients with self-monitoring blood pressure cuffs.33-37 These interventions for improving the control of blood pressure have met with varying levels of success.…”

“…1-3 Two of the major areas of research involve screening programs,4-9 and the problem of maintaining patients on antihypertensive therapy which is part of a broader area regarding the maintenance of behavioral change. [10][11][12] To facilitate compliance and its correlate, blood pressure control, a number of intervention strategies have been tested including locating a hypertension specialty clinic in the community,3 6'320 locating a hypertension treatment clinic in or near the work site, 8,21-23 establishing specialty clinics within university medical clinics,2425 providing intense follow-up for hypertension patients to assure appointment keeping,2627 providing various forms of social support and education,28-32 and providing patients with self-monitoring blood pressure cuffs.33-37 These interventions for improving the control of blood pressure have met with varying levels of success.There is effective in maintaining controlled BP for a time period greater than that required for an initial BP reduction.Three specific hypotheses were tested: I) the use of a home blood pressure cuff administered by a patient-selected significant other (usually a family member identified by the patient) will enhance BP reduction over either a self-administered blood pressure cuff group or a "standard treatment" group; 2) the use of a self-administered blood pressure cuff will enhance blood pressure reduction over a "standard treatment" group; and 3) fewer patients will drop out of treatment from the significant other administered group than from either the self-administered or "standard treatment" groups. …”