Nonpharmacologic Control of Essential Hypertension in Man: A Critical Review of the Experimental Literature

Abstract

Many nonpharmacologic (behavioral) techniques are being proposed for the therapy of essential hypertension. The research in this area is reviewed and divided roughly into two categories: the biofeedback and relaxation methodologies. While feedback can be used to lower pressures during laboratory training sessions, studies designed to alter basal blood pressure levels with biofeedback have not yet been reported. The absence of evidence for such changes through biofeedback limits the usefulness of this technique in hypertension control. The various relaxation methods, such as yoga, transcendental meditation, progressive muscle relaxation, and others have shown more promise. With varying degrees of experimental vigor, many of these techniques have been associated with long-lasting changes in blood pressure. The strengths and weaknesses of the various authors' research designs, data and conclusions are discussed, and suggestions for further experimentation are offered.

Psychological predictors of the antihypertensive effects of music-guided slow breathing

“…Participants in the intervention group [5] listened to the same slow music given to participants in the active control group but were also taught respiration techniques. Thus, the selective BP reduction in the intervention group indicates voluntary breathing rate reduction as the active component in relaxing treatments [31][32][33][34][35].…”

Stress management techniques: Are they all equivalent, or do they have specific effects?

“…Agras and Jacob (1979) Frumkin et al (1978) Seer ( Patel et al (1981Patel et al ( , 1985 GSR FB + PR + meditation + stress education > standard medical treatment Richter-Heinrich et al (1984) RT + BP feedback + BP monitoring + physical exercise + psychoeducation > drug therapy with beta-receptor blockers Goldstein et al (1984) Drug therapy + RT + or EMG FB > drug therapy, nondrug therapy Comparative studies Fray (1975) AT > EMG bfk Longo (1984) Deep breathing > PR Blanchard et al (1984Blanchard et al ( , 1986 TBFK Goldstein et al (1982) BP Feedback > RT, self-monitoring Glasgow et al (1982) RT + BP feedback > RT, BP feedback MED > PR (nonhypertensive alcoholics) Sedlacek et al (1979) EMG + TMP bfk > MED Hafner (1982) MED + EMG-or-SC-BFK > MED Cohen and Sedlacek (1983) AT + PR + EMG and TBFK > MED English and Baker (1983) PR > MED (SBP)…”

Impact of Qigong Exercise on Self-Efficacy and Other Cognitive Perceptual Variables in Patients with Essential Hypertension

“…However, drug therapy has unwanted side-effects that can reduce the quality of life (Croog et al, 1986;Houston, 1989). In response to this concern, there has been increasing interest in nonpharmacologic treatment of hypertension (Frumkin et al, 1978;Joint National Commitee, 1986). Behavioral interventions such as meditation, yoga, and biofeedback have been reported to be effective in controlling high BP (Henderson et al, 1998;Schneider et al, 1995;Sundar et al, 1984).…”