Stress management training for hypertensives: Cognitive and physiological effects

Abstract

The contribution of training procedures designed to alter individuals' psychological responses to stressful life stimuli to the reduction of blood-pressure levels of hypertensives was evaluated. The treatment consisted of a set of coping skill-building experiences. Forty-one black males, mildly to moderately hypertensive and under medical supervision in an outpatient cardiovascular unit of a veterans' hospital, participated. Subjects were randomly assigned to one of three groups: Cognitive Self-Management Training (CSM), Attention Placebo Control, and Current Clinic Conditions Control. The dependent measures were the State Anxiety Scale, Trait Anxiety Scale, Coping Strategic Inventory, systolic blood pressure, and diastolic blood pressure. Subjects in the CSM group reported significant increases in the use of cognitive coping strategies in their lives and demonstrated significant decreases in measured levels of state anxiety and systolic blood pressure. Promising reductions of diastolic blood pressure ratings were obtained as well.

Relaxation therapies for the management of primary hypertension in adults: a Cochrane review

“…The remaining 29 RCTs met our inclusion criteria but we excluded four RCTs from the primary meta-analysis because of missing standard deviations. [26][27][28][29] Three of these were included in a sensitivity analysis by imputing standard deviations; 27-29 one could not be included in any meta-analysis as neither the numbers of participants enrolled nor the number assessed at the end of follow-up were reported for all intervention groups. 26 These excluded trials are described in detail elsewhere.…”

“…26,31,33,40,42,53 Four trials which attempted to keep antihypertensive medication constant excluded from analysis the few participants who altered their medication. 36,39,48,50 Meta-analyses Primary meta-analysis of BP.…”

“…26,51,52 education on hypertension; 26,43,51 meditation without use of a mantra; 50 listening to synthesized music; 41 lectures to encourage anticipation of reduction in BP 32 and non-specific support therapy. 48 Hence, some trials used sham therapies which were similar to the active interventions in other trials.…”

Anger management training with mild essential hypertensive patients

“…At a 6-month follow-up visit, patients who completed the training showed an average reduction of 11.5 mm Hg in systolic blood pressure (SBP) and an 8.7 mm Hg reduction in diastolic blood pressure (DBP), in contrast to patients in a no-treatment control condition, who showed no significant change in blood pressure over the same period. Bosley and Allen (1989) also found significant reductions in SBP among black hypertensive patients relative to attention-placebo control patients subsequent to participation in a cognitive self-control program. This intervention taught self-statement modification but did not employ role-play rehearsal of anger expression.…”

“…have not yet been published" (p. 151). Despite frequent calls from authorities in the field, to date, only a few studies have examined the impact of interventions aimed at improving interpersonal assertion skills (e.g., Achmon et al, 1989;Lehnert et al, 1987) or directly altering anger proneness (Bosley and Allen, 1989) upon sustained levels of high blood pressure. Lehnert et al (1987) studied the impact of a 6-week treatment consisting of health education, blood pressure self-monitoring, relaxation training, a low-salt diet, physical exercise, and training in assertiveness.…”