Nonpharmacologic Intervention for Hypertension Long-Term Foliow-Up

Authors
Jane Leserman, PhD, Eileen M Stuart, RN, MS, Mary E. Mamish, BA, John P. Desckro, RN, MS, Rita J. Beckman, RN, MS, Richard Friedman, PhD, Herbert Benson, MD
Publication
Journal of Cardiopulmonary Rehabilitation
9(8):p 316-324
Abstract

We previously reported reduced blood pressure, psychological symptoms, and other cardiac risk factors in hypertensive patients who participated in a nonpharmacologic, outpatient behavioral program. The present study is a 3 to 5 year follow-up of 59 (60%) of the same patients (who served as their own controls) to assess continued efficacy of the program. At entry into the study, patients had hypertension for a median of 6 years. Therefore, it is unlikely that placebo effect could explain our results. The intervention included training in: elicitation of the relaxation response, nutrition, exercise, and stress management. Comparing measurements taken at the program beginning (pre), end (post) and 3–5 years later (follow-up) showed: (1) reduced systolic blood pressure from pre to follow-up (148–142 mmHg, P < 0.01), with no change from post to follow-up; (2) reduced diastolic blood pressure from pre to follow-up (94–87 mmHg, P < 0.01), with no change from post to follow-up; (3) reduced anxiety, depression and total psychological symptoms on the SCL-90 from pre to follow-up (P < 0.01), with no change from post to follow-up; and (4) increased weight gain from post to follow-up (P < 0.01). Analysis of a subset of patients that could be classified as “never receiving”, “reduced”, or “no change” in medication (N = 24), showed the same reduced blood pressure results. Increased medication use did not account for the long-term efficacy of the intervention.

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