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Biofeedback for Hypertension

1985; American College of Physicians; Volume: 102; Issue: 5 Linguagem: Inglês

10.7326/0003-4819-102-5-709

1539-3704

Heart Rate Variability and Autonomic Control

Position Paper1 May 1985Biofeedback for HypertensionHEALTH AND PUBLIC POLICY COMMITTEE, AMERICAN COLLEGE OF PHYSICIANSHEALTH AND PUBLIC POLICY COMMITTEE, AMERICAN COLLEGE OF PHYSICIANSAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-5-709 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptEssential hypertension is a widespread problem, affecting as much as 10% to 15% of the population (1). Approximately 70% of the hypertensive population has relatively mild hypertension (diastolic blood pressure between 90 and 105 mm Hg) (1). Biofeedback has been applied to the treatment of mild to moderate essential hypertension. As in other behavioral techniques, the objective of biofeedback has been to control blood pressure and reduce medication requirements.DescriptionSeveral different biofeedback techniques, both direct and indirect, have been used. Direct techniques involve either continuous or periodic cuff-pressure measurements or pulse-wave velocity measurements. Indirect biofeedback-assisted relaxation techniques incorporate galvanic...References1. SHAPIROSCHWARTZFERGUSONREDMONDWEISS AGDDS. Behavioral methods in the treatment of hypertension: a review of their clinical status. Ann Intern Med. 1977;86:626-36. LinkGoogle Scholar2. BENSONSHAPIROTURSKYSCHWARTZ HDBG. Decreased systolic blood pressure through operant conditioning techniques in patients with essential hypertension. Science. 1971;173:740-2. CrossrefMedlineGoogle Scholar3. SHAPIROTURSKYSCHWARTZ DBG. Control of blood pressure in man by operant conditioning. Circ Res. 1970;27(suppl 1):I-27-41. Google Scholar4. SHAPIROTURSKYSCHWARTZ DBG. Differentiation of heart rate and systolic blood pressure in man by operant conditioning. Psychosom Med. 1970;32:417-23. CrossrefMedlineGoogle Scholar5. STEPTOEJOHNSON AD. The control of blood pressure using pulse-wave velocity feedback. J Psychosom Res. 1976;20:417-24. CrossrefMedlineGoogle Scholar6. STEPTOE A. New approaches to the management of essential hypertension with psychological techniques. J Psychosom Res. 1978;22:339-54. CrossrefMedlineGoogle Scholar7. WILLIAMSONBLANCHARD DE. Heart rate and blood pressure biofeedback: I. A review of the recent experimental literature. Biofeedback Self Regul. 1979;4:1-34. CrossrefMedlineGoogle Scholar8. PATEL C. Yoga and bio-feedback in the management of hypertension. Lancet. 1973;2:1053-5. CrossrefMedlineGoogle Scholar9. PATEL C. 12-month follow-up of yoga and bio-feedback in the management of hypertension. Lancet. 1975;1:62-4. CrossrefMedlineGoogle Scholar10. PATELNORTH CW. Randomised controlled trial of yoga and biofeedback in management of hypertension. Lancet. 1975;2:93-5. CrossrefMedlineGoogle Scholar11. PATELMARMOTTERRY CMD. Controlled trial of biofeedback-aided behavioral methods in reducing mild hypertension. Br Med J [Clin Res]. 1981;282:2005-8. CrossrefMedlineGoogle Scholar12. MCGRADYYONKERTANFINEWOERNER ARSTM. The effect of biofeedback-assisted relaxation training on blood pressure and selected biochemical parameters in patients with essential hypertension. Biofeedback Self Regul. 1981;6:343-53. CrossrefMedlineGoogle Scholar13. DATEY K. Role of biofeedback training in hypertension and stress. J Postgrad Med. 1980;26:68-73. MedlineGoogle Scholar14. HAFNER R. Psychological treatment of essential hypertension: a controlled comparison of meditation and meditation plus biofeedback. Biofeedback Self Regul. 1982;7:305-16. CrossrefMedlineGoogle Scholar15. BLANCHARDMILLERABELHAYNESWICKER ESGMR. Evaluation of biofeedback in the treatment of borderline essential hypertension. J Appl Behav Anal. 1979;12:99-109. CrossrefMedlineGoogle Scholar16. SURWITSHAPIROGOOD RDM. Comparison of cardiovascular biofeedback, neuromuscular biofeedback, and meditation in the treatment of borderline essential hypertension. J Consult Clin Psychol. 1978;46:252-63. CrossrefMedlineGoogle Scholar17. PATELDATEY CK. Relaxation and biofeedback techniques in the management of hypertension. Angiology. 1977;27:401-5. Google Scholar18. FRANKELPATELHORWITZFRIEDEWALDGAARDER BDDWK. Treatment of hypertension with biofeedback and relaxation techniques. Psychosom Med. 1978;40:276-93. CrossrefMedlineGoogle Scholar19. MESSERLIDECARVALHOCHRISTIEFROHLICH FJBE. Systemic haemodynamic effects of biofeedback in borderline hypertension. Clin Sci. 1979;57(suppl 5):437s-9s. CrossrefMedlineGoogle Scholar20. BENSONBEARYCAROL HJM. The relaxation response. Psychiatry. 1974;37:37-46. CrossrefMedlineGoogle Scholar21. HOFFMANBENSONARNS JHP. Reduced sympathetic nervous system responsivity associated with the relaxation response. Science. 1982;215:190-2. CrossrefMedlineGoogle Scholar22. ENGELGAARDERGLASGOW RKM. Behavioral treatment of high blood pressure: I. Analyses of intra- and interdaily variations of blood pressure during a one-month, baseline period. Psychosom Med. 1981;43:255-70. CrossrefMedlineGoogle Scholar23. BENSONROSNERMARZETTAKLEMCHUK HBBH. Decreased blood-pressure in pharmacologically treated hypertensive patients who regularly elicited the relaxation response. Lancet. 1974;1:289-91. CrossrefMedlineGoogle Scholar24. STEPTOE A. Psychological methods in treatment of hypertension: a review [Editorial]. Br Heart J. 1977;39:587-93. CrossrefMedlineGoogle Scholar25. TARLER-BENLOLO L. The role of relaxation in biofeedback training: a critical review of the literature. Psycholog. Bull. 1978;85:727-55. CrossrefMedlineGoogle Scholar26. BRADYLUBORSKYKRON JLR. Blood pressure reduction in patients with essential hypertension through metronome-conditioned relaxation: a preliminary report. Behav Ther. 1974;5:203-9. CrossrefGoogle Scholar27. LUBORSKYCRITS-CHRISTOPHBRADYKRONWEISSENGELMAN LPJRTK. Antihypertensive effects of behavioral treatments and medications compared [Letter]. N Engl J Med. 1980;303:586. CrossrefMedlineGoogle Scholar28. LUBORSKYCRITS-CHRISTOPHBRADY LPJ. Behavioral versus pharmacological treatments for essential hypertension—a needed comparison. Psychosom Med. 1982;44:203-13. CrossrefMedlineGoogle Scholar29. GOLDRINGCHASSISSCHREINERSMITH WHGH. Reassurance in the management of benign hypertensive disease. Circulation. 1956;14:260-4. CrossrefMedlineGoogle Scholar30. KRISTTENGEL DB. Learned control of blood pressure in patients with high blood pressure. Circulation. 1975;51:370-8. CrossrefMedlineGoogle Scholar31. GOLDMANKLEINMANSNOWBIDUSKOROL HKMDB. Relationship between essential hypertension and cognitive functioning: effects of biofeedback. Psychophysiology. 1975;12:569-73. CrossrefMedlineGoogle Scholar32. KLEINMANGOLDMANSNOWKOROL KHMB. Relationship between essential hypertension and cognitive functioning: II. Effects of biofeedback training generalize to non-laboratory environment. Psychophysiology. 1977;14:192-7. CrossrefMedlineGoogle Scholar33. ELDEREUSTIS SN. Instrumental blood pressure conditioning in out-patient hypertensive. Behav Res Ther. 1975;13:185-8. CrossrefMedlineGoogle Scholar34. BLANCHARDYOUNGHAYNESKALLMAN ELMM. A simple feedback system for self-control of blood pressure. Percept Mot Skills. 1974;39:891-8. CrossrefMedlineGoogle Scholar35. SHOEMAKERTASTO JD. The effects of muscle relaxation on blood pressure of essential hypertensives. Behav Res Ther. 1975;13:29-43. CrossrefMedlineGoogle Scholar36. GLASGOWGAARDERENGEL MKB. Behavioral treatment of high blood pressure: II. Acute and sustained effects of relaxation and systolic blood pressure biofeedback. Psychosom Med. 1982;44:155-70. CrossrefMedlineGoogle Scholar37. ELDERRUIZDEABLER SZH. Instrumental conditioning of diastolic blood pressure in essential hypertensive patients. J Appl Behav Anal. 1973;6:377-82. CrossrefMedlineGoogle Scholar38. SCHWARTZSHAPIRO GD. Biofeedback and essential hypertension: current findings and theoretical concerns. Semin Psychiatr. 1973;5:493-503. MedlineGoogle Scholar39. STONEDELEO RJ. Pschotherapeutic control of hypertension. N Engl J Med. 1976;294:80-4. CrossrefMedlineGoogle Scholar40. TAYLORFARQUHARNELSONAGRAS CJES. Relaxation therapy and high blood pressure. Arch Gen Psychiatry. 1977;34:339-42. CrossrefMedlineGoogle Scholar41. BALI L. Long-term effect of relaxation on blood pressure and anxiety levels of essential hypertensive males: a controlled study. Psychosom Med. 1979;41:637-46. CrossrefMedlineGoogle Scholar42. SOUTHAMAGRASTAYLORKRAEMER MWCH. Relaxation training: blood pressure lowering during the working day. Arch Gen Psychiatry. 1982;39:715-7. CrossrefMedlineGoogle Scholar43. ROBERTSFORESTER BW. Group relaxation acute and chronic effects on essential hypertension. Cardiovasc Med. 1979;4:575-80. Google Scholar44. SEERRAEBURN PJ. Meditation training and essential hypertension: a methodological study. J Behav Med. 1980;3:59-71. CrossrefMedlineGoogle Scholar45. BLACKWELLBLOOMFIELDGARTSIDE BSP. Transcendental meditation in hypertension: individual response patterns. Lancet. 1976;1:223-6. CrossrefMedlineGoogle Scholar46. POLLACKCASEWEBERLARAGH ADMJ. Limitations of transcendental meditation in the treatment of essential hypertension. Lancet. 1977;1:71-3. CrossrefMedlineGoogle Scholar47. BENSONROSNERMARZETTAKLEMCHUK HBBH. Decreased blood pressure in borderline hypertensive subjects who practiced meditation. J Chronic Dis. 1974;27:163-9. CrossrefMedlineGoogle Scholar48. . Five-year findings of the hypertension detection and follow-up program: I. Reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA. 1979;242:2562-71. CrossrefMedlineGoogle Scholar49. . Five-year findings of the hypertension detection and follow-up program: II. Mortality by race-sex and age. JAMA. 1979;242:2572-7. CrossrefMedlineGoogle Scholar50. JACOBKRAEMERAGRAS RHW. Relaxation therapy in the treatment of hypertension. Arch Gen Psychiatry. 1977;34:1417-27. CrossrefMedlineGoogle Scholar51. JOHNSTON D. Behavioural treatment in the reduction of coronary risk factors: type A behaviour and blood pressure. Br J Clin Psychol. 1982;21(pt 4):281-94. CrossrefMedlineGoogle Scholar52. HARRISONRAO DM. Biofeedback and relaxation in blacks with hypertension: a preliminary study. J Natl Med Assoc. 1979;71:1223-7. MedlineGoogle Scholar53. ELDERLONGACREWELSHMCAFEE SADR. Apparatus and procedure for training subjects to control their blood pressure. Psychophysiology. 1977;14:68-72. CrossrefMedlineGoogle Scholar54. ELDERWELSHLONGACREMCAFEE SDAR. Acquisition, discriminative stimulus control, and retention of increases/decreases in blood pressure of normotensive human subjects. J Appl Behav Anal. 1977;10:381-90. CrossrefMedlineGoogle Scholar55. ELDERLEFTWICHWILKERSON SDL. The role of systolic versus diastolic contingent feedback in blood pressure conditioning. Psycholog Rec. 1974;24:171-6. CrossrefGoogle Scholar56. SCHWARTZSHAPIROTURSKY GDB. Learned control of cardiovascular integration in man through operant conditioning. Psychosom Med. 1971;33:57-62. CrossrefMedlineGoogle Scholar57. SCHWARTZSHAPIROREDMONDFERGUSONRAGLANDWEISS GASDDS. Behavioral medicine approaches to hypertension: an integrative analysis of theory and research. J Behav Med. 1979;2:311-63. CrossrefMedlineGoogle Scholar58. BLANCHARDYOUNG EL. Self-control of cardiac functioning: a promise as yet unfulfilled. Psychol Bull. 1973;79:145-63. CrossrefMedlineGoogle Scholar59. BLANCHARDYOUNGHAYNES ELM. A simple system for the treatment of elevated blood pressure. Behav Ther. 1975;6:241-5. CrossrefGoogle Scholar60. FEYLINDHOLM SE. Systolic blood pressure and heart rate changes during three sessions involving biofeedback or no feedback. Psychophysiology. 1975;12:513-9. CrossrefMedlineGoogle Scholar61. SCHWARTZ G. Voluntary control of human cardiovascular integration and differentiation through feedback and reward. Science. 1972;175:90-3. CrossrefMedlineGoogle Scholar62. SHAPIROTURSKYGERSHONSTERN DBEM. Effects of feedback and reinforcement on the control of human systolic blood pressure. Science. 1969;163:588-90. CrossrefMedlineGoogle Scholar63. BRENERKLEINMAN JR. Learned control of decreases in systolic blood pressure. Nature. 1970;226:1063-4. CrossrefMedlineGoogle Scholar64. FEYLINDHOLM SE. Biofeedback and progressive relaxation: effects on systolic and diastolic blood pressure and heart rate. Psychophysiology. 1978;15:239-47. CrossrefMedlineGoogle Scholar65. SHAPIROSCHWARTZTURSKY DGB. Control of diastolic blood pressure in man by feedback and reinforcement. Psychophysiology. 1972;9:296-304. CrossrefMedlineGoogle Scholar66. SCHWARTZ G. Toward a theory of voluntary control of response patterns in the cardiovascular system. In: OBRIST PA, BLACH AH, BRENER J, et al., (eds). Cardiovascular Psychophysiology. Chicago: Adline; 1974:406-41. Google Scholar67. FROSTHOLMES RD. Effects of instructions and biofeedback for increasing and decreasing systolic blood pressure. J Psychosom Res. 1980;24:21-7. CrossrefMedlineGoogle Scholar68. SHANNONGOLDMANLEE BMR. Biofeedback training of blood pressure: a comparison of three biofeedback techniques. Psychophysiology. 1978;15:53-9. CrossrefMedlineGoogle Scholar69. MILLERDWORKIN NB. Critical issues in therapeutic applications of biofeedback. In: SCHWARTZ GE, BEATTY J, eds. Biofeedback: Theory and Research. New York: Academic Press; 1977. Google Scholar70. LAUGHLIN K. Enhancing the effectiveness of behavioral treatments of essential hypertension. Physiol Behav. 1981;26:907-13. CrossrefMedlineGoogle Scholar71. ANDREWSMACMAHONAUSTINBRYNE GSAD. Hypertension: comparison of drug and non-drug treatments. Br Med J [Clin Res]. 1982;284:1523-6. CrossrefMedlineGoogle Scholar72. GOLDSTEINSHAPIROTHANONOPAVARNSAMBNI IDCM. Comparison of drug and behavioral treatments of essential hypertension. Health Psychol. 1982;1:7-24. CrossrefGoogle Scholar73. SEER P. Psychological control of essential hypertension: review of the literature and methodological critique. Psychol Bull. 1979;86:1015-43. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, Pennsylvania*This paper was authored by Peter M. Marzuk, M.D., and was developed for the Health and Public Policy Committee by the Clinical Efficacy Assessment Subcommittee: Donald E. Olson, M.D., Chairman; David Banta, M.D.; Howard S. Frazier, M.D.; Richard B. Hornick, M.D.; Seymour Perry, M.D.; and Willis C. Maddrey, M.D. Members of the Health and Public Policy Committee for the 1984-85 term include Edwin P. Maynard III, M.D., Chairman; John H. Eisenberg, M.D.; Richard G. Farmer, M.D.; Daniel D. Federman, M.D.; John R. Hogness, M.D.; Leo E. Hollister, M.D.; Charles E. Lewis, M.D.; Donald E. Olson, M.D.; Malcolm L. Peterson, M.D.; Theodore B. Schwartz, M.D.; and Helen L. Smits, M.D. This paper was adopted by the Executive Committee of the Board of Regents on 28 January 1985. 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