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Individualized stress management for primary hypertension: a randomized trial
1Psychology/UBC 2136 West Mall, Vancouver, British Columbia, Canada V6T 1Z4. wlinden@cortex.psych.ubc.ca
Archives of Internal Medicine
|April 27, 2001
Summary
Individualized stress management effectively lowers blood pressure (BP) in hypertensive patients. Reductions in psychological stress and improved anger coping mediate these significant BP changes.
Area of Science:
- Cardiology
- Psychology
- Health Sciences
Background:
- Primary hypertension is a significant global health concern.
- Ambulatory blood pressure (BP) monitoring provides accurate hypertension assessment.
- Individualized stress management interventions show promise for BP reduction.
Purpose of the Study:
- To evaluate the efficacy of individualized stress management for primary hypertension.
- To utilize randomized clinical trial methodology with ambulatory BP measures.
Main Methods:
- Adults (28-75 years) with elevated ambulatory BP (>140/90 mm Hg) received 10 hours of individualized stress management.
- Participants were randomized into immediate treatment (n=27) or a wait-list control group (n=33).
- Outcomes included 24-hour ambulatory BP, lipids, weight, and psychological measures at 6-month follow-up.
Main Results:
- Immediate treatment group showed significant systolic and diastolic BP reductions (-6.1/-4.3 mm Hg).
- Wait-list group also experienced significant BP reduction upon receiving treatment (-7.8/-5.2 mm Hg).
- BP reduction correlated with baseline BP, reduced psychological stress, and improved anger coping.
Conclusions:
- Individualized stress management is an effective intervention for reducing ambulatory BP in primary hypertension.
- The positive effects on BP are sustained and potentially enhanced with follow-up.
- Psychological stress reduction and improved anger coping mechanisms appear to be key mediators of BP changes.