Behavioural treatment in the reduction of coronary risk factors: type A behaviour and blood pressure

The literature on direct behavioural interventions to reduce two coronary risk factors, Type A behaviour and essential hypertension, is reviewed. It is concluded that there is preliminary evidence that the alteration of Type A behaviour is possible and that such alteration is associated with a reduction in the risk of recurrence of myocardial infarction. It is also concluded that reductions in blood pressure can be achieved using behavioural techniques and that such reductions persist for at least 12 months. The exact components of an effective treatment package for essential hypertension are not yet fully established but it is suggested that live relaxation training and stress management techniques are an important part of effective therapy. The positive therapeutic effects obtained in the behavioural treatment of essential hypertension are unlikely to be due to either non-specific effects of therapy or to altered compliance with pharmacological treatment. Reductions in blood pressure of the order obtained in the relaxation and stress management studies could be expected to lead to significant gains in health, including reductions in cardiovascular morbidity, if they are sustained for long periods.