治疗高血压的认知行为疗法:系统性审查和元分析
Marthina S Walker1, Natália R Figueiredo1, Wagner de Lara Machado1
1Post-Graduation Program in Psychology, Pontifical Catholic University of Rio Grande do Sulepartment, Porto Alegre, Brasil.
Psychology, health & medicine
|November 22, 2023
概括
认知行为疗法 (CBT) 可以降低高血压的成年人的血压 (BP) 和体重指数 (BMI). 然而,证据质量非常低,这限制了对高血压管理这些发现的信心.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 基于证据的医学 基于证据的医学
背景情况:
- 高血压是一个普遍存在的全球健康问题,需要有效的管理策略.
- 认知行为疗法 (CBT) 是一种心理治疗方法,具有超出心理健康范围的潜在应用.
- CBT在管理诸如高血压之类的生理疾病中的有效性需要严格的评估.
研究的目的:
- 系统地审查和元分析认知行为疗法 (CBT) 对高血压患者血压 (BP) 的影响.
- 评估CBT对缩血压 (SBP) 和腹缩血压 (DBP) 的影响.
- 评估二次结果,如身体质量指数 (BMI).
主要方法:
- 一个系统的审查和元分析,遵循PRISMA指南.
- 在PubMed,EMBASE和Web of Science数据库中使用与CBT和高血压相关的关键词进行的搜索.
- 使用Cochrane的RoB 2工具评估偏差风险;用GRADE评估证据质量;用于数据聚合的随机效应模型.
主要成果:
- 11项涉及2897名患者的研究被纳入了BP结果的元分析.
- 通过CBT干预,SBP (-0.65 mmHg) 和DBP (-0.78 mmHg) 的降低显著,尽管很小.
- 在研究中观察到高异质性 (SBP的I2 85%,DBP的I2 92%) 和高偏差风险.
结论:
- 在高血压成年人中,CBT显示出降低高血压和BMI的潜在效果.
- 显著的异质性,高偏差风险和非常低质量的证据需要谨慎解释这些结果.
- 需要进一步的高质量研究来证实CBT在高血压管理中的有效性.
相关概念视频
01:18Hypertension and Regulation of Blood Pressure
2.1K
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
2.1K
01:25Cognitive Therapy
153
Cognitive therapy, pioneered by Aaron T. Beck in the 1960s, is a structured approach to addressing psychological distress by focusing on the influence of thoughts on emotions and behaviors. All cognitive therapies involve the basic assumption that human beings have control over their feelings, and that how individuals feel about something depends on how they think about it. Unlike psychoanalytic methods that delve into unconscious processes or humanistic approaches emphasizing...
153
01:22Behavior Therapy
54
Behavior therapy incorporates diverse techniques rooted in classical conditioning principles to address maladaptive behaviors and anxiety disorders. These methods aim to reduce avoidance behaviors, foster adaptive coping mechanisms, and alter associations between stimuli and responses, making them effective in a wide range of therapeutic contexts.
Exposure therapy is a cornerstone of behavioral treatment for anxiety disorders. It involves systematic exposure to feared stimuli, either in real...
Exposure therapy is a cornerstone of behavioral treatment for anxiety disorders. It involves systematic exposure to feared stimuli, either in real...
54
01:24Rational Emotive Behavior Therapy
54
Cognitive-behavioral therapies (CBTs) are grounded in the belief that our thoughts profoundly influence our emotions and actions. Advocates of CBT emphasize three core assumptions: first, that cognitions are identifiable and measurable; second, that they are central to psychological functioning; and third, that irrational or maladaptive beliefs can be replaced with rational and adaptive ones. This transformative approach to therapy has paved the way for specific models such as Albert...
54
01:18Neural Regulation of Blood Pressure
2.9K
The neural regulation of blood pressure involves intricate interactions between the autonomic nervous system (ANS) and cardiovascular system, ensuring adequate perfusion of tissues. This regulation primarily occurs through baroreceptor and chemoreceptor reflexes, involving both short-term and long-term mechanisms.
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...
2.9K
01:18Disorders of the Autonomic Nervous System
658
The autonomic nervous system (ANS) is an intricate network of nerves that controls functions such as the regulation of heart rate, digestion, and blood pressure regulation. When this system malfunctions, it can lead to various disorders that affect multiple bodily functions. One common feature of many autonomic disorders is the involvement of smooth blood vessels, which play a crucial role in regulating blood flow throughout the body.
Raynaud's disease, also known as Raynaud's...
Raynaud's disease, also known as Raynaud's...
658