The effects of muscle relaxation on blood pressure of essential hypertensives

Muscle relaxation and noncontinuous biofeedback were investigated as potential nonpharmaceutical treatments for essential hypertension. The two procedures were compared to a waiting list control group. Predictions were made regarding the overall treatment effect, sessions within treatment effect, and periods within session effect. The results of this experiment reveal that biofeedback significantly lowers diastolic blood pressure between premeasures and postmeasures. It was also shown that muscle relaxation has a significant effect upon lowering diastolic and systolic blood pressures between premeasures and postmeasures and has a significant effect upon lowering diastolic and systolic blood pressures as subjects progress from the first period of a treatment session to the last period of a treatment session.     

A controlled comparison of thermal biofeedback and relaxation training in the treatment of essential hypertension: II. Effects on cardiovascular reactivity

In the course of conducting a controlled comparison of progressive muscle relaxation and thermal biofeedback as possible substitutes for second-stage (sympatholytic) antihypertensive medications, we measured reactivity (heart rate, systolic blood pressure, and diastolic blood pressure) to three different stressors (mental arithmetic, cold pressor, and negative mental imagery) before and after treatment and drug withdrawal. Neither treatment was consistently effective in reducing reactivity across a variety of stressors. Relaxation led to more reductions in some aspect of reactivity than did biofeedback. The modest level of reductions in reactivity were seen more for mental arithmetic and systolic blood pressure.     

Effect of Relaxation Therapy in Reducing Blood Pressure of Essential Hypertension Patients

The study investigated the effect of relaxation therapy on arterial blood pressure of Patients with essential hypertension. Ten known essential hypertension patients (males = 3; females = 7, age range 41–70, mean age 57.2 years, SD = 9.93 years) were sampled randomly from Medical outpatient department of the State owned University teaching Hospital in Ebonyi State South East, Nigeria. These Participants were exposed to 30 minutes relaxation therapy and their blood pressures were taken before and after the treatment. Using matched t test to compare baseline and post treatment scores, result showed that relaxation therapy progressively decreased both diastolic and systolic blood pressure readings of the Participants. The study concluded that Relaxation therapy can transiently lower the systolic and diastolic blood pressure.     

Two controlled evaluations of multicomponent psychological treatment of irritable bowel syndrome.

We report two controlled comparisons of a previously validated multicomponent (relaxation, thermal biofeedback, and cognitive therapy) treatment for irritable bowel syndrome (IBS) to an ostensible attention-placebo control (pseudo-meditation and EEG alpha suppression biofeedback) and to a symptom-monitoring control. In Study 1 (n = 10 per condition) there were nonsignificant trends for the multicomponent treatment to be superior to the attention-placebo condition. In Study 2 (n = 30 per condition), we found no advantage for the multicomponent treatment over the attention-placebo condition. Subjects in both treatment conditions showed significant reductions in GI symptoms, as measured by daily symptom diaries, and significant reductions in trait anxiety and depression. The GI symptom reductions held up over a 6 month follow-up. Possible explanations for the results are explored.     

Blood pressure responses to hypnotic and nonhypnotic suggestions in normotensive subjects

Forty normotensive subjects participated on a voluntary basis in a study designed to compare the effect of suggestions on blood pressure (BP). Two experimental groups received suggestions presumed to be specific in lowering or raising BP after simple relaxation (relaxation group) or hypnotic induction (hypnotic group). A control group was used to record the BP changes over time. The time variable was significant for both systolic (SBP) and diastolic blood pressure (DBP). Induction procedures (hypnosis or relaxation) resulted in significant decreases in DBP in both experimental groups. In the control group there was a significant decrease in SBP. A specific suggestion to increase the BP resulted only in DBP increase in the hypnotic group. This group also gave an increase of both SBP and DBP over the entire experiment, whereas the relaxation group resulted in a significant decrease in SBP. There was no significant group variable, indicating no differences between the groups. Further research is needed to enable firm conclusions of the effect of suggestions on BP.     

Associations of depression status and hopelessness with blood pressure: a 24-year follow-up study

Hypertension is estimated to cause 12.8% of all deaths worldwide. Both literature and well-supported cognitive models indicate that hopelessness predicts depressive symptoms. This study aimed to test whether high levels of hopelessness are associated with increased blood pressure, as well as whether depression acts as a mediator between hopelessness and blood pressure. Data from the original 24-year longitudinal Baltimore Epidemiologic Catchment Area Study (ECA) were analyzed via linear regression (N = 917; 60.3% female; 62.9% European American; mean age = 42.96 years, SD = 16.94). Hopelessness was found to have a significant direct relationship with systolic blood pressure (SBP, p < .05), but not with diastolic blood pressure (DBP, p > .05); while depression had no significant direct relationship with SBP or with DBP. Overall, findings indicated that hopelessness has a significant relationship with SBP. Limitations and implications are discussed.     

Hypertension reduction through forgiveness training

The objective of this study was to determine if patients with diagnosed stage-1 hypertension could benefit by a forgiveness training program to achieve measurable reductions in anger expression and blood pressure. Twenty-five participants were randomly divided into wait-listed control and intervention groups. The control group monitored blood pressure while the intervention group participated in an 8-week forgiveness training program. At the end of eight weeks, the wait listed group became an intervention group. Those who received forgiveness training achieved significant reductions in anger expression when compared to the control group. While reductions in blood pressure were not achieved by all the participants, those participants who entered the program with elevated anger expression scores did achieve significant reductions in blood pressure. It is suggested that forgiveness training may be an effective clinical intervention for some hypertensive patients with elevated levels of anger.     

The effect of brief restricted environmental stimulation therapy in the treatment of essential hypertension

This pilot project investigated the effects of controlled frequent brief REST relaxation sessions on the blood pressure of three subjects with borderline essential hypertension. A flotation REST system was used, and subjects had 2 or 3 sessions weekly for 2 months. All three subjects had blood-pressure reductions of a clinically significant magnitude across the treatment and follow-up periods.     

Temperature self-regulation and relaxation with migraine patients and normals

Ten migraine headache subjects and 10 non-migraine subjects were divided equally into two groups: a progressive relaxation group and a finger temperature biofeedback group. Finger temperature, temporal artery pulse amplitude and forehead blood flow were monitored for all subjects during two baseline and six treatment sessions.

The biofeedback group achieved greater (albeit low magnitude) increases in finger temperature than the relaxation group, but no improvement in headache activity was obtained. However the relaxation group improved significantly in terms of headache intensity.

There was no significant difference in the ability to achieve finger temperature control, nor in stability point temperatures, between the migraine and non-migraine subjects.

No systematic relationship was found between finger temperature, forehead blood volume and temporal artery pulse amplitude. Possible mechanisms of the therapeutic effects of finger temperature training are examined in the light of these results.     

An examination of methods for producing relaxation during short-term laboratory sessions

Reductions in psychological and physiological correlates of tension produced by various muscle relaxation training techniques were examined during a short-term laboratory session. Two studies are described involving a combined total of one hundred subjects receiving either abbreviated progressive relaxation, visual, auditory, or tactile electromyographic (EMG) biofeedback procedures. The Anxiety Differential was administered before and after the laboratory session. Heart rate, respiratory rate, skin conductance, systolic blood pressure, and frontalis and dominant forearm extensor EMG measures were obtained before, during, and after administration of relaxation training. Results indicated feedback in the tactile modality to produce overall reductions in tension comparable to those produced by progressive relaxation. Overall reductions in tension displayed by both progressive relaxation and tactile feedback were generally greater than reductions shown by visual or auditory feedback procedures. Interpretations suggest that certain forms of EMG feedback may offer an alternative to progressive relaxation techniques for producing short-term reductions in tension. Feedback modality is further indicated as a potentially important variable during relaxation training using the EMG feedback technique.     

A behavioral medicine intervention as an adjunctive treatment for HIV-related illness

Abstract

This investigation assessed the efficacy of a behavioral medicine intervention in the adjunctive treatment of symptomatic HIV seropositive men. Twenty-six, well coping, seropositive gay males were randomly assigned to either a treatment group or a waiting list control group. The treatment group received eight weeks of training in thermal biofeedback, guided imagery and hypnosis Significant results (p < 0.05) indicated that HIV-related symptoms (fever, fatigue, pain, headache, nausea and insomnia) decreased and that vigor and hardiness increased. No significant changes were found in absolute numbers of CD4 cells, tension-anxiety or depression.     

Self-control progressive relaxation training as an alternative nonpharmacological treatment for essential hypertension: therapeutic effects in the natural environment.

Two clients with 3 and 5$\text{1}\text{2}$ yr history of essential hypertension were successfully treated using self-control progressive relaxation training (PRT). Blood pressure was self-recorded twice daily in the natural environment by each client. The natural environment blood pressures of both clients declined during treatment and stabilized within the normotensive range. Blood pressure reductions were maintained at six months follow-up for one client and two months for the other.     

The psychophsiology of aggressive drivers: comparison to non-aggressive drivers and pre- to post-treatment change following a cognitive-behavioural treatment

Twenty drivers were remanded to our treatment program by the courts following arrests related to serious aggressive driving behaviors. Ten additional drivers entered our program in response to our advertisements thus identifying themselves as aggressive drivers. Psychophysiological assessments were conducted on all 30 drivers and heart rate (HR), systolic and diastolic blood pressure (SBP and DBP), and skin resistance level (SRL) were measured in response to exposure to a mental arithmetic neutral stressor, two idiosyncratic, audio-taped, aggressive driving vignettes (audio 1 and audio 2), and one non-driving related fearful vignette. Fourteen non-aggressive driving controls also completed the assessment. The results indicated that the aggressive drivers (ADs) showed significantly more SBP responsivity during audio 1 and audio 2 and significantly less SBP reactivity during the mental arithmetic stressor than the controls. The aggressive drivers then completed a four-week, group intervention which included relaxation techniques specifically targeting aggressive driving behaviors. The same psychophysiological assessment was conducted at post-treatment. The results showed significant pre- to post-treatment decreases in HR, p<0.003, SBP, p<0.01, and DBP, p<0.02 during audio 1. Similarly, decreases were evident in audio 2 in SBP, p<0.03 only. No decreases in reactivity occurred during the neutral stressor or fearful situation.     

Evaluation of a psychological treatment for inflammatory bowel disease

Inflammatory bowel disease (IBD) encompasses two related gastrointestinal-tract diseases, ulcerative colitis (UC) and Crohn's Disease (CD). This study, a randomized controlled trial, compared the effectiveness of a multi-component behavioral treatment package (n = 11), which included IBD education, progressive muscle relaxation, thermal biofeedback, and training in use of cognitive coping strategies, to the effectiveness of symptom-monitoring (n = 10) as a control condition; 8 controls subsequently completed treatment. At posttreatment, the treatment group showed mean reductions on 5 symptoms, while the symptom monitoring controls showed mean reductions on all 8 symptoms. On a measure of Total Symptomatic change, the controls showed more improvement than the treated group; the treated controls at posttreatment, showed increases on all 8 symptoms. However, treated subjects perceived themselves as coping better with IBD, as feeling less IBD-related stress, and as experiencing less depression and anxiety. It is hypothesized that inherent differences may have existed between CD and UC subjects which could have led to the differences seen in treatment responses.     

Hemodynamic responses to active and passive coping tasks and the prediction of future blood pressure in Thai participants: A preliminary prospective cohort study

Cardiovascular responses to mental stress tests have been related to future blood pressure (BP) levels. However, most studies have been completed in North America and Europe; only one study has been conducted in Asia. Therefore, the study explored whether cardiovascular responses to mental stress predict future resting BP in Thailand. Hemodynamic measures were obtained from 101 healthy adults before, during and after mental arithmetic, a speech task, and a cold pressor task. A follow‐up assessment of resting BP was undertaken 1 year later. Results showed that Thais responded to standardized mental stress tasks with large and significant cardiovascular reactivity. Regression analyses indicated that, after adjustment for baseline BP and traditional risk factors, heightened systolic blood pressure (SBP) responses to mental arithmetic were associated with increased future SBP (ΔR² = .045). These findings suggest that BP reactivity predicts future BP and may play a role in the development of hypertension. In addition, Thais displayed large cardiovascular responses to standardized mental stress tasks, of a similar magnitude to previous studies of North Americans and Europeans.     

Effects of guided imagery with relaxation training on anxiety and quality of life among patients with inflammatory bowel disease

Background: Inflammatory Bowel Disease (IBD) impacts quality of life (QoL). Psychological factors influence the course of the disease and should be targeted for intervention.

Methods: Our study was a prospective, randomised control trial. Fifty-six outpatients were randomly chosen and allocated to a treatment group or a waiting-list control group. Treatment group patients attended three relaxation-training sessions and received an audio disc for home practice. Evaluations performed pre and post-treatment: state anxiety was assessed with the State-Trait Anxiety Inventory, QoL with the IBD Questionnaire. The Visual Analogue Scale assessed pain, depression, stress and mood. Patients completed a symptom monitoring diary. The control group's symptoms were monitored without study-related treatment.

Results: Thirty-nine subjects completed the study and were included in the data analysis. Following the relaxation-training intervention, the treatment group's (n?=?18) measured results showed a statistically significant improvement as compared to the control group (n?=?21) (time by treatment interaction): anxiety levels decreased (p?<?0.01), QoL and mood improved (p?<?0.05), while levels of pain and stress decreased (p?<?0.01).

Conclusions: Findings indicate IBD patients may benefit from relaxation training in their holistic care. New studies as well as further investigation of the subject are warranted.     

Motor and cognitive relaxation in the desensitization of anger

Three procedures were assessed to determine their effectiveness in reducing anger. The procedures were: desensitization, desensitization with cognitive relaxation, and desensitization with the absence of relaxation training. Anger was aroused by exposing white males, selected for their reports of anger toward blacks, to black racial stimuli. The desensitization group reported reductions in anxiety and disgust relative to a no-treatment control group. Therapist ratings indicated reductions in anger for Ss in both the desensitization and desensitization with cognitive relaxation groups. In addition the latter group reported reductions in anger concurrently with increases in diastolic and systolic blood pressure. Post-hoc analyses indicated that Ss for whom desensitization was most effective reported less anger after the pretreatment anger arousal procedure, greater depth of relaxation during treatment, and were liked more by their therapists. These Ss also reported a greater reduction in ethnocentrism and a trend toward lower overt hostility following treatment.     

Clinical effects of biofeedback treatment in migraine: The relation to achieved self-control and pretreatment predictors

Abstract

Factors contributing to the headache reduction six months after treatment of sixty-three migraine subjects were examined in three different studies. Subjects had originally been treated with either peripheral skin temperature biofeedback, biofeedback for blood-volume-pulse amplitude of the temporal artery, or applied relaxation. In Study 1 it was found that biofeedback subjects who had achieved self-control of the trained physiological parameter had significantly greater headache reductions than “nonlearners”. In Studies 2 and 3, potential predicting factors of clinical effects were studied. Age and whether subjects had achieved self-control emerged as (weak) predictors in different analyses using discriminant analysis. Using “PLS” (partial least squares projections to latent structures) a model emerged which gave a more complex picture, and which might indicate for example that there are different sets of factors which predict success and predict nonsuccess in treatment.     

The effects of short term flotation REST on relaxation: a controlled study

The purpose of this study was to compare the effects of restricted environmental stimulation using a flotation tank (Flotation REST) to the effects of a normal sensory environment on relaxation. All of the subjects were first introduced to a simple relaxation program to be used during the experimental sessions. The program consisted of guided point-to-point relaxation, breathing techniques, and visual imagery techniques. Subjects were then pre-tested on measurements of electromyogram (EMG), galvanic skin response (GSR), peripheral skin temperature, and systolic and diastolic blood pressure. The experimental group experienced ten 45-minute sessions practicing the relaxation program in a Flotation REST environment. The control subjects practiced the same relaxation program in a similar body position for 45 minutes in a normal sensory environment. All subjects answered a five-question Subjective Relaxation Questionnaire on trials five through ten and were then post-tested on EMG, GSR, skin temperature, and blood pressure. The results indicated significant differences between groups from pre-test to post-test on systolic and diastolic blood pressure; the experimental group showed greater reductions. Significant differences also were observed on three of five questions on the Subjective Relaxation Questionnaire; the experimental group reported greater subjective relaxation and trends in a similar direction on the remaining two questions. The results of this study indicate that flotation REST enhances point-to-point relaxation, breathing techniques, and visual imagery techniques and, when combined with these techniques, can be an effective means of teaching normal subjects to lower systolic and diastolic pressure and heighten their subjective perception of relaxation.     

Patterns of cardiovascular responses to stress as a function of race and parental hypertension in men

This study investigated cardiovascular responses to two stressors known to elicit either beta-adrenergic (mental arithmetic) or alpha-adrenergic (forehead cold pressor) reactivity in Black and White men. Participants in each group were selected for presence or absence of parental hypertension. Based on previous research, Blacks were expected to show smaller cardiovascular responses to the beta-adrenergic mental arithmetic task and greater responses to the alpha-adrenergic cold pressor relative to the Whites. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, forearm blood flow, and forearm vascular resistance were assessed during a resting baseline, a prestress period, and during and after each experimental procedure. Unlike previous findings, no significant racial differences in cardiovascular responses were found during either task. However, Black participants had significantly higher SBP and DBP levels throughout the cold pressor periods. Parental history did not significantly influence cardiovascular responses in either group. The results are discussed in relation to previous research on racial differences in stress reactivity and their implications for future research.