Relaxation Training May Improve Control of Systolic Hypertension

A new study claims that adding the relaxation response, a stress-management approach, to other lifestyle interventions may significantly improve treatment of systolic hypertension, commonly found in the elderly.

Researchers at the Massachusetts General Hospital (MGH, Boston, USA) and the Benson-Henry Institute for Mind-Body Medicine at MGH (Boston, MA, USA) enrolled more than 100 patients, aged 55 and older, whose systolic pressure remained elevated despite their taking two or more antihypertensive drugs. Participants were randomly assigned to two groups. The control group received weekly counseling sessions on cardiac risk factors, the impact of stress on hypertension, and recommendations on dietary and fitness goals. The treatment group attended sessions that also included instruction and practice eliciting the relaxation response. Both groups also received audiotapes to listen to daily - the control group with general lifestyle recommendations and the treatment group a guided relaxation response session. Participants' blood pressure was checked after eight weeks, and those whose pressures had dropped into the normal range - less than 140 systolic and 90 diastolic - were eligible to start reducing the dose of one of their medications. If blood pressures remained normal during subsequent weeks, dosage could be further reduced or eliminated; but participants whose hypertension returned resumed their previous dosage level. The physician conducting weekly evaluations did not know to which group participants belonged, and participants were told only that the study was evaluating different stress management programs.

The researchers found that by the end of the 20-week study period, participants in both groups had experienced a significant drop in systolic blood pressure, allowing two thirds of all participants to attempt medication reduction. Among the relaxation-response group participants, 32% maintained reduced systolic pressure after eliminating one or more medications, an accomplishment achieved by only 14% of those in the lifestyle-counseling group. The study was published in the March 2008 issue of the Journal of Alternative and Complementary Medicine.

"The other nonpharmacological interventions that we know can reduce systolic blood pressure - reducing dietary sodium, weight loss, smoking cessation, and increasing physical activity - can be very difficult for patients to achieve,” said lead author Jeffrey Dusek, Ph.D. "Our control group received an intensive amount of good-health information and reported making fairly dramatic lifestyle changes, but only the relaxation response group was able to significantly reduce their use of antihypertensive medications.”

The relaxation response is a physiologic state of deep rest--involving both physical and emotional responses to stress--that can be elicited by practices such as meditation, deep breathing, and prayer. While several studies have shown that the relaxation response can help alleviate hypertension involving elevated systolic and diastolic pressures, its usefulness in treating isolated systolic hypertension has not previously been investigated.


Related Links:
Massachusetts General Hospital
Benson-Henry Institute for Mind-Body Medicine