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

Psychological and physiological effects of relaxation and nitrous oxide training

Training in progressive muscle relaxation can improve psychophysiological response to stress but is often time-consuming and may prove ineffective for some individuals. Nitrous Oxide (N2O)may offer an effective adjunct or alternative to training. This study evaluated the relative efficacy of these procedures. Subjects were randomly assigned to one of four treatment conditions: relaxation-only, N2O only, relaxation with N2O, and room air-control. The relaxation procedure was modeled on color videotape. Nitrous oxide was administered from a balloon. In addition to various psychological measures, treatment effects were measured for skin temperature, heart rate, systolic blood pressure, and two measures of diastolic blood pressure. Subjective reports of tension were also recorded. There was a significant multivariate difference between treatment groups. The relaxation-only procedure was generally superior to the others on most dependent measures. Subjects receiving N2O appear to have experienced an improvement in mood. Paradoxically, the initially more relaxed subjects seemed to derive the greater benefit from the inhalation of N2O. The use of videotape-modeled relaxation procedures is discussed.

Psychological treatment of essential hypertension: a controlled comparison of meditation and meditation plus biofeedback

Twenty-one patients with essential hypertension were randomly allocated to eight 1-hour sessions of meditation training, meditation plus biofeedback-aided relaxation, or a no-treatment control group. Statistically significant falls in systolic and diastolic blood pressure occurred after both training programs, although overall reductions in blood pressure were not significantly greater in either program than in the control group. Meditation plus biofeedback-aided relaxation produced falls in diastolic blood pressure earlier in the training program than did meditation alone. All patients practiced mediation regularly between training sessions: The amount of practice did not correlate with the amount of blood pressure reduction after training. On questionnaire measures of psychological symptoms and personality, sex differences emerged, with females showing significant abnormalities in hostility scores and males showing significantly raised levels of somatopsychic symptoms. In females, outward-directed hostility fell significantly and assertiveness increased after training, but in males, somatopsychic symptoms were unchanged.

Setting generality of blood pressure reductions and the psychological treatment of reactive hypertension

The setting generality of treatment effects was examined for a client with 3 years' history of essential hypertension. Self-control progressive relaxation training led to durable normotensive blood pressures (BP) in the natural environment and psychology clinic, although medical setting BP remained elevated. Further assessment indicated that this latter problem was a function of conditioned anxiety to medical setting stimuli. Systematic desensitization led to reductions in medical setting BP to normotensive levels, and laboratory psychophysiological assessments confirmed the elimination of the anxiety response. The present case study raises the issue of to what extent such reactive hypertension is a problem for other individuals similarly diagnosed and demonstrates the importance of the assessment of generality of treatment effects for essential hypertension.