Nonpharmacologic treatment of hypertension: a multiple-risk-factor approach

Cardiac and Mental Benefits of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diet plus Forest Bathing (FB) versus MIND Diet among Older Chinese Adults: A Randomized Controlled Pilot Study

(1) Background: The Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet and forest bathing (FB) are first-line therapies for controlling hypertension. This study aimed to investigate the combined effects of a MIND diet and FB and MIND diet alone among older Chinese patients with hypertension. (2) Methods: Seventy-two participants aged >50 with stages 1 or 2 hypertension were randomly assigned to the MIND group (n = 23), MIND-FB group (n = 25), or control group (n = 24). Systolic blood pressure (SBP) (primary outcome), point-of-care tests for blood lipid panel and glucose (Glu), anxiety levels, mood states, body mass index (BMI), waist-to-hip ratio (WHR), and body fat percentage (BFP) were measured. (3) Results: After a four-week intervention, the change in SBP revealed no significant differences between the intervention groups, and SBP tended to decrease in the MIND and MIND-FB groups. Total cholesterol, and low-density lipoprotein (LDL-C) were significantly decreased (p < 0.01), Triglycerides (TG) and Glu levels were significantly lower (p < 0.05) in the MIND-FB and MIND groups, and the mean differences for anxiety level and negative mood states were significantly lower (p < 0.00) in MIND-FB group. (4) Conclusions: The results provide preliminary evidence that the MIND diet and FB are good for promoting cardiac and mental health well-being in the Chinese population.

Recovery from stress: an experimental examination of focused attention meditation in novices

Identifying strategies that aid in recovery from stress may benefit cardiovascular health. Ninety-nine undergraduate meditation novices were randomly assigned to meditate, listen to an audio book, or sit quietly after a standardized stressor. During recovery, meditators' heart rate variability and skin conductance levels returned to baseline, whereas only heart rate variability returned to baseline for the audio book and control groups. Positive and negative affect were no different than baseline following meditation, whereas, both audio book and control groups had lower positive affect and higher negative affect following the intervention. Findings suggest that the sympathetic nervous system is uniquely affected by meditation, and novices may benefit emotionally from meditating after a stressor. Further research is needed to determine meditation's utility in recovering from stress.

A bio-psycho-socio-molecular approach to pain and stress management

Stress and trauma are interconnected with the experience of pain. This connection is due to a physiological coupling of underlying molecular autoregulatory mechanisms, as well as phenomenological similarities. Nonpharmaceutical therapeutic approaches such as the relaxation response, a process that supports physiological stress reduction and decreases the negative mental and physical effects of stress, also facilitate pain relief, again demonstrating physiological commonalities. These behavioral approaches have a critical impact on molecular patterns of autoregulation, leading to the assumption of a bio-psycho-socio-molecular model of autoregulation, including stress and pain. Thus, molecules and behavior may be seen as two sides of the same problem in pain and stress relief.

Clinical applications of the relaxation response and mind-body interventions

Several hundred peer-reviewed studies in the past 20 years have shown that the relaxation response and mind-body interventions are clinically effective in the treatment of many health problems that are caused or made worse by stress. Recent studies show that mind-body interventions may improve prognosis in coronary heart disease and can enhance immune functioning. It is hypothesized that mind-body interventions reduce sympathetic nervous system activation and increase parasympathetic nervous system activity, and thereby restore homeostasis. Researchers have also concluded that cognitive therapy is as effective, and possibly more effective than antidepressant medication in the treatment of major depression. This report provides an overview of some studies that have shown a beneficial role of the relaxation response and cognitive restructuring in the treatment of headaches, insomnia, and cardiovascular disorders. Studies to date suggest that mind-body interventions are effective and can also provide cost savings in patient treatment. It is also clear, however, that mind-body therapies are not panaceas, and should be used in conjunction with standard medical care.

Nitric oxide inhibits norepinephrine stimulated contraction of human internal thoracic artery and rat aorta

The effect of nitric oxide (NO) on norepinephrine-induced vascular contraction was evaluated using segments of rat aorta and human internal thoracic artery (ITA) and the NO donor, SNAP. NO levels were measured directly using an amperometric probe. Concentrations of NO greater than 2 nM were required to reduce vascular contraction induced by 100 nM norepinephrine (NE). Exposure of the aortic rings to SNAP prior to, or after NE addition, resulted in a similar attenuation of NE-induced contraction. In contrast, increased relaxation of ITA segments in response to SNAP was observed relative to that of rat aorta and significant development of contractile tone following NE addition was not observed. Evaluation of cytoskeletal actin demonstrated marked loss of F-actin content in smooth muscle cells following NO exposure, suggesting that NO may have direct and indirect effects on contractile tone. These data taken together suggest that vascular responsiveness to contractile agents may be significantly attenuated by prior or subsequent exposure to NO, and mechanisms in addition to vascular relaxation are likely to contribute to this effect.

Developing realistic treatment standards in today's economic climate: stroke survivor education

Teaching people about the risk factors and early symptom identification of stroke significantly decreases the incidence of both first time and recurrent strokes. Patient teaching has traditionally been a nursing responsibility. However, in the fiscal constraints of today's health care delivery system, nurses' time for teaching is highly restricted. This pilot study was designed to evaluate the impact of a short 1(1/2) hour stroke education programme in a population of hospitalized stroke survivors prior to their discharge. The first session focused on the disease process of stroke and its warning signs. A second session addressed risk factors and behavioural strategies for exercise, stress management, or smoking cessation. Responses to the teaching programme were evaluated through patient interviews immediately following the teaching session and 3 weeks later. Responses indicated that short-session patient teaching, in and of itself, is not always successful in changing behaviour but is successful for knowledge attainment. The findings from this pilot study suggests a need to consider new teaching strategies and a need to identify opportunities for reinforcement, support and encouragement that will meet the realities of today's time constraints while still meeting our professional responsibilities for patient education.

Mind-body medicine in primary care. Implications and applications

A growing body of research in basic and clinical science confirms that psychological states and interventions affect physiologic and pathophysiologic processes and the outcome of clinical illness. This evidence is reviewed in detail, with special attention paid to those findings that have particular relevance for primary care physicians. Specific guidelines are offered for incorporating mind-body principles and techniques into primary care practice.

The mind/body program for infertility: a new behavioral treatment approach for women with infertility

There is increasing evidence that a behavioral treatment approach might be efficacious in the treatment of the emotional aspects of infertility and may lead to increased conception rates. The first 54 women to complete a behavioral treatment program based on the elicitation of the relaxation response showed statistically significant decreases in anxiety, depression, and fatigue as well as increases in vigor. In addition, 34% of these women became pregnant within 6 months of completing the program. These findings established a role for stress reduction in the long-term treatment of infertility. They further suggest that behavioral treatment should be considered for couples with infertility before or in conjunction with reproductive technologies such as intrauterine insemination and gamete intrafallopian transfer.