Saturday, July 12, 2003

This presentation is part of : Home Care

Biofeedback-Assisted Relaxation Training to Reduce Blood Pressure: Do Effects Generalize outside the Clinic?

Carolyn B. Yucha, RN, PhD, Professor, College of Nursing, University of Florida, Gainesville, FL, USA, Pei-Shan Tsai, PhD, Assistant Professor, College of Nursing, Taipei Medical University, Taipei, Taiwan, Kristine S. Calderon, PhD, CHES, BCIAC, Assistant Professor, Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA, and Lili Tian, PhD, Assistant Professor, Statistics, University of Florida, Gainesville, FL, USA.
Learning Objective #1: Describe the use of biofeedback-assisted relaxation training to lower blood pressure in those with hypertension
Learning Objective #2: Compare the effects of biofeedback-assisted relaxation training on clinic blood pressure and ambulatory blood pressure

Funded by NIH-NCCAM (PI: Carolyn Yucha, R01 AT00310)

Purpose: Approximately 50% of hypertensives can learn to lower their blood pressure (BP), as measured in the clinic, using biofeedback training. Such reports do not demonstrate whether the treatment effects generalize outside the clinic. The purpose of this study was to examine the relationship between those who lowered their clinic BP and those who lowered their ambulatory blood pressure (ABP) after biofeedback-assisted relaxation training.

Methods: Fifty-four adults (17 male and 37 female; 36 white, 15 black, and 3 other races) with hypertension were studied. Biofeedback-assisted relaxation training was provided using thermal, electromyography (EMG), and respiratory sinus arrhythmia (RSA) biofeedback using Procomp+ / Multitrace biofeedback system (STENS Corp, Oakland, CA), coupled with deep breathing, autogenics, and progressive muscle relaxation. ABP was measured over 24 hours using an ambulatory BP monitor (Spacelabs Medical, Inc, Redmond, WA). Clinic BP was measured using the same instrument in the manual mode. Improvement was defined as being able to decrease BP 5 mm Hg or more.

Results: For the entire sample (n=54), 50%, 44%, and 39% reduced their clinic SBP, DBP and MAP, respectively; 33%, 29% and 27% reduced their daytime ambulatory SBP, DBP and MAP respectively. For unmedicated subjects (n=12), 67%, 50%, and 42% reduced their clinic SBP, DBP and MAP, respectively; 50%, 33% and 33% reduced their daytime ambulatory SBP, DBP and MAP, respectively. Forty-four percent of those who lowered their clinic SBP, also lowered their ambulatory SBP; 45% of those who lowered their clinic DBP, also lowered their ambulatory DBP; 42% of those who lowered their clinic MAP, also lowered their ambulatory MAP.

Discussion: Approximately 50% of hypertensives lowered their clinic BP using biofeedback-assisted relaxation training. This BP lowering effect generalized to an ambulatory setting for less than half of the participants.

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Sigma Theta Tau International
10-12 July 2003