Adding the relaxation response, a stress-management approach, to other lifestyle interventions may significantly improve treatment of the type of hypertension most common in the elderly. Among participants in a study conducted at the Massachusetts General Hospital (MGH) Hypertension Program and the Benson-Henry Institute for Mind-Body Medicine at MGH, those who received relaxation response training in addition to advice on reducing lifestyle risk factors were more than twice as likely to successfully eliminate at least one blood pressure medication than were those receiving lifestyle counseling only. The study appears in the Journal of Alternative and Complementary Medicine.
“Nearly 80 million Americans are classified as having hypertension, and although we have many medications to lower blood pressure, only about a third of patients achieve adequate control of their pressures,” says Randall Zusman, MD, co-senior author of the report who leads the Hypertension Program at the MGH Heart Center. “If a practice that takes only 15 to 20 minutes a day can help decrease patients’ dependence on antihypertensive medications – reducing often-unpleasant side effects and the considerable costs of these drugs – we could not only improve their quality of life but lower direct and indirect health costs by billions of dollars.”
Among the elderly patients in whom it is most common, isolated systolic hypertension – an increase in only the peak arterial pressure – is more closely correlated with adverse events like heart attack, stroke or renal failure than is elevated diastolic pressure. Treating systolic hypertension is particularly challenging since older patients who take many medications are at greater risk for drug interactions and may be more vulnerable to other side effects.
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. Herbert Benson, MD, director emeritus of the Benson-Henry Institute and co-senior author of the current report, first described the relaxation response almost 35 years ago, and he and his colleagues have pioneered its use in mind/body medicine. 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 been investigated.
The present study 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.
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 relaxation response group participants, 32 percent maintained reduced systolic pressure after eliminating one or more medications, an accomplishment achieved by only 14 percent of those in the lifestyle-counseling group.
“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,” says Jeffrey Dusek, PhD, the study’s lead author. “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.” Formerly with the Benson-Henry Institute, Dusek is now with the Institute for Health and Healing at Abbott Northwestern Hospital in Minneapolis.
Zusman adds, “We are now going to look at the very large patient population currently termed pre-hypertensives – those whose blood pressure is elevated but does not yet meet the criteria for drug therapy. If we can train those patients to elicit the relaxation response, we may be able to delay or even avoid the onset of hypertension, improving their cardiovascular health, reducing dependence on medications and potentially reducing overall health care costs.” Zusman is an associate professor of Medicine, and Benson is the Mind/Body Medical Institute Associate Professor of Medicine at Harvard Medical School.
Additional co-authors of the report are Patricia Hibberd, MD, PhD, Bei-Hung Chang, ScD, Kathryn Dusek, Jennifer Johnston, MD, and Ann Wohlhueter of the Benson-Henry Institute, and Beverly Buczynski, RN, MGH Cardiology. The study was supported by grants from the Centers for Disease Control and Prevention and the National Institutes of Health. The Benson-Henry Institute has benefited from the interest and support of John Henry, principal owner of the Boston Red Sox.
Massachusetts General Hospital (www.massgeneral.org), established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $500 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, systems biology, transplantation biology and photomedicine.
Nitric oxide-scavenging hydrogel developed for rheumatoid arthritis treatment
06.06.2019 | Pohang University of Science & Technology (POSTECH)
Infants later diagnosed with autism follow adults’ gaze, but seldom initiate joint attention
24.05.2019 | Schwedischer Forschungsrat - The Swedish Research Council
Light can be used not only to measure materials’ properties, but also to change them. Especially interesting are those cases in which the function of a material can be modified, such as its ability to conduct electricity or to store information in its magnetic state. A team led by Andrea Cavalleri from the Max Planck Institute for the Structure and Dynamics of Matter in Hamburg used terahertz frequency light pulses to transform a non-ferroelectric material into a ferroelectric one.
Ferroelectricity is a state in which the constituent lattice “looks” in one specific direction, forming a macroscopic electrical polarisation. The ability to...
Researchers at TU Graz calculate the most accurate gravity field determination of the Earth using 1.16 billion satellite measurements. This yields valuable knowledge for climate research.
The Earth’s gravity fluctuates from place to place. Geodesists use this phenomenon to observe geodynamic and climatological processes. Using...
Discovery by Brazilian and US researchers could change the classification of two species, which appear more akin to jellyfish than was thought.
The tube anemone Isarachnanthus nocturnus is only 15 cm long but has the largest mitochondrial genome of any animal sequenced to date, with 80,923 base pairs....
Researchers at Chalmers University of Technology, Sweden, have discovered a completely new way of capturing, amplifying and linking light to matter at the nanolevel. Using a tiny box, built from stacked atomically thin material, they have succeeded in creating a type of feedback loop in which light and matter become one. The discovery, which was recently published in Nature Nanotechnology, opens up new possibilities in the world of nanophotonics.
Photonics is concerned with various means of using light. Fibre-optic communication is an example of photonics, as is the technology behind photodetectors and...
Fraunhofer IZM is joining the EUROPRACTICE IC Service platform. Together, the partners are making fan-out wafer level packaging (FOWLP) for electronic devices available and affordable even in small batches – and thus of interest to research institutes, universities, and SMEs. Costs can be significantly reduced by up to ten customers implementing individual fan-out wafer level packaging for their ICs or other components on a multi-project wafer. The target group includes any organization that does not produce in large quantities, but requires prototypes.
Research always means trying things out and daring to do new things. Research institutes, universities, and SMEs do not produce in large batches, but rather...
29.04.2019 | Event News
17.04.2019 | Event News
15.04.2019 | Event News
14.06.2019 | Information Technology
14.06.2019 | Materials Sciences
14.06.2019 | Medical Engineering