From: Reuters
Published April 1, 2008 04:41 PM

Relaxation skills help some skip hypertension meds

NEW YORK (Reuters Health) - Learning stress management techniques could help people with a type of high blood pressure common among the elderly to eliminate their need for antihypertensive drugs, a new study shows.

Individuals with the condition, known as isolated systolic hypertension, who participated in relaxation training had a better chance of being able to drop at least one of their blood pressure drugs than individuals in a control group who did not participate in relaxation training, Dr. Jeffery A. Dusek of Massachusetts General Hospital in Boston and colleagues found.

If the findings are confirmed in patients with other types of hypertension, Dusek and colleagues conclude, the benefits in preventing stroke, heart attack, kidney failure and other ill effects of high blood pressure -- as well as reducing spending on drugs -- would be "incalculable."

As people age, their systolic blood pressure -- the top number in the blood pressure reading -- tends to rise, while their diastolic blood pressure, or the bottom number, often drops, Dusek and his team explain in the Journal of Alternative and Complementary Medicine.

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Up to three-quarters of elderly people with hypertension have isolated systolic hypertension, which is a "therapeutic challenge" to treat effectively, given the risk of lowering diastolic blood pressure too much, as well as the fact that many elderly people take multiple medications, they note.

To determine whether learning stress management techniques could help people manage systolic hypertension without drugs, the researchers randomized 122 hypertensive men and women aged 55 and older to 8 weeks of relaxation response training or a control group. All were taking at least two antihypertensive drugs at the study's outset.

Individuals in the relaxation response group participated in weekly sessions that included 15 minutes of instruction in how to produce the response (such as mindfulness meditation and deep breathing), along with a guided 20-minute relaxation response session. They were instructed to listen to a 20-minute relaxation response tape every day.

Patients in the control group listened to a series of 20-minute tapes of instructions on lifestyle modification techniques.

At the end of 8 weeks, 44 people in the relaxation response group and 36 control group participants had reduced their blood pressure to target levels and were eligible for an additional 8 weeks of training that included supervised antihypertensive medication elimination.

Thirty-two percent of the study participants in the relaxation group were able to keep their blood pressure at the recommended level while eliminating one or more of their anti-hypertensive drugs, compared to 14 percent of those in the control group.

After the researchers controlled for various characteristics of people in each group, they found that being in the relaxation response group increased a person's chances of being able to drop at least one medication more than four-fold.

SOURCE: The Journal of Alternative and Complementary Medicine, March 2008.

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