Thermal biofeedback as an effective substitute for sympatholytic medication in moderate hypertension: A failure to replicate

Blanchard, Edward B.; Eisele, George; Gordon, Michael A.; Cornish, Peter J.; Wittrock, David A.; Gilmore, Linda; Vollmer, Alisa; Wan, Chun

doi:10.1007/bf00999082

Cited by 14 publications

(5 citation statements)

References 7 publications

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“…Because standard errors of pre-to posttreatment blood pressure changes were not reported in three studies (27,29,40), the values were calculated using the reported t-values and sample sizes. In seven studies (26,28,35,39,42,43), the standard errors were reported at both pre-and post-interventions, but there was no data on the standard errors of preto posttreatment blood pressure changes.…”

Section: Discussionmentioning

confidence: 99%

“…In this manner, 22 articles with randomized controlled trials were identified, but one article (25) was excluded from the analysis because 28 of its 30 subjects had previously undergone biofeedback treatment in a previous study (16). Another of the articles consisted of two independent studies (26), resulting in a total selection of 22 studies for analysis (6,16,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44). Table 1 provides descriptive characteristics of these 22 biofeedback studies.…”

Section: Quality Assessment Of Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Blood Pressure-Lowering Effects of Biofeedback Treatment in Hypertension: A Meta-Analysis of Randomized Controlled Trials.

et al. 2003

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To examine the blood pressure-lowering effects of biofeedback treatment in patients with essential hypertension, a meta-analysis was conducted on studies published between 1966 and 2001. A total of 22 randomized controlled studies with 905 essential hypertensive patients were selected for review. Compared with clinical visits or self-monitoring of blood pressure (non-intervention controls), biofeedback intervention resulted in systolic and diastolic blood pressure reductions that were greater by 7.3 mmHg (for systole; 95% confidence interval: 2.6 to 12.0) and 5.8 mmHg (for diastole; 95% confidence interval: 2.9 to 8.6). Compared with sham or non-specific behavioral intervention controls, the net reductions in systolic and diastolic blood pressures by biofeedback intervention were 3.9 (95% confidence interval: -0.3 to 8.2) and 3.5 (-0.1 to 7.0) mmHg, respectively. The results of multiple regression analysis also indicated that biofeedback intervention decreased systolic and diastolic blood pressures more than non-intervention controls (p < 0.001), but not more than sham or non-specific behavioral intervention controls (p > 0.05), when controlling for the effects of initial blood pressures. When biofeedback intervention types were classified into two types, simple biofeedback and relaxation-assisted biofeedback, only the relaxation-assisted biofeedback significantly decreased both systolic and diastolic blood pressures (p < 0.05) compared with those in sham or non-specific behavioral intervention controls. The results suggested that biofeedback was more effective in reducing blood pressure in patients with essential hypertension than no intervention. However, the treatment was only found to be superior to sham or non-specific behavioral intervention when combined with other relaxation techniques. Further studies will be needed to determine whether biofeedback itself has an antihypertensive effect beyond the general relaxation response.

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Section: Discussionmentioning

confidence: 99%

Section: Quality Assessment Of Studiesmentioning

confidence: 99%

Blood Pressure-Lowering Effects of Biofeedback Treatment in Hypertension: A Meta-Analysis of Randomized Controlled Trials.

et al. 2003

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“…Among these, 15 trials lacked an adequate BP baseline measurement protocol and two others were shorter than 8 weeks' duration. Hence, 20 trials met the above criteria, and these provided 27 comparisons of an active treatment group with an attention-control group [11,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44].…”

Section: Revisiting the Evidence For Stress Reduction Programs And Himentioning

confidence: 99%

Stress reduction programs in patients with elevated blood pressure: A systematic review and meta-analysis

Rainforth

Schneider²,

Nidich³

et al. 2007

Current Science Inc

256

169

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Substantial evidence indicates that psychosocial stress contributes to hypertension and cardiovascular disease (CVD). Previous meta-analyses of stress reduction and high blood pressure (BP) were outdated and/or methodologically limited. Therefore, we conducted an updated systematic review of the published literature and identified 107 studies on stress reduction and BP. Seventeen trials with 23 treatment comparisons and 960 participants with elevated BP met criteria for well-designed randomized controlled trials and were replicated within intervention categories. Meta-analysis was used to calculate BP changes for biofeedback, -0.8/-2.0 mm Hg (P = NS); relaxation-assisted biofeedback, +4.3/+2.4 mm Hg (P = NS); progressive muscle relaxation, -1.9/-1.4 mm Hg (P = NS); stress management training, -2.3/-1.3 mm (P = NS); and the Transcendental Meditation program, -5.0/-2.8 mm Hg (P = 0.002/0.02). Available evidence indicates that among stress reduction approaches, the Transcendental Meditation program is associated with significant reductions in BP. Related data suggest improvements in other CVD risk factors and clinical outcomes.

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“…Derartige indirekt auf den Blutdruck wirkende Methoden sind EMG-Feedback [z.B. Blanchard et al, 1993;Jurek al., 1992;McGrady al., 1991], Hauttemperatur-Feedback [z.B. Blanchard et al, 1996;Buby et al, 1990;McGrady, 1994;Latha und Kaliappan, 1991;Musso und Blanchard, 1991;Wittrock und Blanchard, 1992], respiratorisches Feedback [z.B.…”

Section: Hintergrundunclassified

Adjuvante Therapie von arterieller Hypertonie durch hochfrequentes Blutdruckbiofeedback

Piesbergen

Kircher²,

Weber³

2008

Verhaltenstherapie

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Hintergrund: Der Mangel an praxisnahen Studien zur Wirksamkeit von kontinuierlichem Blutdruckbiofeedback führte zur Entwicklung und Erprobung einer Aufzeichnungs- und Feedbacksoftware, die eine Beat-to-Beat-Darstellung des arteriellen Blutdrucks auf einem Computermonitor ermöglicht. In Biofeedbacksitzungen mit diesem System machen Hochdruckpatienten die Erfahrung, dass sie über eigene Ressourcen für eine klinisch relevante Blutdrucksenkung verfügen. Patienten und Methoden: Zur Evaluation des Verfahrens wurde an der Klinik Höhenried am Starnberger See (Deutschland) eine Pilotstudie mit 84 stationären Hypertoniepatienten durchgeführt. Zwei Experimentalgruppen, die das normale Heilbehandlungsprogramm der Klinik und zusätzlich 2 (20 Probanden) bzw. 3–6 (22 Probanden) jeweils 30-minütige Biofeedbackbehandlungen erhielten, wurden mit zwei Kontrollgruppen verglichen (20 Probanden mit Pseudobiofeedback und 22 Probanden, die nur das Klinikprogramm durchliefen). Ergebnisse: Aus den mittels Armmanschette gemessenen RR-Werten wurden bei allen Gruppen die Durchschnittswerte des medizinischen Mitteldrucks (MAP) in der ersten und in der Entlassungswoche berechnet und es wurde ein Differenzwert gebildet. Beide Experimentalgruppen erzielten signifikant höhere Senkungen des MAP als die Kontrollgruppen (p = 0,001), allerdings schnitt die Experimentalgruppe mit 3–6 Feedbacksitzungen nicht signifikant besser ab als die Gruppe mit nur 2 Sitzungen (p = 0,517). Schlussfolgerungen: Schon eine 2-malige Behandlung mit hochfrequentem Biofeedback kann klinisch relevante Effekte haben, was Hinweise auf einen erheblichen Einfluss von kognitiven Prozessen wie Selbstwirksamkeit und Selbstkontrolle liefert.

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Thermal biofeedback as an effective substitute for sympatholytic medication in moderate hypertension: A failure to replicate

Cited by 14 publications

References 7 publications

Blood Pressure-Lowering Effects of Biofeedback Treatment in Hypertension: A Meta-Analysis of Randomized Controlled Trials.

Blood Pressure-Lowering Effects of Biofeedback Treatment in Hypertension: A Meta-Analysis of Randomized Controlled Trials.

Stress reduction programs in patients with elevated blood pressure: A systematic review and meta-analysis

Adjuvante Therapie von arterieller Hypertonie durch hochfrequentes Blutdruckbiofeedback

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