BIOBEHAVIORAL APPROACHES TO TREATMENT OF HYPERTENSION

拟议的研究涉及生物行为方法治疗 高血压是一个影响近4000万美国人的健康问题。 它 是一个跨学科的努力，涉及内部领域， 医学精神病学和心理学 拟议的研究是一项正在进行的研究的一年延长 旨在评价：（a）放松疗法对高血压的影响 与利尿剂或β受体阻滞剂治疗相比;（B）是否 放松疗法对高血压的作用是叠加的， 药物治疗;（c）放松的效果是否不同 取决于利尿剂与β受体阻滞剂的伴随药物治疗 （d）生理或心理变量是否可以预测 放松疗法的效果。 在这项拟议的研究中，另外15名受试者将接受为期9个月的 由以下实验阶段组成的程序：（1）安慰剂，（2） 安慰剂+放松，（3）仅氯噻酮或阿替洛尔，（4） 氯噻酮或阿替洛尔加松弛，（5）阿替洛尔或氯噻酮 （6）阿替洛尔或氯噻酮加松弛剂。 的顺序 阿替洛尔与氯噻酮将被随机化。 的每一个阶段期间 阶段，病人将被视为既在办公室的放松 治疗师和高血压诊所。 患者和治疗师将 对药物分配不知情。 相关测量包括办公室和诊所血压，航空电子设备 24-小时动态血压监测和血浆肾素 活动 脉搏和呼吸率的措施也得到了。 治疗前评估包括简短的心理测试 包括贝克抑郁量表，斯皮尔伯格状态特质量表， 焦虑量表和詹金斯A型活动量表。 研究结果可能为生物行为学提供指导。 管理高血压，扩大我们的知识， 放松疗法治疗高血压的作用机制。

The proposed research concerns biobehavioral approaches to the treatment of hypertension, a health problem affecting close to 40 million Americans. It constitutes an interdisciplinary effort involving the fields of internal medicine, psychiatry, and psychology. The proposed research constitutes a one-year extension of an ongoing study aimed at evaluating: (a) the effect of relaxation therapy for hypertension compared to treatment with diuretics or betablocking agents; (b) whether the effect of relaxation therapy on hypertension is additive to that of pharmacological therapy; (c) whether the effect of relaxation differs depending on concomitant drug treatment with a diuretic versus betablocking agents; (d) whether physiological or psychological variables can predict the effect of relaxation therapy. In the proposed study, 15 additional subjects will go through a nine-month program consisting of the following experimental phases: (1) placebo, (2) placebo plus relaxation, (3) chlorthalidone or atenolol only, (4) chlorthalidone or atenolol plus relaxation, (5) atenolol or chlorthalidone only, (6) atenolol or chlorthalidone plus relaxation. The order of atenolol versus chlorthalidone will be randomized. During each of the phases, patients will be seen both at the office of the relaxation therapist and at a hypertension clinic. Patients and therapists will be blind as to medication assignment. Dependent measures include office and clinic blood pressures, Avionics 24-hour ambulatory monitoring of blood pressure, and plasma renin activity. Measures on pulse and respiration rates are also obtained. Pretreatment assessment includes a brief psychological test battery consisting of the Beck Depression Scale, the Spielberger State-Trait Anxiety Inventory and the Jenkins Type A Activity Scale. The results of the study may provide guidelines for the biobehavioral management of hypertension and expand our knowledge regarding the mechanisms of the effect of relaxation therapy with hypertension.