Meditation for High Blood Pressure

描述(申请人提供)：高血压是主要人群 影响美国近25%成年人的健康问题 并通过以下途径增加发病率和死亡率 心血管和肾脏疾病。尽管抗高血压药物是 通常在治疗高血压方面有效，非药物疗法 被认为是血液的重要一线或辅助治疗 压力管理。各种放松和压力管理技巧 已经测试了它们对控制血压的潜在贡献 通过减轻压力。在这些干预中，冥想训练有 作为一种辅助行为疗法显示出最大的前景 血压。 这个项目调查冥想训练计划的有效性。 用于降低血压。这项为期3年的研究是一项随机、 120例成年高血压患者的临床对照试验 或从社区招募的正常血压偏高者。扩展后 筛选和基线测试，参与者将被随机分配到 接受实验冥想训练计划(N=60)，以获得 作为安慰剂对照的渐进式肌肉放松训练计划 (n=30)，或继续常规护理(n=30)。治疗后的测试将 在培训开始后1、2和3个月进行。治疗结果将 通过以实验室为基础的和24小时动态测量的变化来评估 血压从基线到随访。此外，这项研究将测试 减压是否是一种合理的机制，可以解释临床 结果，使用与治疗相关的神经内分泌和 主观的压力测量。最后，这项研究将调查 对这种治疗反应最好的患者的特征 无论那些开始训练时压力更大的人 与焦虑相比，焦虑对血压和压力测量的改善更大 那些从较低层次开始的人。 冥想训练可能是一种具有成本效益的非药物治疗方法 高血压的管理。这项试验的结果将会有所进展 我们对这种行为干预的潜在好处的理解， 它的运作机制，以及哪种人将受益 大部分都来自于此。

DESCRIPTION (provided by applicant): High blood pressure is a major public health problem that affects nearly 25 percent of adults in the United States and contributes to increased risks of morbidity and mortality via cardiovascular and renal diseases. Although anti-hypertensive medications are often effective in the treatment of hypertension, non-pharmacological therapies are recognized as important first-line or adjunctive treatments for blood pressure management. A variety of relaxation and stress management techniques have been tested for their potential contributions to blood pressure control through stress reduction. Among these interventions, meditation training has shown the greatest promise as an adjunctive behavioral treatment for lowering blood pressure. This project investigates the effectiveness of a meditation-training program for the reduction of blood pressure. The 3-year study is a randomized, controlled clinical trial involving 120 adult men and women with hypertension or high-normal blood pressure recruited from the community. After extended screening and baseline testing, participants will be assigned at random to receive the experimental meditation training program (N= 60), to receive a progressive muscle relaxation training program that serves as a placebo control (N = 30), or to continue with usual care (N= 30). Post-treatment testing will be conducted 1, 2, and 3 months after training begins. Treatment outcome will be assessed by changes in laboratory-based and 24-hour ambulatory measures of blood pressure from baseline to follow-up. In addition, the study will test whether stress-reduction is a plausible mechanism that can account for clinical outcomes, using measurements of treatment-related changes in neuroendocrine and subjective measures of stress. Finally, the study will investigate the characteristics of those who respond best to this treatment and determine whether those individuals who begin training with higher levels of stress and anxiety show greater improvements in blood pressure and measures of stress than those who begin with lower levels. Meditation training may be a cost-effective non-pharmacological treatment for the management of high blood pressure. The results of this trial will advance our understanding of the potential benefits of this behavioral intervention, the mechanisms through which it works, and the kind of person who will benefit most from it.