Impact of LifeSkills Training on Blood Pressure in Youth

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DESCRIPTION (provided by applicant): Essential hypertension (EH) has its pathobiologic origins in childhood. Since blood pressure (BP) ranking tracks from late childhood onward, adolescents with elevated BP are at risk for development of EH later in life. The need for development of effective primary prevention programs for EH highlighted the NHLBI is corroborated by recent BP rises in youth. The Williams LifeSkills (WLS) Workshop has been shown to improve stress-related coping skills, alleviate psychosocial distress and associated health-damaging effects, i.e., reduce BP in adults with cardiovascular disease (CVD). Enhancing student's abilities to manage stress and anger will reduce risk of hypertension and related cardiovascular disease later in life. To date, there have been no controlled studies evaluating behavioral stress/anger management approaches on BP control in youth. The overall aim of this proposed research is to develop and test a highly effective, easily delivered method of delivering anger and stress management through coping skills training to high school students as part of a regular high school curriculum. The primary goal is to reduce BP and anger in adolescents. Under Phase I, we have developed and field-tested a new anger/stress management program for health curriculums in schools which has been shown to reduce resting BP and anger, and improve LifeSkills profiles in normotensive youth. Under Phase II, we propose to examine the impact of WLS in an adolescent population (i.e., 240 youth) after a 12-lession (3 months) WLS intervention and 3- month follow-up, compared to a health education control. Primary specific aims are to determine whether WLS results in: 1) decreases in ambulatory SBP and 2) decreases in anger; 3) improvements in life skills profile. If successful in achieving these aims, this research will lead to a product that can be delivered on a large scale in real world settings with considerable potential for commercial success. This program could be introduced widely in schools across the country, in the form of easily deliverable curricula, and gives tremendous potential for its dissemination. The importance of this study lies in the concept that a blood pressure-reducing intervention imbedded in the school curriculum could potentially have an enormous impact on public health via reduction of cardiovascular diseases. This project has the potential to significantly impact cardiovascular disease by reducing blood pressure in youth.