Lifestyle Modification and blood Pressure Study (LIMBS)

描述(由申请人提供)： 在美国，高血压患病率继续上升。瑜伽是心身疗法的一种，在美国越来越受欢迎，代表着药物疗法的另一种选择。在我们之前的先导性研究中，我们评估了瑜伽与强化生活方式改变在降低高血压前期和1期高血压受试者血压方面的效果。我们的结果显示，瑜伽练习确实导致24小时动态血压读数在临床上有意义的下降。在这项拟议的研究中，我们计划确定瑜伽疗法、强化的生活方式改变和瑜伽治疗和生活方式改变的联合干预对高血压前期和1期高血压患者降低血压的效果。我们相信，联合干预将导致显着的临床意义的血压下降。如果这项研究显示血压显著下降，这种联合干预可以作为一种干预纳入患者的生活方式，以避免药物治疗。要解决的具体目标是：1.确定有组织的24周瑜伽计划对患有正常高血压病到I期高血压的成年人的降压效果。2.确定瑜伽和改变生活方式的联合作用是否比单独使用其中任何一组更有效地降低24小时动态血压。3.通过动脉自旋标记(ASL)功能磁共振成像(FMRI)检测脑血流量(CBF)的变化，以检验瑜伽对血压变化的影响是否反映在脑血流量(CBF)的变化上。这将通过在休息和刺激状态下进行功能磁共振成像，并观察瑜伽、生活方式改变或联合干预前后24周前额叶皮质和扣带回局部脑血流的变化来实现。4.比较干预组内心理和生理情绪、感知压力和健康能力的平均分的变化与血压的变化。

DESCRIPTION (provided by applicant): Hypertension prevalence continues to increase in the United States. Yoga, a form of mind body therapy has become increasingly popular in the United States and represents an alternative to drug therapy. In our previous pilot study we assessed the effects of yoga vs. enhanced lifestyle modification in lowering blood pressure in subjects with prehypertension and stage 1 hypertension. Our results showed that yoga practice did result in clinically meaningful decreases in 24 hour ambulatory blood pressure readings. In this proposed study we plan to determine the effects of yoga therapy vs. enhanced lifestyle modification vs. the combined intervention of yoga therapy and lifestyle modification on lowering blood pressure in subjects with prehypertension and stage 1 hypertension. We believe that the combined intervention will result in significant clinically meaningful decreases in blood pressure. If this study shows significant decreases in blood pressure, this combined intervention can be incorporated into patients lifestyles as an intervention to avoid drug therapy. Specific aims to be addressed are: 1. To determine the effect of a structured 24-week yoga program on reducing blood pressure in adults with high-normal to stage I hypertension. 2. To determine if the combined effects of yoga and lifestyle modification are more effective at reducing 24 ambulatory blood pressure than either group alone. 3. To test if the effects of yoga on changes in blood pressure are reflected in changes in cerebral blood flow (CBF) as measured by arterial spin labeling (ASL) functional magnetic resonance imaging (fMRI). This will be accomplished by performing fMRI during a resting and stimulated state and observing changes in regional CBF in the prefrontal cortex and cingulate gyrus before and after 24 weeks of yoga, lifestyle modification or the combined intervention. 4. To compare changes in mean scores of both psychological and physiological measures of mood, perceived stress and health competence with changes in blood pressure within the intervention groups.