BIOBEHAVIORAL APPROACHES TO TREATMENT OF HYPERTENSION

这项拟议的研究涉及生物行为疗法，用于治疗 高血压是影响近4000万美国人的健康问题。它 构成了一项跨学科的努力，涉及到内部 医学、精神病学和心理学。 拟议的研究是正在进行的研究的一年延长 旨在评估：(A)放松疗法对高血压的疗效 与利尿剂或补液剂治疗相比；(B) 放松疗法对高血压的疗效是相加的。 药物疗法；(C)松弛效果是否不同 依赖于利尿剂与更佳库存的同时用药治疗 代理；(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 该计划包括以下实验阶段：(1)安慰剂，(2) 安慰剂加松弛，(3)仅使用氯替利酮或阿替洛尔，(4) 氯替利酮或阿替洛尔加松弛，(5)阿替洛尔或氯替利酮 单用，(6)阿替洛尔或氯沙利酮加松弛。的顺序 阿替洛尔和氯替利酮将被随机分配。在每一个 各阶段，患者都会在放松的办公室看到 治疗师和高血压诊所的医生。患者和治疗师将成为 对药物分配视而不见。 相关测量包括办公室和诊所血压、航空电子产品 24小时动态监测血压和血浆肾素 活动。还获得了脉搏和呼吸频率的测量结果。 前期评估包括简短的心理测试 由贝克抑郁量表、斯皮尔伯格状态特征组成 焦虑量表和Jenkins A型活动量表。 本研究结果可为生物行为学研究提供指导。 高血压的管理，扩大我们对高血压的认识 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.