Impact of LifeSkills Training on Blood Pressure in Youth

描述（由申请人提供）：原发性高血压（EH）的病理生物学起源于儿童期。由于血压（BP）从童年后期开始排名，血压升高的青少年在以后的生活中有患EH的风险。NHLBI强调了制定有效的EH一级预防计划的必要性，这一点得到了最近青年BP上升的证实。威廉姆斯生活技能（WLS）研讨会已被证明可以提高与压力相关的应对技能，减轻心理社会压力和相关的健康损害影响，即，降低患有心血管疾病（CVD）的成年人的血压。提高学生管理压力和愤怒的能力将降低高血压和相关心血管疾病的风险。到目前为止，还没有对照研究评估行为压力/愤怒管理方法对青少年血压控制的影响。这项拟议研究的总体目标是开发和测试一种高效，易于交付的方法，通过应对技能培训，高中学生的愤怒和压力管理作为常规高中课程的一部分。主要目标是降低青少年的血压和愤怒。在第一阶段，我们已经开发并实地测试了一种新的愤怒/压力管理计划，用于学校的健康课程，该计划已被证明可以降低静息血压和愤怒，并改善血压正常的年轻人的生活技能。在第二阶段，我们建议研究工作学习计划对青少年人口的影响（即，240名青年）进行为期12个疗程（3个月）的WLS干预和3个月的随访，并与健康教育对照组进行比较。主要具体目的是确定WLS是否导致：1）动态SBP降低和2）愤怒降低; 3）生活技能改善。如果成功地实现这些目标，这项研究将导致一种产品，可以在真实的世界环境中大规模交付，具有相当大的商业成功潜力。这一方案可以以易于实施的课程的形式在全国各地的学校广泛推行，并具有巨大的传播潜力。这项研究的重要性在于这样一个概念，即学校课程中的降血压干预可能会通过减少心血管疾病对公共健康产生巨大影响。该项目有可能通过降低青年血压来显著影响心血管疾病。

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.