Impact of LifeSkills Training on Blood Pressure in Youth

描述(申请人提供)：原发性高血压(EH)在儿童时期就有其病理生物学起源。由于血压(BP)排名从童年后期开始跟踪，血压升高的青少年在以后的生活中有患高血压的风险。制定有效的EH初级预防计划的必要性突出了NHLBI，最近BP在青年中的上升证实了这一点。威廉姆斯生活技能(WLS)研讨会已被证明可以改善与压力相关的应对技能，缓解心理社会痛苦和相关的健康损害影响，即降低患有心血管疾病的成年人的血压。提高学生管理压力和愤怒的能力将降低日后患高血压和相关心血管疾病的风险。到目前为止，还没有一项对照研究评估行为压力/愤怒管理方法对青年血压控制的影响。这项拟议研究的总体目标是开发和测试一种高效、易于实施的方法，通过作为常规高中课程的一部分对高中生进行应对技能培训，来传递愤怒和压力管理。主要目标是降低青少年的血压和愤怒。在第一阶段，我们为学校的健康课程开发了一项新的愤怒/压力管理计划并进行了现场测试，该计划已被证明可以减少静息BP和愤怒，并改善正常血压青少年的生活技能概况。在第二阶段，我们建议在12个月(3个月)的WLS干预和3个月的随访后，与健康教育对照组相比，检查WLS在青少年人群(即240名年轻人)中的影响。主要的具体目标是确定WLS是否导致：1)动态SBP的降低；2)愤怒的减少；3)生活技能的改善。如果成功实现这些目标，这项研究将带来一种可以在现实世界中大规模交付的产品，具有相当大的商业成功潜力。这项计划可以以易于交付的课程形式在全国各地的学校广泛推广，并为其传播提供了巨大的潜力。这项研究的重要性在于，学校课程中嵌入的降血压干预措施可能会通过减少心血管疾病对公众健康产生巨大影响。该项目有可能通过降低年轻人的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.