Hypertension: Prediction of Biofeedback Success
Hypertension: Prediction of Biofeedback Success
Hypertension, present in more than 50 million Americans, increases the risk of cardiovascular
 disease and its associated complications. More persons are turning to alternative medicine to
 deal with their health problems. Biofeedback may reduce blood pressure and/or allow the
 reduction of antihypertensive medications in some patients, while having no adverse effects.
 Yet biofeedback therapy is time-intensive and technician-intensive. Therefore, it is critical
 to be able to predict which patients with essential hypertension are most likely to lower
 his/her blood pressure using these techniques. This research proposes to test three different
 means of predicting whether a hypertensive subject will or will not be successful in lowering
 his/her blood pressure using biofeedback. Sixty hypertensive subjects will be studied over a
 three-year period. The results of this study will enable those caring for hypertensive
 persons to recommend biofeedback in an individualized way, thereby promoting adherence.
In the next century, our health care system will attempt to manage chronic illness in the
 largest aging population ever known. Non-adherence to pharmacological therapy and to
 non-pharmacological therapy will prove very costly. Hypertension, present in more than 50
 million Americans, increases the risk of cardiovascular disease and its associated morbidity
 and mortality. Thus is it critical that adherence to treatment of hypertension be increased.
 While medications are effective in certain patients, their adverse effects make compliance
 with treatment difficult to ensure. In addition, more and more persons are turning to
 alternative medicine to deal with their health problems. Biofeedback offers an alternative to
 medical treatment, having been shown to reduce both systolic and diastolic blood pressures
 and/or allow the reduction of antihypertensive medications in some patients, while having no
 adverse effects. Yet biofeedback therapy is time-intensive and technician-intensive.
 Therefore, it is critical to be able to predict which patients with essential hypertension
 are most likely to lower his/her blood pressure using these techniques.

 This research proposes to test three different means of predicting whether a hypertensive
 subject will or will not be successful in lowering his/her blood pressure using biofeedback.
 Specifically, the first set of predictive criteria to be tested is that proposed by Weaver &
 McGrady (1995). This model is derived from five variables: heart rate, finger temperature,
 forehead muscle tension, plasma rennin response to furosemide, and mean arterial pressure
 response to furosemide. The second prediction model is based on the magnitude of circadian
 variations in blood pressure as measured by 24-hour ambulatory blood pressure monitoring. The
 third prediction model is based on locus of control of behavior. A total of 60 hypertensive
 subjects will be studied over a three-year period. The results of this study will enable
 those caring for hypertensive persons to recommend treatment (i.e., biofeedback) in an
 individualized way, thereby promoting adherence.
-  essential hypertension

 -  stages 1 or 2

 -  not taking beta blockers or central acting alpha agonists

 -  permission from primary care provider