THE EFFECT OF HOME TRAINING WITH DIRECT BLOOD-PRESSURE BIOFEEDBACK OFHYPERTENSIVES - A PLACEBO-CONTROLLED STUDY

Background Home training in self-lowering of blood pressure using cont inuous blood pressure feedback has not previously been reported. Enhan cement of laboratory-learned skills was hypothesized on the basis of o utcomes from other intellectual, emotional and physical endeavours. Ob jective To examine the supplementary effect of home blood pressure bio feedback training. Design Thirty unmedicated, mild hypertensives parti cipated in a randomized, double-blinded, modified contingency placebo- controlled study, Method After suitable screening and baseline blood p ressure measurements subjects undertook eight laboratory biofeedback s essions and then 12 home training sessions over 4 weeks using continuo us finger blood pressure monitoring. Results In the laboratory those b eing administered active therapy (n = 16) lowered systolic pressures b y 5 +/- 5.4 mmHg compared with a lowering of 4 +/- 4.2 mmHg with place bo (NS), During the fourth week at home lowering for the active group (11 +/- 8 mmHg) was greater than that with placebo (4 +/- 6.2 mmHg, P = 0.017), Arm-cuff blood pressures were not statistically different fo r groups and with time but that of the active group was lower by 9 +/- 15.4/7 +/- 0.2 mmHg, which is a clinically relevant change, after hom e biofeedback. Conclusions The efficacy of self-lowering of systolic b lood pressure in mild hypertensives by continuous feedback was enhance d by 6 mmHg with 4 weeks of practice at home. Standard arm-cuff blood pressure was reduced by a clinically relevant amount The home environm ent proved cost effective for this 'high-tech' approach. (C) 1998 Lipp incott-Raven Publishers.