This study uses an experimental panel design with control groups to examine the relationships between vasomotor and psychophysiologic mechanisms of blood pressure and cognitive/affective/behavioral features of hypertension patients. The design utilizes a self-management training program (cognitive/physiologic feedback) to alter cognitive/effective/behavioral features and reduce blood pressure. The specific objective is to examine the dynamics in the reduction of blood pressure. A long-term objective is to understand the mechanisms at play in the use of cognitive physiologic feedback for blood pressure reduction. Of interest as well is how the relationships among the multiple mechanisms also are manifested only with medication use. The samples used in this study are those only marginally successful with medications. On ethical grounds it was felt that among those with high blood pressure, medication use should be an inclusion criteria. Data will be collected at 5 time periods over a year on a sample of 80 (40 experimental; 40 controls): an initial assessment, at exit, from a 7 week training period, at 6 months, 9 months and 1 year post treatment. Physiologic data include: cardiac output, stroke volume, heart rate, blood velocity, distolic and systolic blood pressure, mean arterial pressure, baroceptor sensitivity, digital temperature, skin conductance and electromygraph readings. Cognitive/affective/behavioral data include: anger, anxiety, depression, and health habits. Analysis of data will be accomplished by time sequenced multiple regressions, using path analytic models to predict relationships and hypothesize mechanism taking place over time. Comparison of mechanisms taking place in the group with medication alone will be made with those occurring in the group with combination medication/self-management training.
NIH ExPorter
NIH ExPorter