| Abstract: | This review summarizes findings from controlled studies on the treatment of essential hypertension by relaxation and/or biofeedback and examines the efficacy of behavioral versus pharmacological approaches. It is concluded that behavioral treatment is superior to (a) no-treatment, (b) blood pressure-self-monitoring, and (c) attention-control conditions, but exceptions are noted. Although behavioral treatments compared with each other usually show no significant differences in effectiveness, behavioral treatment is clearly less effective than pharmacotherapy in the control of essential hypertension. Despite this last conclusion, a behavioral approach may be of real clinical value in the treatment of some patients, based upon findings of 24-hour reductions in blood pressure and the generalization and long-term maintenance of treatment effects. Predictors of response to behavioral treatment are examined, and the conclusions of this review are discussed in terms of their similarity to findings from comparative studies of psychotherapies. Recommendations for research and a stepped-care treatment approach are presented. |
