Self-management of hypertension: Predictors of success in diastolic blood pressure reduction

Authors

  • Helen Nakagawa-Kogan,

    Corresponding author
    • Psychosocial Nursing, University of Washington, SC-76, Seattle, WA 98195
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    • Helen Nakagawa-Kogan, PhD, is a Professor, Annabaker Garber, PhD, and Monica Jarrett, PhD, are Research Associates, and Susan Hendershot, MN, is a Nurse Practitioner in the Department of Psychosocial Nursing at the University of Washington, Seattle.

  • Annabaker Garber,

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    • Helen Nakagawa-Kogan, PhD, is a Professor, Annabaker Garber, PhD, and Monica Jarrett, PhD, are Research Associates, and Susan Hendershot, MN, is a Nurse Practitioner in the Department of Psychosocial Nursing at the University of Washington, Seattle.

  • Monica Jarrett,

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    • Helen Nakagawa-Kogan, PhD, is a Professor, Annabaker Garber, PhD, and Monica Jarrett, PhD, are Research Associates, and Susan Hendershot, MN, is a Nurse Practitioner in the Department of Psychosocial Nursing at the University of Washington, Seattle.

  • Kelly J. Egan,

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    • Kelly J. Egan, PhD, is an Acting Assistant Professor, Department of Rehabilitation Medicine also at the University of Washington.

  • Susan Hendershot

    Search for more papers by this author
    • Helen Nakagawa-Kogan, PhD, is a Professor, Annabaker Garber, PhD, and Monica Jarrett, PhD, are Research Associates, and Susan Hendershot, MN, is a Nurse Practitioner in the Department of Psychosocial Nursing at the University of Washington, Seattle.


Abstract

The purpose of this study was to determine which borderline hypertension subjects could succeed in self-regulating blood pressure, and to distinguish the psychologic and physiologic variables that predicted success. Thirty-four white, male, unmedicated, borderline hypertensive subjects participated in a 14-session biofeedback/cognitive selfmanagement training program. Of these, 22 exited with diastolic pressure below 90 mm Hg; 12 exited equal to or above 90 mm Hg. Both groups exited with scores markedly lower on the Symptoms Checklist-90 (SCL-90). The successful group began and ended on all cognitive/affective subscales at a lower level than the unsuccessful group. A discriminant analysis revealed that lower scores on the SCL-90, lower systolic blood pressures, and higher heart rates during a mental task at the beginning of treatment distinguished those who succeeded in self-regulation from those who could not succeed. The possible mechanisms for blood pressure control/change as a consequence of biofeedback are discussed.

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