Psycho-behavioral treatment of hypertension

  Drug therapy is the most effective and commonly used clinical method for patients with moderate to severe hypertension, which can both reduce symptoms and significantly reduce the occurrence of hypertensive complications. However, the side effects of medication and the economic and mental burden brought by medication make many patients unable to adhere to the medication. Especially for patients with mild hypertension (diastolic blood pressure 12-13.9kpa), who account for 80% of hypertension, medication is not seen to have much benefit.  Since the 1970s, some scholars began to report that behavioral interventions have antihypertensive effects.  Although the meaning and mode of various relaxation training vary, the following common training features, including elimination of distractions, whole body relaxation, deep and slow breathing, and repetitive training, are directly targeted at the cause of hypertension. Their efficacy has been confirmed by clinical and experimental results in recent years.  Jiang Qianjin et al. (1985) used musical relaxation training to observe the immediate hypotensive effect in hypertensive patients, and 10 minutes after stopping the training, the recovery of blood pressure had reached 40% of the decrease. It is evident that relaxation therapy can be an effective adjunct to antihypertensive treatment is not due to direct relaxation effects. The behavioral or visceral learning process is a factor that cannot be ignored.  Through long-term repeated training, patients master the individual experience when the whole body is actively relaxed, and gradually achieve easy re-presentation of this psychosomatic state, as a result, blood pressure becomes a visceral behavior that can be manipulated by patients “at will”, thus achieving the purpose of lowering blood pressure. Clinical experiments also prove that long-term relaxation training can reduce the tension of peripheral sympathetic nerve activity.  2, biofeedback therapy biofeedback treatment of hypertension in foreign countries often choose systolic blood pressure, diastolic blood pressure or pulse wave velocity as feedback information. Patients generally receive inpatient treatment, but there are also activities performed at home. Indirect information feedback such as electromyography or skin temperature is commonly used in China to do antihypertensive treatment. Chen Xiaomin et al. (1995) observed the efficacy of 39 patients with stage I-II essential hypertension, and the results showed that biofeedback seemed to be superior to relaxation training.  3, exercise therapy Most studies point out that endurance exercise training or aerobic exercise training have moderate antihypertensive effects. Patients with mild hypertension, especially those who lack exercise, can achieve both hypotension and weight loss and reduce cardiac complications through endurance exercise training such as brisk walking, running, cycling, swimming and skiing. It has also been pointed out that exercise can raise HDL cholesterol to prevent atheromatous plaque formation. However, people with moderate or heavy hypertension should avoid competitive sports.  4, qigong therapy The basic elements of qigong exercise for hypertensive patients are: quiet mind, loose body, gas and, combined with the static and dynamic, identify the gong, step by step. The key is to seriously adhere to, 1-2 times a day, each time the program exercise 30 minutes. According to more than 30 years of observation of the efficacy of qigong in the prevention and treatment of hypertension throughout the country, qigong therapy has good effects in lowering blood pressure, stabilizing the efficacy, reducing medication, improving symptoms and reducing complications and improving prognosis.  A long-term prospective controlled study of 204 patients with primary hypertension in randomized groups at the Shanghai Institute of Hypertension found that the total effective rate of hypotension in the qigong group was stable at 85-90.2% at all stages of follow-up (5 years, 10 years, 15 years, 20 years), and the apparent rate reached 48-62.8%, which was significantly different from that of the control group (Wang Zongxing).  5, other non-drug therapy Weight reduction, salt restriction, smoking cessation and alcohol control are effective measures to lower blood pressure, which can be addressed through behavior modification therapy. The results of a group study in the United States pointed out that weight control can reduce the incidence of hypertension in blacks by 25% and 48% per person, and weight reduction applies to all hypertensive patients, with the most pronounced effect in obese people. Others, such as heavy drinkers, smokers, and salty eaters, should also be persuaded and daintily corrected.