given to the use of behavioral techniques, and most have been practiced at one time or another. In fact, as mentioned previously, such methods were all that were available in the “early days.” Certain usages, such as reassurance and resistance to panic (both on the part of the patient as well as the doctor) when finding an unusually high pressure, have remained a part of the therapeutic armamentarium in the present era of specific and effective drug therapy. Our interests in biofeedback and relaxation treatments were primarily research- oriented and from our own work and from review of the contributions of many others, we have come to certain conclusions. Relaxation and biofeedback have provided further evidence of the reactivity and variability of blood pressure in the hypertensive patient. Just as stress studies have clearly delineated the pressor response as a feature of blood pressure control, which may cause detrimental consequences in the predisposition, precipitation, and perpetuation of hypertensive disease, the behavioral therapies have established the existence of a depressor response, which may in the short-term occasionally have ameliorative consequences, at least on blood pressure alone. As such, the lowering of blood pressure by relaxation is an epiphenomenon. It is the converse of the well-established pressor response, involving varied depressor mechanisms-autonomic nervous system, hormonal and local-of considerable interest in understanding blood pressure control, but of minimal clinical significance in the long-term management of hypertension. Similar conclusions regarding the effectiveness of cognitive behavioral therapies have been reached in a recent meta-analysis reported by Eisenberg et al. (1993). On the other hand, a report by Schneider et al. (1995) on a favorable short-term outcome from transcendental meditation amd progressive muscle relaxation in a group of older African Americans is worthwhile to note and may have further application.
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