Blood Pressure Biofeedback Exerts Intermediate-Term Effects on Blood Pressure and Pressure Reactivity in Individuals with Mild Hypertension: A Randomized Controlled Study

Biofeedback therapeutic effects on blood pressure levels in hypertensive individuals: A systematic review and meta-analysis

INTRODUCTION

Systemic arterial hypertension (SAH) is considered a multifactorial disease characterized by a persistent increase in blood pressure levels. Currently, the efficient control of blood pressure is achieved by both the use of pharmacological therapy and the control of risk factors. In addition, the use of biofeedback (BFB) as a non-pharmacological strategy represents a promising therapy.

OBJECTIVE

This study aims to evaluate the effects of BFB on systolic and diastolic blood pressure levels, as well as on environmental and psychosocial factors in patients with essential SAH.

METHODS

A systematic review (SR) of the literature was carried out in English and Portuguese using the following databases: SCIELO, LILACS, CINAHL, Cochrane, and PubMed. The search strategy included a mix of terms for the key concepts Biofeedback, Heart Rate Variability, Psychophysiological Feedback, and Heart Biofeedback. Studies were analyzed independently.

RESULTS

The included studies evaluated a total of 462 subjects of both sexes. The meta-analysis revealed that BFB significantly elicited greater blood pressure control, mainly improving DBP levels (Z = 2.15; P = 0.03).

DISCUSSION

Besides improvement in DBP readings post-intervention, BFB also resulted in better disease-related environmental and psychosocial factors, such as reduced stress levels. The magnitude of effect did not appear to depend on the type of BFB applied.

CONCLUSION

This SR demonstrated that BFB with visual and/or auditory information is a complementary option to pharmacological treatment in the management of individuals with systolic and diastolic arterial hypertension. Moreover, the use of this adjuvant therapy seems to facilitate better DPB control.

Effect of nurse-led home-based biofeedback intervention on the blood pressure levels among patients with hypertension: Pretest-posttest study

AIM

To investigate the effect of nurse-led home-based biofeedback intervention on the blood pressure levels among patients with hypertension.

BACKGROUND

Nurse-led interventions are emerging as cost-effective as well as clinically proven in chronic illness management. Hypertension, a leading long-term cardiovascular condition, has autonomic dysregulation and increased sympathetic tone as its pathophysiological background. Complementary interventions evidenced to interplay hypertension pathophysiology.

DESIGN

A pretest-posttest design.

MATERIALS AND METHODS

Uncomplicated primary hypertension outpatients were randomly assigned as study group (n = 173) and control group (n = 173) at a tertiary care hospital. Sociodemographic, clinical, and outcome variables [the baseline blood pressure and galvanic skin response (GSR)] were collected. Study group patients were given four teaching sessions of abdominal breathing-assisted relaxation facilitated by GSR biofeedback. Daily home practice was encouraged and monitored to measure the effects on blood pressure and GSR at the end of the 1st, 2nd, and 3rd month of intervention.

RESULTS

The study group participants showed significant decrease in mean (SD) systolic [140.77 (8.31) to 136.93 (7.96), F = 469.08] and diastolic blood pressure [88.24 (5.42) to 85.77 (4.66), F = 208.21]. In contrast, control group participants had a mild increase in the mean systolic (F = 6.02) and diastolic blood pressure (F = 4.70) values from pretest to posttests. GSR showed a significant increase from 559.63 (226.33) to 615.03 (232.24), (F = 80.21) from pretest to posttest III.

CONCLUSIONS

Use of home-based biofeedback-centered behavioral interventions enabled BP reduction among hypertensive patients. Further studies should use biochemical markers of sympathetic nervous system activity to endorse this home-based chronic illness intervention.

Role of complementary and alternative medicine in geriatric care: A mini review

Since time immemorial homo sapiens are subjected to both health and diseases states and seek treatment for succor and assuagement in compromised health states. Since last two decades the progressive rise in the alternative form of treatment cannot be ignored and population seems to be dissatisfied with the conventional treatment modalities and therefore, resort to other forms of treatment, mainly complementary and alternative medicine (CAM). The use of CAM is predominantly more popular in older adults and therefore, numerous research studies and clinical trials have been carried out to investigate the effectiveness of CAM in the management of both communicable and non-communicable disease. In this current mini review, we attempt to encompass the use of CAM in chronic non-communicable diseases that are most likely seen in geriatrics. The current review focuses not only on the reassurance of good health practices, emphasizing on the holistic development and strengthening the body's defense mechanisms, but also attempts to construct a pattern of self-care and patient empowerment in geriatrics. The issues of safety with CAM use cannot be sidelined and consultation with a health care professional is always advocated to the patient. Likewise, responsibility of the health care professional is to inform the patient about the safety and efficacy issues. In order to substantiate the efficacy and safety of CAMs, evidence-based studies and practices with consolidated standards should be planned and executed.

How should clinical psychologists approach complementary and alternative medicine? Empirical, epistemological, and ethical considerations

As complementary and alternative medicine (CAM) practices are often recommended for mental health problems, many clients in clinical psychology will be in receipt of such treatments from other practitioners. Some psychologists have argued that CAM and psychology are natural bedfellows, given their sharing of philosophies (e.g., holism), professional orientations (e.g., person-centeredness), and theoretical positions (e.g., mind-body connectionism). It has specifically been argued that the practices of CAM could productively be appropriated, or at least promoted, by clinical psychologists. However, other commentators have criticized CAM for comprising therapies that, by definition, are both intrinsically unscientific and lacking in empirical evidence. This article examines the current standing of CAM from empirical, epistemological, and ethical perspectives. CAM treatments are found to be based on heterogeneous epistemologies and to suffer from poor records in empirical efficacy research. Attention is given to possible psychological explanations for CAM's popularity in the face of poor evidence for efficacy. It is argued that, given the likely incompatibility of CAM with clinical psychology's positivist scientific ethos, CAM practices should not be integrated into clinical psychology at this time.