2000 Volume 27 Pages 44-52
The treatment of hypertension (HT) is presumably designed to prevent hypertension-induced organ disturbances and improve the patients's quality of life (QOL). Though blood pressure (BP) in the medical environment falls under the category of HT, the group of normal BP in the non-medical environment, including families, is broadly known as white-coat hypertension (WHT) in conceptual terms. The 6th report (1997) of the Joint National Committee takes up the relaxation or biofeedback (BF) therapy as a non-pharmaceutical therapy for HT. This time, we used the BF therapy for WHT without any organ disturbances on the assumption that psychogenic factors have something to do with it. By performing more than seven years of observation, we checked and saw if the BF therapy would be of effect in the prevention of organ disturbances and the enhancement of QOL. Of 72 cases to which the BF therapy was provided more than 20 times, 37 placed under more than seven years of observation were divide into two groups, depending on whether they had organ disturbances, and both groups compared. Insofar as four or less years of observation were concerned, the BF therapy turned out to be effective for both groups with significant drops in the values of clinical BP and blood catecholamine (CA) and with improvements in symptoms. In the group with organ disturbances in the seventh year, however, there were rises in clinical BP, in anxiety inventory and in the values of CA. For cases with many symptoms, a high anxiety inventory and the base line of the α-wave at upwards of 50%, the use of the BF therapy should be positively put into consideration, judging from the long-term prognosis of WHT. For an assessment of effects, it was suggested that there was the need to take account of not just a drop in clinical BP but also the correct prediction rate of the α-wave's appearance rate (controllability) and its correct prediction rate (discriminablity). When it comes to observation of the clinical course, it was demonstrated that there was also the need to take into consideration trends in clinical BP, blood CA, the anxiety inventory, controllability and discriminability.
