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Query: UMLS:C0020538 (hypertension)
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Recent clinical research on the psychological treatment of cardiovascular diseases is reviewed in four categories: hypertension, cardiac arrhythmias, coronary artery disease, and peripheral circulatory disease. In the treatment of hypertension biofeedback of blood pressure, electromyography and galvanic skin responses both seem useful, as does systematic relaxation training of either an active or passive-meditative nature. Biofeedback of heart rate has shown some utility in treating premature ventricular contractions and sinus tachycardia. Supportive and educational group therapy for patients recovering from myocardial infarctions has shown some utility. In the treatment of Raynaud's disease, biofeedback of skin temperature is helpful. In no area has a large scale clinical trial been conducted, and only three controlled group outcome studies have been reported (two in hypertension, one in coronary artery disease). Overall, the evidence is impressive enough to warrant more systematic controlled investigation in all four areas.
Arch Gen Psychiatry 1977 Dec
PMID:Psychological treatment of cardiovascular disease. 40 Jul 79

The literature on the use of relaxation or relaxation-like procedures (relaxation therapy) in the treatment of hypertension was critically reviewed. Relaxation therapy resulted in greater reduction of blood pressure than placebo or other control procedures. A positive relationship was found between the average blood pressure decrease and the average pretreatment pressure. Relaxation-like therapies shared the features of muscular relaxation, regular practice, mental focusing, and task awareness. Research on the relative contributions of these components indicated that task awareness adds to the treatment effect in the laboratory setting, and that regular practice is necessary for optimal results in the clinical setting. The role of muscular relaxation and mental focusing is unclear. We concluded that relaxation therapy may become a useful adjunct to medication in the clinical management of hypertension, especially for individuals whose blood pressures remain high despite pharmacological treatment.
Arch Gen Psychiatry 1977 Dec
PMID:Relaxation therapy in the treatment of hypertension. A review. 40 Jul 80

After completing a screening for hypertension among patients aged between 45 and 54 in a group practice, a sample of both responders and non-responders to screening were surveyed to determine their attitude to screening and knowledge of hypertension.The reasons for non-response were various, and 18 per cent felt screening to be unnecessary. There was little difference between responders (both hypertensive and non-hypertensive) and non-responders in their knowledge of hypertension, and they were well informed about related conditions and illnesses caused by hypertension. The majority were aware of some likelihood of the disease being symptomless, and 38 per cent thought no symptoms were likely to be caused by hypotensive drugs. They seemed aware that the treatment was long term, but only 14 per cent thought it would be life-long.
J R Coll Gen Pract 1979 Apr
PMID:High blood pressure: public views and knowledge. 44 69

During a two-month period in general practice we compared morbidity records from the teaching practices at Southampton, UK, and Nijmegen, The Netherlands. Although the commonest conditions - emotional disorders, upper respiratory tract infection, and musculo-skeletal disorders - were equally prevalent, obesity was five times as prevalent and hypertension and urinary tract infection were twice as prevalent in Nijmegen as in Southampton. The Dutch doctors were far more ready to prescribe oral contraception to women over 50 years old. We met many difficulties in what had appeared to be a simple project and our results may reflect important differences about doctors' attitudes to care as well as differences in morbidity.
J R Coll Gen Pract 1979 Feb
PMID:Some difficulties in comparing morbidity between countries. 48 Mar

In order to clarify current opinion on aspects of the management of hypertension, a postal questionnaire was sent to all 420 general practitioners in the Lothian Health Board Area. Three hundred and nine doctors (74 per cent) replied.A high proportion were willing to undertake the investigation and follow-up of most hypertensive patients in general practice but there were conflicting opinions on the use of Phase 4 and Phase 5 in the measurement of blood pressure, the number and type of investigations which were appropriate, the level of diastolic blood pressure at which treatment should begin, and the level to which the diastolic blood pressure should be reduced with treatment.
J R Coll Gen Pract 1979 Oct
PMID:The management of hypertension--a survey of opinions among general practitioners. 53 66

In 1967/68, a screening examination was carried out on 18,277 male London civil servants, of whom 488 were referred to their general practitioners with high blood pressure. After this referral, 23 per cent did not attend their doctor and among those who did, a relatively high frequency of anxiety was noted. In one third of the patients, the general practitioners were already aware of the presence of hypertension, but were not treating it. This reluctance to treat asymptomatic people continued with the management of referred and confirmed newly diagnosed hypertensive patients. The problems associated with mass screening examinations can be overcome by careful, expensive and time-consuming preparations. Where the purpose is to find and treat newly diagnosed hypertensive patients then screening by general practitioners is likely to be a more cost-effective approach.
J R Coll Gen Pract 1979 Oct
PMID:Screening for hypertension: some practical problems. 53 68

Male patients with psoriasis in one general practice have a significantly higher blood pressure than males in the general population. Such patients have been compared with the values recorded by Hamilton and colleagues (1954) and with matched pair controls from the same general practice. Statistical analysis using four separate methods has shown a highly significant association between psoriasis and hypertension in males, with close agreement between the tests.
J R Coll Gen Pract 1977 Dec
PMID:Raised blood pressure and psoriasis. 61 61

In a small group of hypertensive patients studied at home, once daily early morning sotalol therapy effectively decreased lying, standing, and post-exercise blood pressure and pulse rate. A dose-response relationship was seen. Adverse effects were mild and transient. The once daily regimen is easy to administer and appears to give precision in blood pressure reduction. Providing there is no subsequent escape from control, once daily beta-blocking therapy should aid long-term hypertension treatment in general practice.
J R Coll Gen Pract 1977 Dec
PMID:Once daily sotalol in the treatment of hypertension. 61 64

While mania usually occurs as a phase of manic-depressive disease, it can occur in association with organic dysfunction--medical and pharmacological--in patients with no history of affective disorder. In reviewing the literature, we have found that mania occurs secondary to drugs, infection, neoplasm, epilepsy, and metabolic disturbances. These cases are best considered secondary manias. They suggest that mania--like, for example, hypertension--is a syndrome with multiple causes and that with further research many manic syndromes currently considered primary will be shifted into the secondary category. Furthermore, the concept of secondary mania casts doubt on any unitary or single-agent hypothesis of the etiology of mania and supports the notion of a continuum of psychopathologic syndromes. Clinicians are alerted to the existence of this syndrome and are urged to screen for it when conditions warrant.
Arch Gen Psychiatry 1978 Nov
PMID:Secondary mania: manic syndromes associated with antecedent physical illness or drugs. 75 97

An attempt has been made to show that there is still a need to evaluate screening for moderate hypertension (i.e. diastolic blood pressure equal or above 110 mm Hg). At present it has not been satisfactorily shown that treatment reduces mortality and morbidity. It is suggested that in the meantime individual general practitioners can be encouraged to find cases and that this method is probably the most suitable for identifying patients with diastolic blood pressure levels above 110 mm Hg (diastolic IV).In addition it has been indicated that at present we have little knowledge about how to make treatment acceptable and that this in itself needs further study. The question has also been raised as to who will do the work of screening and treating, and whether those earmarked to do this will find it acceptable. Finally, the need for accurate costing of the benefits and disadvantages before the wide-scale implementation of a screening service has been discussed.
J R Coll Gen Pract 1976 Mar
PMID:Detection of blood pressure in general practice screening or case finding? 77 97


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