P02.149 LB
Purpose: The use of device-guided breathing for blood pressure (BP) reduction allows recording of the dosage of the intervention, unlike other mind-body-intervention. Patient-specific details might predict outcomes. While completing a large RCT, we looked for predictors of BP response.
Methods: We studied a subgroup of subjects (n=50) participating in a randomized clinical trial of testing the RESPeRate device for the treatment of hypertension, in the device-guided treatment arm. Subjects with good adherence to the intervention (>20 practice sessions total), were included, 5 low users (<20 sessions total) were excluded from the analysis. We examined downloaded device data and ambulatory BP monitoring data before and after the 8 or 16 week intervention. We tested psychosocial variables as predictors of BP change. We performed a qualitative data analysis of their exit interviews.
Results: The number of practice sessions did not change systolic (r=−.05) or diastolic (r=−.07) BP. No differences in demographics were found. Patients with higher levels of brooding had better responses (−7.3mmHg vs. −8.4mmg Hg, p=.05). Nonresponders had larger white coat effects (6.7mmHg vs. 0.4mmHg, p=.05). Qualitative analysis showed responders and nonresponders endorsed relaxation effects during the practice. Responders voiced more enjoyment of using the device, endorsed learning an ability to utilize learned skills outside of formal practice, and less reactivity to life events after completing the intervention. Nonresponders enjoyed the practice less and were less able to utilize learned skills outside formal practice.
Conclusion: BP lowering by using the RESPeRATE biofeedback device does not depend on demographics including gender, age, or race. Some psychological characteristics predict better response to this intervention. Responders share some characteristics of enjoyment of the practice and an ability to transfer learned skills. White coat hypertension might be a negative predictor to BP reduction using this feedback device.
Contact: Beatrix Roemheld-Hamm, hammbr@rutgers.edu
