Key result
Nadolol lowers BP versus placebo, while relaxation therapy adds no benefit to beta blockers.
Why the study?
The comparative blood pressure-lowering effectiveness of relaxation therapy, beta blocker, and their combination in mildly hypertensive patients was unclear.
Does nadolol and/or relaxation therapy reduce blood pressure in untreated, mildly hypertensive patients?
RCT (n=47)
two by two factorial design
Does nadolol and/or relaxation therapy reduce blood pressure in untreated, mildly hypertensive patients?
Pharmacologic treatment with a beta blocker is superior to relaxation therapy for lowering blood pressure in mild hypertensives.
Nadolol reduces BP in mild hypertension; confirms beta-blocker superiority over relaxation therapy without additive benefit.
In this industrial-based study we compared the blood pressure (BP)-lowering effectiveness of relaxation, a beta blocker, and the combined use of these two treatments in 47 untreated, mildly hypertensive blue collar steel workers. Using a randomized two by two factorial design, patients received either nadolol or placebo drug daily, and either a relaxation training or an education program, each lasting 8 weeks. A pre-intervention and post-intervention stress test measured response of heart rate and BP to mental and physical tasks. BP assessments were done at baseline, post-intervention, 1 month, and 3 month follow-up. Change in several self-report measures was determined. Results showed that beta blocker was more effective in lowering BP than placebo, but relaxation was not more effective in lowering BP than health education. The combined effect of beta blocker and relaxation was not superior to beta blocker alone. Compliance with relaxation practice was not superior to compliance with medication. We conclude that pharmacologic treatment is superior to the relaxation therapy tested.
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Adsett et al. (1989) conducted an RCT in mild hypertension (n=47). Nadolol and relaxation training vs. Placebo and education program was evaluated on Blood pressure lowering. Nadolol was more effective in lowering blood pressure than placebo, while relaxation therapy was not superior to health education and did not add benefit to beta blocker therapy.
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