Thermal biofeedback as an effective substitute for sympatholytic medication in moderate hypertension: A failure to replicate

Thirty-three moderate hypertensives were converted to a 2-drug regimen of metoprolol and diuretic and BPs stabilized at a well-controlled level. They then completed one of three conditions over an 8-week interval: (I) 16 sessions of TBF (hand and foot warming); (II) 16 sessions of frontal EMG-BF; (III) regular home monitoring of BP. Attempts were then made to withdraw the patients from the sympatholytic medication. Those successfully withdrawn were followed up for one year. There were no significant advantages for TBF over the other two conditions in the short term or with long-term follow-up. Only 27% of treated patients (including Condition III failures who were remedicated and treated with TBF) were successfully off of the sympatholytic at a one-year follow-up. The generally poor results on clinical outcome were confirmed by clinic BPs, home BPs by patients, and 24-hour ambulatory BPs.This research was supported by grant No. HL-27622 from NHLBI. The authors wish to thank Dr. Guy C. McCoy for his role in the initial conceptualization of the study, Dr. Jim Jaccard and Barbara Greene for their assistance in the analyses of the 24-hour ambulatory BP data, and Annabel Prins, Bruce Steffek, and Debra Belkin, who served as therapists for a portion of the study.