Simple relaxation and stress management techniques may make it possible for elderly people with a form of high blood pressure reduce their reliance on antihypertensive drugs, which pose certain risks for this age group.

The recent study, by Dr. Jeffery A. Dusek of Massachusetts General Hospital in Boston and colleagues, found that people with isolated systolic hypertension who participated in relaxation training had a better chance of being able to drop at least one of their blood pressure drugs, unlike those in a control group who did not participate in relaxation training.

Systolic blood pressure — the top number in the blood pressure reading systolic — represents the maximum pressure exerted when the heart contracts. It tends to rise as people age, while their diastolic blood pressure, the bottom number representing the pressure in the arteries when a person is at rest, often drops. Up to three-quarters of elderly people with hypertension have isolated systolic hypertension. Treatment can be difficult because there is a risk of lowering diastolic or resting blood pressure too much. In addition, many elderly people take multiple medications, leaving them vulnerable to drug interactions that further complicate the treatment process.

Nearly one-third of those in the relaxation group were able to keep their blood pressure at the recommended level while eliminating one or more of their anti-hypertensive drugs.

Dusek and his team separated 122 hypertensive men and women aged 55 and older in to two randomized groups. One group learned relaxation response training for 8 weeks; the control group did not. Members of both groups were taking at least two antihypertensive drugs at the start of the study, which was published in the March issue of the Journal of Alternative and Complementary Medicine.

People in the relaxation group also participated in weekly sessions on techniques such as mindfulness meditation and deep breathing to produce a relaxation response as well as a guided 20-minute relaxation response session. They were supposed to listen to a 20-minute relaxation response tape every day.

Those in the control group listened to a series of 20-minute tapes of instructions on lifestyle modification techniques.

After 8 weeks, 44 people in the relaxation response group and 36 control group participants had reduced their blood pressure to target levels and were able to participate in the next phase: an additional 8 weeks of training that included eliminating antihypertensive medication under supervision.

Nearly one-third of those in the relaxation group were able to keep their blood pressure at the recommended level while eliminating one or more of their anti-hypertensive drugs. Only 14 percent of those in the control group were able to do so.

Being in the relaxation response group increased a person's chances of being able to drop at least one medication more than four-fold. If the findings are confirmed in patients with other types of hypertension, Dusek and colleagues conclude, the benefits in preventing stroke, heart attack, kidney failure and other ill effects of high blood pressure — as well as reducing spending on drugs — would be "incalculable."