Lower High Blood Pressure with Biofeedback

Biofeedback is a clinically-validated therapy that measures and displays your body’s performance to help you increase awareness and control of your physiology. Patients who want to reduce their reliance on medication and increase their control of their own health are excellent candidates for biofeedback. Biofeedback clinical trials have shown that personal biofeedback training is an effective treatment for hypertension.

What is hypertension?

The National Heart, Lung, and Blood Institute has defined blood pressures of 140/90 or higher as hypertension and values between 120-139/80-89 as pre-hypertension

The upper number is systolic blood pressure, which measures blood pressure when the left ventricle of the heart contracts. The lower number is diastolic blood pressure, which measures blood pressure when the left ventricle relaxes.

High blood pressure is a major risk factor for coronary heart disease and heart attack, kidney failure, and stroke.

Who is mainly affected?

About 60% of American adults suffer from prehypertension or hypertension.

High risk groups include:

  • African Americans
  • the elderly
  • individuals with low socioeconomic status
  • individuals who are overweight

While the prevalence of hypertension has increased 10% in the past decade, hypertension is still poorly controlled:

  • 31% of patients are unaware that they have high blood pressure
  • 66% have been told by health professionals to modify lifestyle and take drugs to control their blood pressure
  • 31% achieve satisfactory control

How do biofeedback practitioners assess patients with essential hypertension?

After a medical evaluation to rule out diseases and medications that can produce elevated blood pressure, a clinician may conduct a psychophysiological profile that monitors your breathing, finger temperature, heart rhythm, skeletal muscle activity, and skin conductance using biofeedback electrodes during resting, mild stressor, and recovery conditions.

The psychophysiological profile will enable your clinician to develop an individualized training program to correct abnormal physiological changes associated with hypertension.

Frequent findings during biofeedback stress tests of hypertensive patients include:

  • shallow, rapid breathing with frequent breath-holding
  • constriction of the small arteries of the fingers and toes
  • reduced heart rate variability
  • contraction of muscles in the upper shoulders, neck, and forehead
  • increased sweat gland activity

What is biofeedback therapy?

Biofeedback techniques use biofeedback instruments to increase your awareness and control of minute-to-minute physiological changes. A clinician’s biofeedback instructions are guided by the information provided by the biofeedback devices suggested by the psychophysiological profile.

How does biofeedback treat this disorder?

Biofeedback training methods may combine stress management training with one or more forms of biofeedback, including:

  • EEG biofeedback (brain electrical activity)
  • EMG biofeedback (skeletal muscle activity)
  • heart rate variability biofeedback (timing between heartbeats)
  • respiratory biofeedback (breathing patterns)
  • skin conductance biofeedback (sweat gland activity)
  • temperature biofeedback (blood flow through small arteries)

How effective is biofeedback for hypertension?

Biofeedback instructions can help patients achieve impressive reductions in blood pressure using biofeedback equipment. One review found that the most effective treatments were stress management training, EMG biofeedback, and temperature biofeedback, respectively. Stress management biofeedback that guides stress management training with biofeedback is a promising treatment strategy.

In a landmark Menninger Foundation study that combined EMG and temperature biofeedback with breathing training and relaxation, 65% of patients completely discontinued medication while reducing their blood pressure 15/10 mmHg to an average value of 128/80. Another 24% of their patients reduced their medication by one-half while reducing pressure 17/12 mmHg.

The Association for Applied Psychophysiology and Biofeedback’s (AAPB) Evidence-Based Practice in Biofeedback and Neurofeedback by Carolyn Yucha, PhD, and Christopher Gilbert, PhD, awarded this treatment the second-highest rating of efficacious.

Is there insurance coverage for biofeedback?

Payment for biofeedback therapy varies across insurers and geographical locations. Psychologists may bill biofeedback services as psychotherapy to increase the likelihood of reimbursement.

How safe is biofeedback training?

Biofeedback is safer and has a better side-effect profile than many conventional medical treatments, including aspirin.

Patients may briefly experience mild side-effects during deep relaxation, including intrusive thoughts, fear of losing control, anxiety, tingling, increased heart rate, muscle spasms, tics, and muscle twitches, which disappear with training.

Who are poor candidates for biofeedback training?

Biofeedback may be inappropriate if you suffer from:

  • acute medical crisis
  • agitation
  • delirium
  • severe depression
  • dissociation (depersonalization, dissociative reaction, and fugue)
  • mania
  • severe obsessive-compulsive disorder (OCD)
  • paranoid disorders
  • schizophrenia

Why is an experienced therapist important?

In rare cases, inexperienced therapists may depart from evidence-based practice and apply a procedure to a disorder for which it was never intended or they may ineffectively apply an appropriate procedure, resulting in treatment failure. Insufficiently trained clinicians can potentially harm their patients if they do not understand the effect of training on existing medical conditions (epilepsy) or medication (high blood pressure).

Biofeedback training may reduce your need for medication for asthma, diabetes mellitus, epilepsy, glaucoma, hypertension, and hypothyroidism. You should regularly evaluate the dosage of these medications with your physician to avoid the possibility of an overdose.

Who should treat this disorder?

Biofeedback practitioners who are experienced in treating hypertension and certified by the Biofeedback Certification Institute of America (BCIA) in General Biofeedback or EEG biofeedback are qualified to treat this disorder.

Why should you select a BCIA-certified professional?

Biofeedback Certification Institute of America (BCIA) certification was developed to protect patients by ensuring that approved biofeedback providers demonstrate entry-level competence and subsequently increase their expertise through continuing education. BCIA certifies professionals in three areas: General biofeedback, EEG biofeedback, and Pelvic Muscle biofeedback. BCIA certification is endorsed by healthcare leaders like the Mayo Clinic and by the Association for Applied Psychophysiology and Biofeedback (AAPB), Biofeedback Foundation of Europe (BFE), and International Society for Neurofeedback and Research (ISNR).

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