Combining behavioral treatments to reduce blood pressure. A controlled outcome study.
A six-month mix of relaxation, salt cuts, and weight coaching failed to beat simple clinic checks for lowering blood pressure.
01Research in Context
What this study did
Doctors tested a six-month package on adults with borderline high blood pressure. The package mixed relaxation lessons, less salt, and weight-loss coaching.
Half the adults got the full package. The other half only came to the clinic for blood-pressure checks. Staff then compared which group dropped their pressure more.
What they found
Both groups ended with nearly the same blood-pressure numbers. The extra lessons, diet tips, and weigh-ins did not beat simple clinic visits.
People in the package group did lose more weight, but the scale change did not move the blood-pressure needle.
How this fits with other research
Eugenia Gras et al. (2003) later warned that "nonspecific" stuff like therapist attention can hide real effects. Carr et al. (1985) built that control in: both groups saw friendly staff, so the null result is cleaner.
Anderson-Carpenter et al. (2023) sweep this old trial into today’s public-health playbook. They say behavior tools still matter, but each one must prove it adds value beyond routine care.
Sajwaj (1977) asked who should set the rules for using new packages. This 1985 study gives a clear rule: if the combo does not beat monitoring, send it back to the lab.
Why it matters
Before you stack three procedures, test each one alone. Your time, your client’s time, and insurance money ride on real gains, not on good intentions. Run a quick reversal or alternating-treatment probe. If the extra piece does not lift the data line, drop it and keep the part that works.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Add a brief return-to-baseline phase before you stack a new procedure on top of one that is already working.
02At a glance
03Original abstract
A six-month multifocal behavioral treatment program was compared to clinic blood pressure monitoring only. Subjects were 50 men and women with blood pressures in the borderline hypertensive or upper normotensive range. The behavioral treatment combined relaxation therapy, reduction of salt intake, and weight reduction. After six months, both groups showed a significant decline of systolic pressure (5.7 and 6.1 mm Hg, respectively), but there was no difference between the groups. There was no significant change in diastolic pressure in either group. There was a significantly larger decline of weight in the behavioral group. At the one-year follow-up, there was a significant decline of diastolic pressure in both groups, and systolic pressures remained significantly below baseline levels. Again, the changes were equivalent in both groups. Thus both interventions were associated with decrease of blood pressure, but there was no advantage of the behavioral treatment over clinic blood pressure monitoring.
Behavior modification, 1985 · doi:10.1177/01454455850091003