{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T21:39:16Z","timestamp":1774474756897,"version":"3.50.1"},"reference-count":24,"publisher":"BMJ","issue":"6475","license":[{"start":{"date-parts":[[1985,4,13]],"date-time":"1985-04-13T00:00:00Z","timestamp":482198400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J (Clin Res Ed)"],"published-print":{"date-parts":[[1985,4,13]]},"abstract":"<jats:p>On screening 192 men and women aged 35-64 were identified as having two or more of the following risk factors: blood pressure greater than or equal to 140\/90 mm Hg, plasma cholesterol concentration greater than or equal to 6.3 mmol\/l (243.6 mg\/100 ml), and current smoking habit greater than or equal to 10 cigarettes a day. They were randomly allocated to a group for modification of behaviour or to serve as controls. Both groups were given health education leaflets containing advice to stop smoking, to reduce animal fats in the diet, and on the importance of reducing blood pressure. In addition, the treatment group had group sessions of one hour a week for eight weeks in which they were taught breathing exercises, relaxation, and meditation and about managing stress. It had previously been found that after eight weeks and eight months there was a significantly greater reduction in both systolic and diastolic blood pressures in the group taught to relax compared with the control group. After four years of follow up these differences in blood pressure were maintained. Plasma cholesterol concentration and the number of cigarettes smoked were lower in the treatment group at eight weeks and eight months but not at the four year follow up. At four years more subjects in the control group reported having had angina and treatment for hypertension and its complications. Incidence of ischaemic heart disease, fatal myocardial infarction, or electrocardiographic evidence of ischaemia was significantly greater in the control group. If the results of this study could be obtained in a larger study the financial and health care implications would be enormous.<\/jats:p>","DOI":"10.1136\/bmj.290.6475.1103","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T11:00:59Z","timestamp":1238670059000},"page":"1103-1106","source":"Crossref","is-referenced-by-count":163,"title":["Trial of relaxation in reducing coronary risk: four year follow up."],"prefix":"10.1136","volume":"290","author":[{"given":"C","family":"Patel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M G","family":"Marmot","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D J","family":"Terry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Carruthers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Hunt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1985,4,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1016\/S0140-6736(73)92660-3","article-title":"Yoga and biofeedback in the management of hypertension","volume":"ii:","author":"Patel, C.H.","year":"1973","unstructured":"Patel CH. Yoga and biofeedback in the management of hypertension. Lancer 1973;ii: 1053-5.","journal-title":"Lancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/S0140-6736(75)91070-3","article-title":"of yoga and biofeedback in the management of hypertension","volume":"i:","author":"Patel, C.","year":"1975","unstructured":"Patel C. 12 month follow up of yoga and biofeedback in the management of hypertension. Lancet 1975;i:62-5.","journal-title":"Lancet"},{"key":"ref_3","first-page":"289","article-title":"Decreased blood pressure in pharmacologically treated hypertensive patients who regularly elicited the relaxation response","volume":"i:","author":"Benson, H.; Rosener, B.A.; Marzetta, B.; Klemchuk, M.","year":"1975","unstructured":"Benson H, Rosener BA, Marzetta B, Klemchuk M. Decreased blood pressure in pharmacologically treated hypertensive patients who regularly elicited the relaxation response. 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Behav Res Ther 1975;13:29-41.","journal-title":"Behav Res Ther"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1056\/NEJM197601082940204","article-title":"Psychotherapeutic control of hypertension","volume":"294","author":"Stone, R.A.; De Leo, J.","year":"1976","unstructured":"Stone RA, De Leo J. Psychotherapeutic control of hypertension. N EnglJ3 Med 1976;294:80-4.","journal-title":"N EnglJ3 Med"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1001\/archpsyc.1977.01770150097011","article-title":"Relaxation therapy and high blood pressure","volume":"34","author":"Taylor, C.B.; Farquhar, J.W.; Nelson, E.; Agras, W.S.","year":"1977","unstructured":"Taylor CB, Farquhar JW, Nelson E, Agras WS. Relaxation therapy and high blood pressure. 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Relaxation therapy for essential hypertension: a veterans administration outpatients study. 7 Behav Med 1979;2:21-9.","journal-title":"7 Behav Med"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1097\/00006842-197912000-00005","article-title":"Long term effect of relaxation on blood pressure and anxiety levels in essential hypertensive males: a controlled study","volume":"41","author":"R, Bali L.","year":"1979","unstructured":"Bali L.R. Long term effect of relaxation on blood pressure and anxiety levels in essential hypertensive males: a controlled study. Psychosom Med 1979;41: 637-46.","journal-title":"Psychosom Med"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/BF00844914","article-title":"Meditation training and essential hypertension: a methodological stuldy","volume":"3","author":"Seer, P.; Raeburn, J.M.","year":"1980","unstructured":"Seer P, Raeburn JM. Meditation training and essential hypertension: a methodological stuldy. J Behav Med 1980;3:59-73.","journal-title":"J Behav Med"},{"key":"ref_12","first-page":"343","article-title":"The effect of biofeedback-assisted relaxation training on blood pressure and selected biochemical parameters in patients with essential hypertension. Biofeedback Self Regul","volume":"6","author":"McGrady, A.V.; Yonker, R.; Tay, S.Y.; Fine, T.M.; Woewrner, M.","year":"1978","unstructured":"McGrady AV, Yonker R, Tay SY, Fine TM, Woewrner M. The effect of biofeedback-assisted relaxation training on blood pressure and selected biochemical parameters in patients with essential hypertension. 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J Behav Med 1983;6:169-87.","journal-title":"J Behav Med"},{"key":"ref_15","article-title":"A controlled study of relaxation and stress management in the treatment of essential hypertension","author":"Irvine, M.J.","year":"1983","unstructured":"Irvine MJ. A controlled study of relaxation and stress management in the treatment of essential hypertension. Oxford: University of Oxford, 1983. (DPhil thesis.)"},{"key":"ref_16","first-page":"211","article-title":"Reduction of serum cholesterol and blood pressure in hypertensive patients by behaviour modification","volume":"26","author":"Patel, C.","year":"1976","unstructured":"Patel C. Reduction of serum cholesterol and blood pressure in hypertensive patients by behaviour modification. J R Coll Gen Pract 1976;26:211-5.","journal-title":"J R Coll Gen Pract"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1080\/0097840X.1979.10545991","article-title":"A relaxation technique in the management of hypercholesterolaemia","volume":"5","author":"Cooper, M.J.; Aygen, M.M.","year":"1979","unstructured":"Cooper MJ, Aygen MM. A relaxation technique in the management of hypercholesterolaemia. 7 Human Stress 1979;5:24-7.","journal-title":"7 Human Stress"},{"key":"ref_18","first-page":"401","article-title":"Coronary risk factor reduction through biofeedbackaided relaxation and medication","volume":"27","author":"Patel, C.; Carruthers, M.","year":"1977","unstructured":"Patel C, Carruthers M. Coronary risk factor reduction through biofeedbackaided relaxation and medication. 7 R Coll Gen Pract 1977;27:401-5.","journal-title":"Coll Gen Pract"},{"key":"ref_19","first-page":"2005","article-title":"Controlled trial of biofeedback-aided behavioural methods in reducing mild hypertension","volume":"282","author":"Patel, C.; Marmot, M.G.; Terry, D.J.","year":"1981","unstructured":"Patel C, Marmot MG, Terry DJ. Controlled trial of biofeedback-aided behavioural methods in reducing mild hypertension. Br MedJ3 1981;282:2005-8."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/S0140-6736(84)91337-0","article-title":"Treatment of hypertension in pregnancy by relaxation and biofeedback","volume":"i:","author":"Little, B.; Hayworth, J.; Benson, P.","year":"1984","unstructured":"Little B, Hayworth J, Benson P, et al. Treatment of hypertension in pregnancy by relaxation and biofeedback. Lancet 1984;i:865-8.","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1136\/bmj.282.6279.1847","article-title":"A strategy for prevention: lessons from cardiovascular disease","volume":"282","author":"Rose, G.A.","year":"1981","unstructured":"Rose GA. A strategy for prevention: lessons from cardiovascular disease. Br Med J 1981;282:1847-51.","journal-title":"Br Med J"},{"key":"ref_22","author":"Accepted 30_7anuary 1985)","unstructured":"(Accepted 30_7anuary 1985)"},{"key":"ref_23","series-title":"of Computing and Statistics, Clinical Research Centre, Harrow, Middlesex; Dr P A Jenkins, head of; Cardiff; and Dr A R Somner, consultant physician, Chest Clinic, Wallsend, Tyne and Wear","article-title":"The study was organised by a subcommittee of the research committee of the British Thoracic Society, whose members were: Dr I A Campbell (chairman), consultant in thoracic medicine, Llandough and Sully hospitals, Cardiff; Dr C R McGavin (coordinator and compiler of the report), chest physician, Plymouth Chest Clinic; Dr J A R Friend, consultant in thoracic medicine, City Hospital, Aberdeen; Dr R M Greenwood, member of scientific team, Division","author":"Mycobacterium Reference Unit, University Hospital of Wales","unstructured":"The study was organised by a subcommittee of the research committee of the British Thoracic Society, whose members were: Dr I A Campbell (chairman), consultant in thoracic medicine, Llandough and Sully hospitals, Cardiff; Dr C R McGavin (coordinator and compiler of the report), chest physician, Plymouth Chest Clinic; Dr J A R Friend, consultant in thoracic medicine, City Hospital, Aberdeen; Dr R M Greenwood, member of scientific team, Division of Computing and Statistics, Clinical Research Centre, Harrow, Middlesex; Dr P A Jenkins, head of department, Mycobacterium Reference Unit, University Hospital of Wales, Cardiff; and Dr A R Somner, consultant physician, Chest Clinic, Wallsend, Tyne and Wear."},{"key":"ref_24","article-title":"A survey of notifications of tuberculosis in England and Wales in 1978 showed that disease of the lymph nodes was the commonest form of non-respiratory tuberculosis.' The British Thoracic Association's first controlled trial of chemotherapy for tuberculosis of lymph nodes compared two 18 month regimens in 90 patients.2 3 The regimens comprised either rifampicin plus isoniazid or ethambutol plus isoniazid, both supplemented with streptomycin for the first two months. A satisfactory response to chemotherapy was seen, and microbiological relapse did not occur when treatment was stopped. In a retrospective study of lymph node tuberculosis Summers and McNicol reported no relapse in 239 patients, some of whom were treated","volume-title":"rifampicin and isoniazid.4","year":"with nine month regimens incorporating","unstructured":"A survey of notifications of tuberculosis in England and Wales in 1978 showed that disease of the lymph nodes was the commonest form of non-respiratory tuberculosis.' The British Thoracic Association's first controlled trial of chemotherapy for tuberculosis of lymph nodes compared two 18 month regimens in 90 patients.2 3 The regimens comprised either rifampicin plus isoniazid or ethambutol plus isoniazid, both supplemented with streptomycin for the first two months. A satisfactory response to chemotherapy was seen, and microbiological relapse did not occur when treatment was stopped. In a retrospective study of lymph node tuberculosis Summers and McNicol reported no relapse in 239 patients, some of whom were treated with nine month regimens incorporating rifampicin and isoniazid.4"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.290.6475.1103","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.290.6475.1103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T14:49:39Z","timestamp":1765550979000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.290.6475.1103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1985,4,13]]},"references-count":24,"journal-issue":{"issue":"6475","published-online":{"date-parts":[[1985,4,13]]},"published-print":{"date-parts":[[1985,4,13]]}},"alternative-id":["10.1136\/bmj.290.6475.1103"],"URL":"https:\/\/doi.org\/10.1136\/bmj.290.6475.1103","relation":{},"ISSN":["0267-0623","1468-5833"],"issn-type":[{"value":"0267-0623","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1985,4,13]]}}}