Efficacy versus effectiveness of relaxation therapy in hypertension

Abstract Non‐pharmacological measures are gaining popularity in the reduction of mildly elevated blood pressure. Their efficacy has been reported in a number of controlled trials. However, efficacy does not automatically ensure effectiveness in everyday clinical practice. Three main factors are likely to determine the effectiveness of relaxation or stress reduction therapy (relaxation techniques plus stress management strategies): 1) the efficacy of the treatment, 2) the characteristics of the therapists and 3) the characteristics of the patients to whom the treatment is applied. Reviewing the literature, and our own studies, we conclude that therapy is more likely to be effective if it includes relaxation techniques as well as behavioural and cognitive strategies, taught by an experienced and committed therapist to highly motivated patients living in favourable family and social surroundings.