An analysis of the placebo effect in hospitalized hypertensive patients

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Abstract
A study was done in which six patients with moderately severe essential hypertension without significant end‐organ disease were hospitalized and treated with placebo only. Placebo was administered in gradually increasing doses and then discontinued in the reverse order. A significant fall in blood pressure from that seen in the outpatient clinic and that on admission to the hospital was demonstrated in all patients. Analyses of these data indicated that the major component to the decline was the hospitalization per se and not the administration of the placebo. Cumulative drug effects and dose‐response patterns were not noted with the placebo to any significant extent. A major component of the effect of hospitalization appears to be the removal of pressor stimuli of psychological origin including the procedure of the blood pressure measurement itself, in addition to physical inactivity. The data also demonstrated a striking difference between blood pressure readings taken by nurses and doctors, primarily in the systolic component. Following discharge from the hospital and initiation of specific drug therapy, blood pressure levels returned toward their original levels but did not rise as high as they had been preViously.