title: The effect of cognitive behavior therapy-based "forest therapy" program on blood pressure, salivary cortisol level, and quality of life in elderly hypertensive patients.
abstract: OBJECTIVE
  This article aimed to develop the "forest therapy" program, which is a cognitive behavior therapy (CBT)-based intervention program using forest environment, and investigate its effects on blood pressure (BP), salivary cortisol, and quality of life (QoL) measures in patients with hypertension.
  
  
  METHODS
  A total of 56 men and women were enrolled for this study, being referred from local health centers in Republic of Korea, from April to October 2009. They were conveniently assigned to either "forest" group participating in the forest therapy program or control group doing self-monitoring of BP. Measurements of salivary cortisol level and QoL were done at initial visits and at 8-week final visits.
  
  
  RESULTS
  Both groups did not differ significantly in baseline clinical characteristics. The BP change at week 4 and week 8 did not differ between the two groups. Salivary cortisol level reduction was significantly larger and QoL measures improved significantly more in the forest group at week 8 compared with the control group.
  
  
  CONCLUSIONS
  The forest therapy program did not induce prolonged systolic blood pressure (SBP) reduction. However, considering the significant decrease in cortisol level and improvement in QoL measures, this may be a useful model of community hypertension management program.
authors: Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Seoul, Republic of Korea.
authors: Jidong
authors: J
authors: Sung
authors: Jong-Min
authors: JM
authors: Woo
authors: Won
authors: W
authors: Kim
authors: Seoung-Kyeon
authors: SK
authors: Lim
authors: Eun-Joo
authors: EJ
authors: Chung
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004777:Environment; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D006973:Hypertension / Q000523:psychology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012463:Saliva / Q000378:metabolism; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy; D014197:Trees
chemical_list: D006854:Hydrocortisone