Department of Physiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China.
J Altern Complement Med. 2012 Feb;18(2):143-52. doi: 10.1089/acm.2010.0607.
Individuals with prehypertension are at risk of hypertension and cardiovascular diseases, and yet efficient interventions are lagging behind. Studies indicate that heart rate variability-biofeedback (HRV-BF) increases HRV and baroreflex sensitivity (BRS) as well as reduces related pathological symptoms, suggesting potentially beneficial effects of HRV-BF on prehypertension, but little is known about these effects. In this study, these effects were investigated and their mechanisms were explored.
The effect of HRV-BF on prehypertension in young adults and its potential mechanism were explored.
Forty-three (43) individuals with prehypertension were recruited and classified into three categories: HRV-BF group, slow abdominal breathing group, and control group. All groups were assessed with measurements of noninvasive blood pressure (BP), BRS, respiration, and galvanic skin response (GSR) at pre-intervention, in the entire process of each session, at postintervention, as well as at a 3-month follow-up.
Subjects participated in a 10-session HRV-BF protocol or simple slow abdominal breathing protocol conducted over 5 weeks. A 3-month follow-up was also performed on these individuals.
The incidence of prehypertension was as high as 14.5% in young college students. Individuals with prehypertension were lower in BRS (7.5±5.2 ms/mm Hg) and HRV (log10-transformed of the standard deviation of normal-to-normal beats [SDNN]=1.62±0.13 ms, lgTotal power of spectral density in the range of frequencies between 0 and 0.4Hz (TP)=8.02±0.55 ms2) than those with normal blood pressure (BRS=18.4±7.4 ms/mm Hg, lgSDNN=1.79±0.10 ms, lgTP=8.68±0.85 ms2). HRV-BF reduced blood pressure (from 131.7±8.7/79.3±4.7 mm Hg to 118.9±7.3 mm Hg/71.9±4.9 mm Hg, p<0.01), increased BRS (from 7.0±5.9 ms/mm Hg to 15.8±5.3 ms/mm Hg, p<0.01) and increased HRV (lgSDNN from 1.61±0.11 to 1.75±0.05 ms, and lgTP from 8.07±0.54 to 9.08±0.41 ms2, p<0.01). These effects were more obvious than those of the slow-breathing group, and remained for at least 3 months. HRV-BF also significantly increased vagus-associated HRV indices and decreased GSR (indices of sympathetic tone).
These effects suggest that HRV-BF, a novel behavioral neurocardiac intervention, could enhance BRS, improve the cardiac autonomic tone, and facilitate BP adjustment for individuals with prehypertension.
患有高血压前期的个体有患高血压和心血管疾病的风险，但有效的干预措施却滞后。研究表明，心率变异性生物反馈（HRV-BF）可以增加心率变异性（HRV）和压力反射敏感性（BRS），同时降低相关的病理症状，这表明 HRV-BF 对高血压前期可能有潜在的有益作用，但对这些作用知之甚少。在这项研究中，我们探讨了这些影响及其潜在机制。
探讨 HRV-BF 对年轻成年人高血压前期的影响及其潜在机制。
招募了 43 名高血压前期患者，并将其分为三组：HRV-BF 组、缓慢腹式呼吸组和对照组。所有组在干预前、整个疗程中、干预后以及 3 个月随访时均进行非侵入性血压（BP）、BRS、呼吸和皮肤电反应（GSR）的测量。
受试者参加了为期 10 次的 HRV-BF 方案或简单的缓慢腹式呼吸方案，共 5 周。对这些个体也进行了 3 个月的随访。
在年轻大学生中，高血压前期的发病率高达 14.5%。高血压前期患者的 BRS（7.5±5.2ms/mm Hg）和 HRV（窦性心搏之间标准差的对数变换[SDNN]=1.62±0.13ms，频带 0 到 0.4Hz 之间的频谱密度总功率的对数[TP]=8.02±0.55ms2）均低于正常血压者（BRS=18.4±7.4ms/mm Hg，lgSDNN=1.79±0.10ms，lgTP=8.68±0.85ms2）。HRV-BF 降低了血压（从 131.7±8.7/79.3±4.7mmHg 降至 118.9±7.3mmHg/71.9±4.9mmHg，p<0.01），增加了 BRS（从 7.0±5.9ms/mm Hg 增至 15.8±5.3ms/mm Hg，p<0.01）和 HRV（lgSDNN 从 1.61±0.11 增至 1.75±0.05ms，lgTP 从 8.07±0.54 增至 9.08±0.41ms2，p<0.01）。这些效果比缓慢呼吸组更明显，且至少持续 3 个月。HRV-BF 还显著增加了与迷走神经相关的 HRV 指数，并降低了 GSR（交感神经张力指数）。
这些结果表明，HRV-BF 作为一种新型行为神经心脏干预措施，可增强 BRS、改善心脏自主神经张力，并促进高血压前期患者的血压调节。
