Chen S, Sun P, Wang S, Lin G, Wang T
Department of Physiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
Department of Physiology, Kiang Wu Nursing College of Macau, Macau, China.
J Hum Hypertens. 2016 Feb;30(2):105-11. doi: 10.1038/jhh.2015.27. Epub 2015 Apr 30.
Autonomic dysfunction is implicated in prehypertension, and previous studies have suggested that therapies that improve modulation of sympathovagal balance, such as biofeedback and slow abdominal breathing, are effective in patients with prehypertension at rest. However, considering that psychophysiological stressors may be associated with greater cardiovascular risk in prehypertensives, it is important to investigate whether heart rate variability biofeedback (HRV-BF) results in equivalent effects on autonomic cardiovascular responses control during stressful conditions in prehypertensives. A total of 32 college students with prehypertension were enrolled and randomly assigned to HRV-BF (n=12), slow abdominal breathing (SAB, n=10) or no treatment (control, n=10) groups. Then, a training experiment consisting of 15 sessions was employed to compare the effect of each intervention on the following cardiovascular response indicators before and after intervention: heart rate (HR); heart rate variability (HRV) components; blood volume pulse amplitude (BVPamp); galvanic skin response; respiration rate (RSP); and blood pressure. In addition, the cold pressor test and the mental arithmetic challenge test were also performed over two successive days before and after the invention as well as after 3 months of follow-up. A significant decrease in HR and RSP and a significant increase in BVPamp were observed after the HRV-BF intervention (P<0.001). For the HRV analysis, HRV-BF significantly reduced the ratio of low-frequency power to high-frequency power (the LF/HF ratio, P<0.001) and increased the normalized high-frequency power (HFnm) (P<0.001) during the stress tests, and an added benefit over SAB by improving HRV was also observed. In the 3-month follow-up study, similar effects on RSP, BVPamp, LF/HF and HFnm were observed in the HRV-BF group compared with the SAB group. HRV-BF training contributes to the beneficial effect of reducing the stress-related cardiovascular response in prehypertensives by improving autonomic sympathovagal modulation.
自主神经功能障碍与高血压前期有关，先前的研究表明，改善交感神经-迷走神经平衡调节的疗法，如生物反馈和缓慢的腹式呼吸，对静息状态下的高血压前期患者有效。然而，考虑到心理生理应激源可能与高血压前期患者更高的心血管风险相关，研究心率变异性生物反馈（HRV-BF）在应激状态下对高血压前期患者自主心血管反应控制是否有同等效果很重要。总共招募了32名高血压前期大学生，并将他们随机分为HRV-BF组（n = 12）、缓慢腹式呼吸组（SAB，n = 10）或无治疗组（对照组，n = 10）。然后，采用一个由15节课程组成的训练实验，比较每种干预措施对干预前后以下心血管反应指标的影响：心率（HR）；心率变异性（HRV）成分；血容量脉搏幅度（BVPamp）；皮肤电反应；呼吸频率（RSP）；以及血压。此外，在干预前后以及随访3个月后，连续两天进行冷加压试验和心算挑战试验。HRV-BF干预后观察到HR和RSP显著降低，BVPamp显著增加（P < 0.001）。对于HRV分析，HRV-BF在应激测试期间显著降低了低频功率与高频功率之比（LF/HF比值，P < 0.001），并增加了标准化高频功率（HFnm）（P < 0.001），并且还观察到通过改善HRV比SAB有额外益处。在3个月的随访研究中，与SAB组相比，HRV-BF组在RSP、BVPamp、LF/HF和HFnm方面观察到类似的效果。HRV-BF训练通过改善自主交感神经-迷走神经调节，有助于降低高血压前期患者与应激相关的心血管反应。
