心率变异性生物反馈对高血压前期患者应激反应的干预效果

Effects of heart rate variability biofeedback on cardiovascular stress response of prehypertensives

目的探讨心率变异性生物反馈(HRV BF)干预高血压前期患者心血管应激反应的效果。方法比较高血压前期者与正常血压者应激反应上血压变化的差异;将36位高血压前期受试者随机分为心率变异性生物反馈(HRV BF)组、慢腹式呼吸(SAB)组和空白对照组。干预组受试者接受每次30 min,每周2次,持续2个月共15次的训练;空白对照组不予干预。实验间隔期嘱受试者每天进行不少于20 min的家庭训练。所有受试者在实验开始前及实验结束后均接受连续2 d同一时间点进行的两种应激测试。结果高血压前期者较正常血压者在应对心算应激时收缩压和舒张压反应性更大。干预2个月后,HRV BF和SAB组收缩压和舒张压平均降压幅度分别为15.4/10.2 mmHg、11.6/7.4 mmHg;空白对照组干预后血压无明显变化。HRV BF能显著降低受试者心算应激时收缩压反应性,较SAB更为明显。结论高血压前期者应激反应性较高,HRV BF训练可以降低受试者应对心理应激时心血管的反应,并降低高血压前期者血压。

Objective The present study aims to evaluate the effects of heart rate variability biofeedback on the cardiovascular stress response in prehypertension patients.Methods Cardiovascular response to stressors was compared between subjects with prehypertension and normotension.36 subjects with prehypertension（blood pressure ranging 120-80-139/89 mmHg） were randomized to heart rate variability biofeedback group（HRV BF）,slow abdominal breathing group（SAB） and Blank control（Blank）.Subjects in the intervention groups received 15 sessions of training for 2 months with each session lasting for 30 min.Subjects in the control group received no intervention,with BP measurement only in the first and last session.All subjects received two different laboratory stressors at the same time point at two different days for both the pre-and post-intervention.Results Prehypertension subjects had a greater BP change during MAT compared to normotension subjects.Both HRV BF and SAB could significantly reduce systolic blood pressure（SBP） and diastolic blood pressure（DBP） by 15.4/10.2 mmHg and 11.6/7.4 mmHg,respectively.SBP response to MAT was also significantly reduced after both HRVBF,with a significant difference in HRV BF as compared with SAB.Conclusion Prehypertensive patients have an abnormal cardiovascular response.HRV BF training can effectively reduce BP and cardiovascular response elicited by mental activity.