Capnometric feedback training decreases 24-h blood pressure in hypertensive postmenopausal women.
Capnometric feedback training decreases 24-h blood pressure in hypertensive postmenopausal women.
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DOI：
10.1186/s12872-021-02240-x
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发表时间：
2021-09-17
影响因子：
2.1
通讯作者：
Chesney MA
中科院分区：
文献类型：
--
作者：
Anderson DE;Reeves AN;Mehling WE;Chesney MA
高正常静息pCO 2是血压正常人群血压（BP）盐敏感性的危险因素，并与绝经后妇女较高的静息收缩压相关。然而，迄今为止，还没有已知的研究调查过定期进行自愿轻度低二氧化碳呼吸对高血压患者血压的影响。本研究的目的是验证二氧化碳监测反馈训练可以降低一系列轻度高血压绝经后妇女的静息pCO 2和24小时BP的假设。构建了一个小型便携式呼气末CO2（etCO 2）监测仪，并配备了确定瞬时etCO 2和预编程标准范围之间差异的软件。监护仪启用了CO2变化超出标准范围的听觉反馈。16名轻度高血压绝经后妇女接受单独训练，以在诊所每周6次和家中每日一次的治疗期间维持etCO 2的小幅下降。在干预前后进行24小时血压监测，并在对照组中的16名绝经后高血压前期妇女谁没有从事二氧化碳监测训练。干预后，所有16名二氧化碳监测训练参与者的静息etCO 2均下降（− 4.3 ± 0.4 mmHg; p <0.01），而15名参与者的24小时收缩压下降（− 7.6 ± 2.0 mmHg; p <0.01）。在对照组中没有观察到这两项指标的显著变化。此外，在二氧化碳监测训练后，夜间（− 9.5 ± 2.6; p <0.01）和白天（− 6.7 ± 0.2 mmHg）收缩压均降低，而对照组的夜间（− 2.8 ± 2.2 mmHg; p = 0.11）或白天（− 0.7 ± 1.0 mmHg; p ≤ 0.247）收缩压无显著变化。这些研究结果支持了以下假设：定期进行轻度低碳酸血症呼吸，降低静息etCO 2，可靠地降低高血压绝经后妇女的24小时血压。这些影响持续超过训练期或在其他高血压亚组中观察到的程度仍有待研究。
High normal resting pCO2 is a risk factor for salt sensitivity of blood pressure (BP) in normotensive humans and has been associated with higher resting systolic BP in postmenopausal women. To date, however, no known studies have investigated the effects of regular practice of voluntary mild hypocapnic breathing on BP in hypertensive patients. The objective of the present research was to test the hypothesis that capnometric feedback training can decrease both resting pCO2 and 24-h BP in a series of mildly hypertensive postmenopausal women. A small portable end tidal CO2 (etCO2) monitor was constructed and equipped with software that determined the difference between the momentary etCO2 and a pre-programmed criterion range. The monitor enabled auditory feedback for variations in CO2 outside the criterion range. 16 mildly hypertensive postmenopausal women were individually trained to sustain small decreases in etCO2 during six weekly sessions in the clinic and daily sessions at home. 24-h BP monitoring was conducted before and after the intervention, and in 16 prehypertensive postmenopausal women in a control group who did not engage in the capnometric training. Following the intervention, all 16 capnometric training participants showed decreases in resting etCO2 (− 4.3 ± 0.4 mmHg; p < .01) while 15 showed decreases in 24-h systolic BP (− 7.6 ± 2.0 mmHg; p < .01). No significant changes in either measure was observed in the control group. In addition, nighttime (− 9.5 ± 2.6; p < .01) and daytime (− 6.7 ± 0.2 mmHg) systolic BP were both decreased following capnometric training, while no significant changes in nighttime (− 2.8 ± 2.2 mmHg; p = .11) or daytime (− 0.7 ± 1.0 mmHg; p ≤ .247) systolic BP were observed in the control group. These findings support the hypothesis that regular practice of mild hypocapnic breathing that decreases resting etCO2 reliably decreases 24-h blood pressure in hypertensive postmenopausal women. The extent to which these effects persist beyond the training period or can be observed in other hypertensive subgroups remains to be investigated.
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