Behavioral Neurocardiac Training in Hypertension A Randomized, Controlled Trial
Behavioral Neurocardiac Training in Hypertension A Randomized, Controlled Trial
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DOI：
10.1161/hypertensionaha.109.146233
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发表时间：
2010-04-01
期刊：
影响因子：
8.3
通讯作者：
Chen, Maggie H.
中科院分区：
文献类型：
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作者：
Nolan, Robert P.;Floras, John S.;Chen, Maggie H.
行为干预是否能增加药物治疗对高血压的益处尚不明确。我们假设，行为神经心脏训练（BNT）与心率变异性生物反馈将通过修改迷走神经心率调制在反应性和恢复标准化的认知任务（“精神压力”），进一步降低血压。这项随机对照试验招募了65例无并发症的高血压患者，接受BNT或主动控制（自体放松），在2个月内进行6次1小时的家庭练习。结果用线性混合模型分析，调整了抗高血压药物。BNT降低了白天和24小时收缩压（分别为-2.4 +/- 0.9 mm Hg，P=0.009和-2.1 +/- 0.9 mm Hg，P=0.03）和脉压（分别为-1.7 +/- 0.6 mm Hg，P=0.004和-1.4 +/- 0.6 mm Hg，P=0.02）。对照组未观察到影响（所有指标P>0.10）。BNT还增加RR高频功率（0.15 - 0.40 Hz; P=0.01）和RR间期（P
It is not established whether behavioral interventions add benefit to pharmacological therapy for hypertension. We hypothesized that behavioral neurocardiac training (BNT) with heart rate variability biofeedback would reduce blood pressure further by modifying vagal heart rate modulation during reactivity and recovery from standardized cognitive tasks ("mental stress"). This randomized, controlled trial enrolled 65 patients with uncomplicated hypertension to BNT or active control (autogenic relaxation), with six 1-hour sessions over 2 months with home practice. Outcomes were analyzed with linear mixed models that adjusted for antihypertensive drugs. BNT reduced daytime and 24-hour systolic blood pressures (-2.4 +/- 0.9 mm Hg, P=0.009, and -2.1 +/- 0.9 mm Hg, P=0.03, respectively) and pulse pressures (-1.7 +/- 0.6 mm Hg, P=0.004, and -1.4 +/- 0.6 mm Hg, P=0.02, respectively). No effect was observed for controls (P>0.10 for all indices). BNT also increased RR-high-frequency power (0.15 to 0.40 Hz; P=0.01) and RR interval (P