CLINICAL EFFECTS OF BLOOD PRESSURE BIOFEEDBACK ON ESSENTIAL HYPERTENSION

为探讨血压生物反馈（BP）治疗原发性高血压的临床疗效及心理应激试验对心血管反应的改善作用，将30例原发性高血压患者随机分为A、B组，A组接受4次BP治疗，B组接受4次BP治疗。B组在对照期间自行监测血压，随后进行与A组相同的BE治疗。在治疗期间，B组血压显著降低17*18/8*7 mmHg（p<0.01）A.in，在对照期间没有显著变化，但在治疗期间血压显著降低20 × 15/9 × 7 mmHg（p<0.05）。并且，BE治疗在A组和B组中均显著抑制由心理应激测试（心算任务）引起的心血管反应增强。另一项研究旨在评估原发性高血压患者对心理应激的反应。本文观察了10例门诊高血压病人在心算任务（MAT）和画镜试验（MDT）中的血流动力学和内分泌变化。MAT期间血压显著升高37.8*11.1/17.5*3.1 mmHg（p<0.01），MDT期间血压显著升高41.0*9.4/21.2*3.9 mmHg（p<0.01）。MAT和MDT时血浆去甲肾上腺素和肾上腺素水平均显著升高（P<0.01），去甲肾上腺素对MAT和MDT的反应相似，而肾上腺素对MAT的反应强于MDT，提示MAT可能比MDT更能激活交感肾上腺髓质系统。

The purpose of this study is to discuss the clinical effects of blood pressure biofeedback (BF) on essential hypertension, and to investigate the modification of cardiovascular responses induced by the mental stress test.The subjects of this study were thirty outpatients with essential hypertension (10 men and 20 women), which were randomly assigned to group A or B.Subjects of group A underwent four BE treatment sessions. Those of group B monitored their blood pressure by oneself during the control period, and later underwent the same BE treatment as group A.There were significant blood pressure reduction by 17*18/8*7 mmHg (p<.01) during the treatment period in group A.in group B, there were no significant changes during the control period but significant blood pressure reduction by 20*15/9*7 mmHg (p<.05) during the treatment period. And, the enhanced cardiovascular responses induced by the mental stress test (the mental arithmetic task) were significantly suppressed by the BE treatment in both group A and B.Another study aimed to evaluate the reactivity to psychological stress in patients with essential hypertension. We investigated the hemodynamic and endocrinological changes during the mental arithmetic task (MAT) and the mirror drawing test (MDT) in 10 hypertensive outpatients. There were significant blood pressure elevations by 37.8*11.1/17.5*3.1 mmHg (p<.01) during MAT, and by 41.0*9.4/21.2*3.9 mmHg (p<.01) during MDT, respectively. The plasma levels of Norepinephrine and Epinephrine also increased significantly (p<.01) during both MAT and MDT.Although Norepinephrine had similar response to both MAT and MDT, Epinephrine had more response to MAT than to MDT.By the results of this study, it was indicated that the sympathoadrenomedullary system might be more activated by MAT than MDT.