Heart Rate Variability Biofeedback Decreases Blood Pressure in Prehypertensive Subjects by Improving Autonomic Function and Baroreflex

Department of Physiology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, People's Republic of China.
Journal of alternative and complementary medicine (New York, N.Y.) (Impact Factor: 1.59). 02/2012; 18(2):143-52. DOI: 10.1089/acm.2010.0607
Source: PubMed


Individuals with prehypertension are at risk of hypertension and cardiovascular diseases, and yet efficient interventions are lagging behind. Studies indicate that heart rate variability-biofeedback (HRV-BF) increases HRV and baroreflex sensitivity (BRS) as well as reduces related pathological symptoms, suggesting potentially beneficial effects of HRV-BF on prehypertension, but little is known about these effects. In this study, these effects were investigated and their mechanisms were explored.
The effect of HRV-BF on prehypertension in young adults and its potential mechanism were explored.
Forty-three (43) individuals with prehypertension were recruited and classified into three categories: HRV-BF group, slow abdominal breathing group, and control group. All groups were assessed with measurements of noninvasive blood pressure (BP), BRS, respiration, and galvanic skin response (GSR) at pre-intervention, in the entire process of each session, at postintervention, as well as at a 3-month follow-up. Interventions: Subjects participated in a 10-session HRV-BF protocol or simple slow abdominal breathing protocol conducted over 5 weeks. A 3-month follow-up was also performed on these individuals.
The incidence of prehypertension was as high as 14.5% in young college students. Individuals with prehypertension were lower in BRS (7.5±5.2 ms/mm Hg) and HRV (log10-transformed of the standard deviation of normal-to-normal beats [SDNN]=1.62±0.13 ms, lgTotal power of spectral density in the range of frequencies between 0 and 0.4Hz (TP)=8.02±0.55 ms2) than those with normal blood pressure (BRS=18.4±7.4 ms/mm Hg, lgSDNN=1.79±0.10 ms, lgTP=8.68±0.85 ms2). HRV-BF reduced blood pressure (from 131.7±8.7/79.3±4.7 mm Hg to 118.9±7.3 mm Hg/71.9±4.9 mm Hg, p<0.01), increased BRS (from 7.0±5.9 ms/mm Hg to 15.8±5.3 ms/mm Hg, p<0.01) and increased HRV (lgSDNN from 1.61±0.11 to 1.75±0.05 ms, and lgTP from 8.07±0.54 to 9.08±0.41 ms2, p<0.01). These effects were more obvious than those of the slow-breathing group, and remained for at least 3 months. HRV-BF also significantly increased vagus-associated HRV indices and decreased GSR (indices of sympathetic tone).
These effects suggest that HRV-BF, a novel behavioral neurocardiac intervention, could enhance BRS, improve the cardiac autonomic tone, and facilitate BP adjustment for individuals with prehypertension.

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    • "their resonance frequency) varies slightly from person to person based on individual differences in physiology and factors like height (Vaschillo et al., 2002; Vaschillo et al., 2006). A growing number of studies show HRV BFBBs potential for treating a variety of physical and mental disorders, including depression (Karavidas et al., 2007; Siepmann et al., 2008; Zucker et al., 2009), post-traumatic stress disorder (Tan, Dao, Farmer, Sutherland, & Gevirtz, 2011; Zucker et al., 2009), various anxiety disorders and stress symptoms (Henriques, Keffer, Abrahamson, & Horst, 2011; McCraty, Atkinson, Lipsenthal, & Arguelles, 2009; Nolan et al., 2005; Reiner, 2008), food craving (Meule, Freund, Skirde, Vögele, & Kübler, 2012), hypertension (Lin et al., 2012; McCraty et al., 2009; Nolan et al., 2005), chronic pain (Hallman, Olsson, von Schéele, Melin, & Lyskov, 2011; Hassett et al., 2007; Sowder, Gevirtz, Shapiro, & Ebert, 2010), asthma (Lehrer, Smetankin, & Potapova, 2000; Lehrer et al., 2004), and heart disease (Nolan et al., 2005). HRV BFB has also been shown to reduce symptom severity and improve quality of life for individuals with chronic obstructive pulmonary disease (Giardino, Chan, & Borson, 2004), and heart failure (Moravec, 2008), as well as for individuals reporting medically unexplained symptoms (Katsamanis et al., 2011). "
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    ABSTRACT: Heart rate variability biofeedback (HRV BFB) is a biobehavioral clinical intervention that is gaining growing empirical support for the treatment of a number of psychological disorders, several of which are highly comorbid with substance use disorders (SUDs). The present article reviews the autonomic nervous system bases of two key processes implicated in the formation and maintenance of addictive pathology—affect dysregulation and craving—and asks if HRV BFB may be an effective intervention to ameliorate autonomic nervous system dysregulation in these processes, and as such, prove to be an effective intervention for SUDs. A detailed description of HRV BFB and its delivery is provided. Preliminary evidence suggests HRV BFB may be an effective addendum to current first-line SUD treatments, though no firm conclusions can be drawn at this time; more research is needed.
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    • "It also suggested that various conditions affected by blood pressure lability and baroreflex control may be affected by HRV biofeedback. Thus, there is a growing body of evidence that a course of HRV biofeedback can help hypertensive patients lower their blood pressures (Nolan et al., 2010; Wang et al., 2010; Lin et al., 2012). "
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    Frontiers in Psychology 07/2014; 5:756. DOI:10.3389/fpsyg.2014.00756 · 2.80 Impact Factor
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    • "Essa tendência de (log) HF também foi observada no artigo de Nolan et al. (2010), juntamente com redução na pressão sistólica, o que não ocorreu no grupo treinado com relaxamento passivo autógeno. Quando o biofeedback de VFC é comparado ao treinamento realizado apenas com respiração abdominal , observa-se que ambas as técnicas reduzem a pressão sanguínea sistólica e diastólica, sendo essa redução mais significativa no primeiro caso (Lin et al., 2012). Essas alterações permaneceram três meses após o treinamento. "

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