Related Experiment Videos
Behavioral neurocardiac training in hypertension: a randomized, controlled trial
Robert P Nolan1, John S Floras, Paula J Harvey
1Division of Cardiology, Faculty of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada. rnolan@uhnres.utoronto.ca
Hypertension (Dallas, Tex. : 1979)
|March 3, 2010
Summary
Behavioral neurocardiac training (BNT) with heart rate variability biofeedback modestly lowered systolic blood pressure in hypertensive patients. This intervention also enhanced vagal heart rate modulation during mental stress, suggesting a promising new approach for hypertension management.
Area of Science:
- Cardiology
- Behavioral Medicine
- Psychophysiology
Background:
- Hypertension management often involves pharmacological therapy.
- The added benefit of behavioral interventions alongside medication is not well-established.
- Vagal heart rate modulation may play a role in blood pressure regulation during stress.
Purpose of the Study:
- To investigate if behavioral neurocardiac training (BNT) with heart rate variability (HRV) biofeedback further reduces blood pressure in hypertensive patients.
- To determine if BNT modifies vagal heart rate modulation during mental stress reactivity and recovery.
- To compare BNT with an active control (autogenic relaxation).
Main Methods:
- A randomized controlled trial with 65 patients with uncomplicated hypertension.
- Participants received either BNT with HRV biofeedback or autogenic relaxation (active control).
- Interventions consisted of six 1-hour sessions over 2 months with home practice; outcomes analyzed using linear mixed models adjusted for antihypertensive drugs.
Main Results:
- BNT significantly reduced daytime and 24-hour systolic blood pressure and pulse pressure compared to controls.
- BNT increased RR-high-frequency power and RR interval during cognitive tasks, indicating enhanced vagal modulation.
- No significant changes in spontaneous baroreflex sensitivity were observed with either intervention.
Conclusions:
- BNT with HRV biofeedback modestly lowers ambulatory blood pressure during wakefulness in hypertensive patients.
- BNT augments tonic vagal heart rate modulation, particularly during mental stress.
- BNT may be a promising adjunct or standalone intervention for hypertension management.
Related Concept Videos
01:28Hypertension IV: Drug Therapy and Lifestyle Modifications
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
01:23Hypertension V: Nursing Management
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
01:30Hypertension III: Clinical Manifestations and Diagnostic Studies
Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
01:18Hypertension and Regulation of Blood Pressure
Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
01:29Hypertension II: Pathophysiology
Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...