Abstract
The present study aimed to evaluate the influence of cardiac coherence through Biofeedback Therapy (BT) with paced breathing on blood pressure, stress and anxiety levels in individuals with essential arterial hypertension. The participants underwent 8 sessions of paced breathing guided by biofeedback visual therapy for 20 minutes, in which they were evaluated through clinical assessment, Hamilton Anxiety Rating Scale, Perceived Stress Scale and cardiovascular variables. Comparisons of means were performed using the paired and unpaired Student's t-test. Statistically significant correlations were considered when p ≤ 0.05 with a 95% confidence interval. The effect size (Cohen's d) and common language effect size were calculated to assess the effect of such therapy. Sixteen patients with mean age of 57.3 ± 14 years old participated in this study. Comparisons between mean initial and final systolic blood pressure levels (SBP) in women (p = 0.007; Cohen's d = 0.50), pre- and post-training heart rate (p = 0.02; Cohen's d = 0.60) and anxiety levels (p = 0.01; Cohen's d = 1.04) were significant. Comparisons between pre- and post-training SBP (p = 0.006; Cohen's d = 0.81) and pre- and post-training anxiety levels (p = 0.04; Cohen's d = 0.32) were significant among males. In conclusion, paced breathing training with biofeedback therapy can be promising to reduce anxiety levels in individuals with essential arterial hypertension.
Highlights
Arterial hypertension (AH) is a chronic disease displaying multifactorial etiology (Brazilian Society of Cardiology, 2016)
Among the determinant risk factors for AH development, psychosocial factors play a significant role on AH aggravation, being psychosocial stress and anxiety commonly observed in such population (Whelton et al, 2018), since the clinical and subclinical levels of these emotional conditions influence biological pathways of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, interfering in the cascade processes involved in blood pressure (BP) regulation (Trudel-Fitzgerald et al, 2015)
In view of the high worldwide prevalence of AH and its elevated costs for health systems, studies that investigate the effects of new therapeutic strategies combined with drug therapy are important this study aimed to evaluate the effects of paced breathing guided by biofeedback therapy (BT) on BP, stress and anxiety levels in hypertensive individuals
Summary
Arterial hypertension (AH) is a chronic disease displaying multifactorial etiology (Brazilian Society of Cardiology, 2016). Studies claim that meditation techniques, behavioral psychotherapies (Bai et al, 2015; Sharma & Rush, 2014), relaxation and biofeedback therapy (BT) (Brook et al, 2013) demonstrate significant effects on these patients, due to their decreasing effects on BP levels (Greenberg et al, 20088) Such therapies may provide self-regulation of the autonomic nervous system, providing effects on cardiac coherence, i.e., the balance between heart rate (HR) and respiratory rate (RR), as well as on muscle contraction, BP and brain activity (Neto, 2010; Gomes & Coghi & Coghi, 2016); the reduction of anxiety and stress levels are expected. All these events can contribute with a positive influence on BP control (Bhardwaj et al, 2020)
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