Introduction
The continual rise in cardiovascular disease, led by hypertension, requires innovative treatment [1]. Patients are becoming younger; Russian authors report prevalence of 4.8–14.3% among children and adolescents [3]. Early treatment prioritises nondrug therapy, including physiotherapy [4], but no unified evidence-based paediatric hypertension rehabilitation programme yet exists [2]. Considering disease mechanisms and a gentle physiotherapy approach, normobaric hypoxic therapy, Mountain Air, merits investigation as an artificial physical factor close to natural conditions and safe for children [6].
Study design
A prospective cohort study at the SC ME ESSC RAMS clinic included 166 hypertensive children and adolescents. Group I comprised 91 receiving conventional care plus normobaric hypoxic therapy; group II comprised 75 receiving conventional care and standard electrotherapy. Allocation was not preselected but followed children’s and parents’ preference for hypoxic therapy. Follow-up ran from treatment initiation through four months after completion. Age distribution is in Table 1; sex composition scarcely differed (Table 2).
Boys predominated over girls in Table 2. This was incidental, probably related to medical examinations before military registration.
Methods
Group I received normobaric hypoxic therapy using our modified method. Sessions began in the morning at least 30 minutes after food, with EVEREST-1, Russia, model MPFK.941589.001-05PS. Ten daily procedures used intermittent hypoxic breathing for 10–40 minutes. All underwent standard ambulatory blood-pressure monitoring at admission and three months after treatment. Neuropsychological strain is a major hypertension risk factor [5]. Hypertension is associated with sensitive personality traits, increasingly common as severity rises [7]. We therefore examined anxiety before and after treatment using J. Taylor’s 1991 test, which additionally assesses response sincerity.
Results
Data were standardised. Discriminant analysis identified significant group differences, and the F-test confirmed symptom informativeness. Ambulatory monitoring showed significantly lower average daily blood pressure in group I (Figures 1,2). Hypoxic therapy stabilised hypertension time index at ages 12–15 and significantly reduced it above age 15, from 38.5±3.2 to 29.4±3.38. Controls showed no significant differences; at 12–15 stable hypertension continued developing and the index rose from 35.81±2.21 to 47.65±4.88.
Baseline anxiety was higher in group I, corresponding to a high level, and became moderate after treatment. Controls showed no significant difference (Table 3).
Conclusions
Normobaric hypoxic therapy significantly reduces average daily blood pressure. Stabilisation or reduction of hypertension time index suggests a more favourable prognosis than controls. It also significantly reduces emotional strain, one of hypertension’s initiating factors, thereby improving quality of life.
Age
| Age | I, n=91 | II, n=75 |
|---|---|---|
| 12–15 years | 41 (45,05%) | 26 (34,67%) |
| Over 15 | 50 (54,95%) | 49 (65,33%) |
Sex
| Sex | I: 12–15 | I: >15 | II: 12–15 | II: >15 |
|---|---|---|---|---|
| Boys | 29 (70,73%) | 34 (68,0%) | 23 (88,4%) | 35 (71,43%) |
| Girls | 12 (29,27%) | 16 (32,0%) | 3 (11,6%) | 14 (28,57%) |
Anxiety
| Group | Before | After |
|---|---|---|
| I: 12–15 | 23,8±1,1 | 16,98±1,1* |
| I: >15 | 21,62±1,1 | 15,14±1,0* |
| II: 12–15 | 18,04±1,7 | 17,08±1,7 |
| II: >15 | 19,71±1,2 | 19,31±1,1 |
* p<0.05 comparing groups I and II.
References
1. Алмазов В.А. Профилактика, диагностика и лечение первичной артериальной гипертонии в Российской федерации. Доклад экспертов ВОЗ /
2. Автандилов А.Г. Рекомендации по диагностике, лечению и профилактике артериальной гипертензии у детей и подростков / А.Г. Автандилов // Методические рекомендации для врачей. – Волгоград, 2003. – 43 с.
3. Боголюбов В.М. Программы физиотерапии артериальной гипертонии / В.М. Боголюбов // Физиотерапия, бальнеология и реабилитация. – 2002. – № 3. – С. 51.
4. Брязгунов И.П. Первичная артериальная гипертензия у детей и подростков / И.П. Брязгунов // Вопросы современной педиатрии. – М., 2003. – Т. 2, № 3. – С. 68–71.
5. Долгих В.В. Патогенез эссенциальной артериа льно й ги пертензи и у детей / В.В. До лгих, Л.И. Колесникова // Иркутск: Изд-во ВСНЦ СО РАМН, 1999. – С. 16.
6. Закощиков К.Ф. Гипокситерапия – «Горный воздух» / К.Ф. Закощиков, С.О. Катин. – М., 2005. – 64 с.
7. Ровда Ю.И. Факторы риска и их значимость в развитии артериальной гипертензии у детей / Ю. И. Ровда // Педиа три я. – 1993. – № 6. – С. 97–30.
Full main-text translation of: Власенко А.В., Долгих В.В., Рычкова Л.В., Бугун О.В. Влияние нормобарической гипокситерапии на эмоциональное состояние детей и подростков с артериальной гипертензией. Бюллетень ВСНЦ СО РАМН. 2007;3(55):29–31.
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