Graded blood pressure reduction in hypertensive outpatients associated with use of a device to assist with slow breathing

Abstract

To study the effects of device-guided breathing on office systolic blood pressure (SBP), five centers randomized 149 untrained hypertensives (50% male, age 59+/-10 years, baseline blood pressure 150+/-9/86+/-9 mm Hg, 77% taking drug therapy). One half received a device to guide slow breathing; all received a home blood pressure monitor and only simple, written instructions. The changes in office SBP (adjusted for office-to-home difference in baseline SBP and accumulated time spent in slow breathing, guided and measured by the device) were significantly (p<0.001 for trend) correlated with accumulated time spent in slow breathing. Greater decreases in SBP (-15.0+/-1.8 vs. -7.3+/-1.9 mm Hg) were observed for those who spent more (vs. less) than 180 minutes over 8 weeks in slow breathing, as well as those who just monitored their blood pressure at home (-9.2+/-1.6 mm Hg). Thus, even without training, hypertensive patients who receive a device to guide slow breathing significantly lowered their office SBP if the total time spent in slow breathing over 8 weeks exceeded a "threshold" value of 180 minutes.

Figures

Figure 1

Correlation of individual patient changes in office systolic blood pressure (SBP) (y‐axis) on total time spent in slow device‐guided breathing (x‐axis) in 76 patients. The vertical dotted line marks the 180‐minute threshold value that best separates low users (empty circles) from high users (filled circles), and the filled arrow marks the minimum slow breathing time recommended by the user's manual. The adjusted analysis refers to a regression analysis that incorporated the office‐to‐home blood pressure (BP) differences for each participant.

Figure 2

Dose‐response relationship between mean office systolic blood pressure (SBP) and the total time (minutes) spent in slow breathing after grouping the data of Figure 1 (p<0.02 for trend). Error bars denote one standard error of the mean.