Graded blood pressure reduction in hypertensive outpatients associated with use of

Graded blood pressure reduction in hypertensive outpatients associated with use of a device to assist with slow breathing - Elliot et al. (2004)

Key Points

Slow breathing significantly reduces systolic blood pressure in hypertensive patients
The greater time spent breathing slowly, the greater the improvements in blood pressure
Only 5 minutes/day of slow breathing is needed to significantly improve blood pressure

The Breathing Diabetic Summary

We have learned from previous studies that slow breathing decreases blood pressure and increases heart rate variability. This paper examined if there was a minimum threshold for achieving these improvements, that is, is there a minimum effective dose?

The participants in this study were broken into a control and an intervention group. All subjects were asked to measure their blood pressure 3 times in the morning. In the evening, the intervention group performed 15 min of slow breathing using RESPeRATE®, a device that gradually guided their breathing toward slower rates. Instead of slow breathing, the control group was asked to measure their blood pressure 3 more times in the evening. The participants did not change their physical activity or dietary habits.

The patients who performed slow breathing significantly reduced their systolic blood pressure. Moreover, as we might expect, the authors found a correlation between the length of time spent breathing slowly and the reduction in blood pressure. A statistical analysis revealed that the threshold separating “low users” with “high users” was 180 min of slow breathing over the 8-week study period.

Overall, this study found that 180 min of slow breathing over an 8-week period was required to significantly improve systolic blood pressure. This equates to 23 minutes a week, or less than 5 minutes a day! Obviously, everyone is different and this is only one study, but these results are incredibly encouraging if you are a diabetic with hypertension. Simply adding 5 minutes/day of slow breathing onto your current treatment could significantly improve your blood pressure control.

Abstract from Paper

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.

Journal Reference:

William J. Elliott, MD, PhD; Joseph L. Izzo, Jr, MD; William B. White, MD; Douglas R. Rosing, MD; Christopher S. Snyder, DO; Ariela Alter, PhD; Benjamin Gavish, PhD; Henry R. Black, MD, (2004) Graded blood pressure reduction in hypertensive outpatients associated with use of a device to assist with slow breathing, The Journal of Clinical Hypertension, VI (X), 553 – 559.