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Effects of guided breathing on blood pressure and heart rate variability in hypertensive diabetic patients

2013; Elsevier BV; Volume: 179; Issue: 1-2 Linguagem: Inglês

10.1016/j.autneu.2013.08.065

1872-7484

Kinga Howorka, Jiri Pumprla, Jennifer Tamm, Alfred Schabmann, Sophie Klomfar, Elysee Kostineak, Nora Howorka, Eliška Sovová,

Cardiovascular and exercise physiology

Abstract Objective Our aim was to investigate medium-term effects of device-guided breathing on blood pressure (BP) and its capacity to improve the cardiovascular autonomic balance in hypertensive diabetic patients. This feasibility study was conceived as a proof-of-concept trial under real life conditions for justification of further investigations. Methods A randomized, controlled study (RCT) of the effects of device-guided slow breathing on top of usual care against usual care alone (including non-pharmacological and pharmacological treatment). The intervention included 12-min sessions of guided breathing performed daily for 8weeks. Treatment effects were assessed with ambulatory blood pressure monitoring (24h ABPM) and with spectral analysis of short-term heart rate variability (HRV) obtained during standardized modified orthostatic load. Thirty-two subjects with diabetes and antihypertensive therapy were randomly assigned to both study groups. Results After 8weeks of guided breathing, significant reductions were demonstrated in 24h systolic BP (x±SEM: 126.1±3.0 vs 123.2±2.7mmHg, p=0.01), and in 24h pulse pressure (PP, 53.6±2.6 vs. 51.3±2.5mmHg, p=0.01), whereas no significant impact in the control group was shown. The differences in treatment effects (delta mmHg, RESPeRATE® vs control) were significant only for PP (−2.3±0.8 vs +0.2±1.2mmHg, p<0.05). Strong baseline dependence of treatment effects (delta systolic BP) was observed (p<0.01). Guided breathing showed a stronger treatment effect in terms of an increase in HRV, predominantly in low frequency band (p<0.03 vs. usual care). Conclusion Even in well controlled hypertensive diabetic patients, guided breathing induced relevant effects on BP and HRV, finding which should be investigated further.