P-425a: Hypertension reduction by device-guided breathing has a dose-response relationship

Abstract

To evaluate the blood pressure (BP) response of hypertensive patients to routine home use of device-guided breathing (DGB), 135 hypertensive patients (systolic BP [SBP] > 140 mm Hg at 2 office visits) were studied. Of the patients (53% male; age 59±10 years; BMI 29±4 kg/m²), 76% took antihypertensive drug therapy, 41% required ≥ 3 drugs, and 67% had isolated systolic hypertension. Patients were randomized into either treatment (n=54) or control (n=57) groups; an additional 24 were assigned to treatment only. Treated patients slowed their respiratory rate over 8 weeks by prolonging expiration for 15 minutes daily using DGB (RESPeRATE, InterCure). The study was double-blinded in two ways: 1) all patients self-monitored home BP daily using a digital BP monitor (with automatic data logging); 2) DGB was not mentioned on enrollment and patients in the treatment group were self-trained. The primary endpoint was change in office SBP from baseline to end of treatment. BP reduction was linearly correlated with total slow breathing time (TSBT) accumulated during the treatment period (slope [mean±SE] = 1.0±0.3 mm Hg for 1 hr of SB, p<0.005). BP reduction in a subgroup of 32 high users of DGB (TSBT > 3 hrs) was significantly greater than in the 34 low users (TSBT ≤ 3 hour; SBP difference of 8.0 mmHg, p=0.01), whose response was similar to Control. BP reduction among high users was 15.0±10.7/4.6±7.2 mm Hg- significantly larger than in control patients (9.2±12.3/3.2±7.1 mmHg, p=0.01 for SBP), with no change in heart rate or dependence on age, gender or medication status. There were no reported side effects. In conclusion, device-guided breathing is an effective adjunct for treating hypertension, with benefit increasing with the time spent in slow breathing exercise.

Non-pharmacological therapy, respiration, RESPe-RATE