title: An inspiratory load enhances the antihypertensive effects of home-based training with slow deep breathing: a randomised trial.
abstract: OBJECTIVE
  Can adding an inspiratory load enhance the antihypertensive effects of slow breathing training performed at home?
  
  
  METHODS
  Randomised trial with concealed allocation.
  
  
  METHODS
  Thirty patients with essential hypertension Stage I or II.
  
  
  METHODS
  Experimental groups performed slow deep breathing at home, either unloaded or breathing against a load of 20 cmH(2)O using a threshold-loaded breathing device. Participants trained for 30 min, twice daily for 8 weeks. A control group continued with normal activities.
  
  
  METHODS
  Resting blood pressure and heart rate were measured at home and in the laboratory before and after the training period.
  
  
  RESULTS
  Compared to the control group, systolic and diastolic blood pressure decreased significantly with unloaded breathing by means of 13.5 mmHg (95% CI 11.3 to 15.7) and 7.0 mmHg (95% CI 5.5 to 8.5), [corrected] respectively (laboratory measures). With loaded breathing, the reductions were greater at 18.8 mmHg (95% CI 16.1 to 21.5) and 8.6 mmHg (95% CI 6.8 to 10.4), respectively. The improvement in systolic blood pressure was 5.3 mmHg (95% CI 1.0 to 9.6) greater than with loaded compared to unloaded [corrected] breathing. Heart rate declined by 8 beats/min (95% CI 6.5 to 10.3) with unloaded breathing, and 9 beats/min (95% CI 5.6 to 12.2) with loaded breathing. Very similar measures of blood pressure and heart rate were obtained by the patients at home.
  
  
  CONCLUSIONS
  Home-based training with a simple device is well tolerated by patients and produces clinically valuable reductions in blood pressure. Adding an inspiratory load of 20 cmH(2)O enhanced the decrease in systolic blood pressure.
  
  
  BACKGROUND
  NCT007919689.
authors.affiliation: Department of Physical Therapy, Khon Kaen University, Thailand. chulee@kku.ac.th
authors.forename: Chulee U
authors.initials: CU
authors.lastname: Jones
authors.forename: Benjarat
authors.initials: B
authors.lastname: Sangthong
authors.forename: Orathai
authors.initials: O
authors.lastname: Pachirat
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D004864:Equipment and Supplies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology* / Q000628:therapy*; D001239:Inhalation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D026741:Physical Therapy Modalities; D015656:Respiratory Mechanics / Q000502:physiology*; D016896:Treatment Outcome