title: Device-guided paced respiration as an adjunctive therapy for hypertension in obstructive sleep apnea: a pilot feasibility study.
abstract: Data suggest that device-guided paced respiration (<10 breaths/min) may reduce blood pressure in hypertensive patients. We hypothesized that daily device-guided slow breathing may lower blood pressure in patients with hypertension and obstructive sleep apnea (OSA). In this one-arm pilot study, we enrolled 25 subjects with hypertension and OSA. Subjects were asked to perform device-guided paced respiration 30 min a day for 8 weeks. Our primary outcome was change in office systolic and diastolic blood pressures from baseline to 8 weeks. Twenty-four subjects completed the study. Mean baseline blood pressure was 140.0 ± 10.2 mmHg systolic and 82.7 ± 8.9 mmHg diastolic. Complete device data were available for 17 subjects. Mean device adherence was 81 ± 24% and 51% achieved a mean breath rate ≤10 breaths/min over 8 weeks. Three subjects had changes in their anti-hypertensive medications during the study. Among the remaining 21 subjects, mean difference in office blood pressure from baseline to 8 weeks was -9.6 ± 11.8 mmHg systolic (p ≤ 0.01) and -2.52 ± 8.9 mmHg diastolic (p = 0.21). Device-guided paced respiration may lower systolic blood pressure in patients with hypertension and OSA; however, our findings need to be confirmed with larger randomized controlled trials.
authors.affiliation: Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon Street, 2nd floor, Brookline, Boston, MA 02446, USA. sbertisc@bidmc.harvard.edu
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Bertisch
authors.forename: Ashley
authors.initials: A
authors.lastname: Schomer
authors.forename: Erin E
authors.initials: EE
authors.lastname: Kelly
authors.forename: Leonardo A
authors.initials: LA
authors.lastname: Baloa
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Hueser
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Pittman
authors.forename: Atul
authors.initials: A
authors.lastname: Malhotra
mesh_terms: D001676:Biofeedback, Psychology / Q000379:methods*; D001794:Blood Pressure / Q000502:physiology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D017286:Polysomnography; D012119:Respiration; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome