title: Efficacy of device-guided breathing for hypertension in blinded, randomized, active-controlled trials: a meta-analysis of individual patient data.
abstract: OBJECTIVE
  Device-guided breathing (DGB) is recommended by the American Heart Association for its blood pressure-lowering effects. Most previous studies that showed beneficial effects on blood pressure had low methodological quality and only investigated short-term blood pressure effects.
  
  
  OBJECTIVE
  To assess the efficacy of DGB on blood pressure in a meta-analysis of individual patient data from blinded, randomized controlled trials with an active control group.
  
  
  METHODS
  MEDLINE, EMBASE, clinicaltrials.gov, and the Cochrane Library.
  
  
  METHODS
  Included were randomized studies of at least 4 weeks' duration, with a single- or double-blind design and an active control group. Bias was assessed with the Cochrane risk of bias tool, and analyses were performed with linear mixed models.
  
  
  METHODS
  Articles were searched in MEDLINE (using PubMed), EMBASE, and the Cochrane Library.
  
  
  METHODS
  Office blood pressure.
  
  
  RESULTS
  From the 15 selected abstracts, 5 studies were suitable for inclusion. Individual patient data from 2 of 5 studies were not provided. The effect of DGB on office systolic blood pressure compared with music therapy or a sham device was 2.2 mm Hg (95% CI, -2.7 to 7.0) in favor of the control group; DGB did not significantly lower office diastolic blood pressure (0.2 mm Hg [95% CI, -2.8 to 3.1] in favor of DGB).
  
  
  CONCLUSIONS
  All trials included in the analysis had a short follow-up period; therefore, no recommendations could be made regarding hypertension treatment. Treatment with DGB did not significantly lower office blood pressure compared with a sham procedure or music therapy.
authors.affiliation: Diabetes Centre, Isala, Zwolle, the Netherlands2Department of Internal Medicine, Gelre Hospital, Apeldoorn, the Netherlands.
authors.forename: Gijs W D
authors.initials: GW
authors.lastname: Landman
authors.affiliation: Diabetes Centre, Isala, Zwolle, the Netherlands.
authors.forename: Kornelis J J
authors.initials: KJ
authors.lastname: van Hateren
authors.affiliation: Diabetes Centre, Isala, Zwolle, the Netherlands.
authors.forename: Peter R
authors.initials: PR
authors.lastname: van Dijk
authors.affiliation: Diabetes Centre, Isala, Zwolle, the Netherlands3Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Susan J J
authors.initials: SJ
authors.lastname: Logtenberg
authors.affiliation: Diabetes Centre, Isala, Zwolle, the Netherlands.
authors.forename: Sebastiaan T
authors.initials: ST
authors.lastname: Houweling
authors.affiliation: Diabetes Centre, Isala, Zwolle, the Netherlands4Department of General Practice, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Klaas H
authors.initials: KH
authors.lastname: Groenier
authors.affiliation: Diabetes Centre, Isala, Zwolle, the Netherlands3Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Henk J G
authors.initials: HJ
authors.lastname: Bilo
authors.affiliation: Diabetes Centre, Isala, Zwolle, the Netherlands3Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Nanne
authors.initials: N
authors.lastname: Kleefstra
mesh_terms: D001794:Blood Pressure; D001945:Breathing Exercises; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic