title: Device-Guided Breathing for Hypertension: a Summary Evidence Review.
abstract: Persistently raised blood pressure is one of the major risk factors for diseases such as myocardial infarction and stroke. Uncontrolled hypertension is also associated with high rates of mortality, particularly in middle and high-income countries. Lifestyle factors such as poor diet, obesity, physical inactivity and smoking are all thought to contribute to the development of hypertension. As a result, the management of hypertension should begin with modifying these lifestyle factors. Beyond this, drug interventions are used as the predominant form of management. However, adherence to medications can be highly variable, medication side effects are common, and may require regular monitoring or, in some individuals may be ineffective. Therefore, additional non-pharmacologic interventions that lower blood pressure may be advantageous when combined with lifestyle modifications. Such interventions may include relaxation therapies such as slow breathing exercises, which can be initiated by means of specific devices. The technique of device-guided breathing (DGB) has been considered by guideline developers in the management of hypertension. One specific device, the Resperate, has received US FDA and UK NHS approval over the last few years. In this review, we summarise the evidence base on efficacy and find that although some clinical trials exist that demonstrate a BP-lowering effect, others do not. There is currently insufficient evidence from pooled data to recommend the routine use of device-guided breathing in hypertensive patients.
authors.affiliation: Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. kamal.mahtani@phc.ox.ac.uk.
authors.forename: Kamal R
authors.initials: KR
authors.lastname: Mahtani
authors.affiliation: Centre of Evidence-Based Medicine, Clinic of Internal Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Tumas
authors.initials: T
authors.lastname: Beinortas
authors.affiliation: Centre of Evidence-Based Medicine, Clinic of Internal Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Karolis
authors.initials: K
authors.lastname: Bauza
authors.affiliation: Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
authors.forename: David
authors.initials: D
authors.lastname: Nunan
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D001945:Breathing Exercises; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D012119:Respiration; D012307:Risk Factors
keywords: Blood pressure; Device-guided breathing; Hypertension