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Role of Paced Breathing for Treatment of Hypertension

  • Device-Based Approaches for Hypertension (M Schlaich, Section Editor)
  • Published:
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Abstract

Purpose of Review

Hypertension remains to be a major contributor to global morbidity and mortality. Despite a plethora of pharmacological options available, an abundance of patients have uncontrolled blood pressure thus creating the need for additional strategies, including non-pharmacologic approaches. In this review, we discuss the antihypertensive effect of slow and deep respiration by increasing baroreflex sensitivity.

Recent Findings

Asking patients to carry out paced breathing sessions unaccompanied by a personal coach or unaided by a device may be unfeasible. Among proposed breathing techniques, RESPeRATE is a US Food and Drug Administration–certified device that assists slow breathing. In this review, we consider the mechanisms through which guided breathing mechanisms may impact on blood pressure control and alternative techniques.

Summary

Guided breathing techniques along with lifestyle therapies may be helpful as a first step for patients with mild hypertension and prehypertension who do not suffer from cardiovascular disease, renal disease, or diabetes. Drug therapy must be considered after a couple of months if non-pharmacological therapy was unsuccessful. Device-guided paced breathing (DGB) may be recommended for those who cannot obtain full control of their hypertension with medical therapy alone or cannot tolerate potential side effects of pharmacologic treatment. Also, patients with well-controlled hypertension who may wish to try to reduce medication burden may be candidates for DGB. Patients with white coat or labile hypertension who are interested in biofeedback techniques could also be considered.

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Authors and Affiliations

  1. Department of Nephrology, Tel Aviv University and Wolfson Medical Center, Holon, Israel

    Relu Cernes

  2. Faculty of Medicine, Tel Aviv University and Wolfson Medical Center, Holon, Israel

    Reuven Zimlichman

  3. The Brunner Institute for Cardiovascular Research, Tel Aviv University and Wolfson Medical Center, Holon, Israel

    Relu Cernes & Reuven Zimlichman

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Correspondence to Reuven Zimlichman.

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Conflict of Interest

R.Z. served as a medical consultant to Intercure, the manufacturer of RESPeRATE, from March 21, 2013, until July 11, 2014. R.C. declares no conflict of interest relevant to this manuscript.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Device-Based Approaches for Hypertension

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Cernes, R., Zimlichman, R. Role of Paced Breathing for Treatment of Hypertension. Curr Hypertens Rep 19, 45 (2017). https://doi.org/10.1007/s11906-017-0742-1

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