An inspiratory load enhances the antihypertensive effects of home-based training with slow deep breathing: a randomised trial

Jones, Chulee; Sangthong, Benjarat; Pachirat, Orathai

doi:10.1016/s1836-9553(10)70023-0

Cited by 31 publications

(61 citation statements)

References 23 publications

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“…In a recent clinical trial, hypertensive patients practiced controlled breathing at 0.1 Hz with or without inspiratory load of 20 cmH 2 O for 8 weeks. Although blood pressure and heart rate decreased in both groups, a greater reduction in blood pressure (and a trend for heart rate) was observed for the group practicing with the inspiratory load (Jones, Sangthong, & Pachirat, ). These results, in addition to the findings of our experiment, suggest that applying inspiratory threshold load during controlled breathing at 0.1 Hz may enhance the effect of this breathing exercise on baroreflex function and cardiac vagal control when practiced for several weeks.…”

Section: Discussionmentioning

confidence: 84%

“…The low‐to‐moderate levels of dyspnea reported by our participants with the load of 10 cmH 2 O may be reduced by decreasing the duration of the exercise and by more frequent practice over time. Studies in hypertension patients using long‐term practice with loads of 18‒20 cmH 2 O have reported good compliance without any specific adverse events (Jones et al, ; Sangthong, Ubolsakka‐Jones, Pachirat, & Jones, ; Ubolsakka‐Jones, Sangthong, Khrisanapant, & Jones, ).…”

Section: Discussionmentioning

confidence: 99%

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Influence of inspiratory threshold load on cardiovascular responses to controlled breathing at 0.1 Hz

et al. 2019

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Slow, deep breathing is being used as a self‐management intervention for various health conditions including pain and hypertension. Stimulation of the arterial baroreceptors and increased vagal modulation are among the proposed mechanisms for the therapeutic effects of slow, deep breathing. We investigated whether adding inspiratory threshold load can enhance the cardiovascular responses to controlled breathing at the frequency of 0.1 Hz, a common form of slow, deep breathing. Healthy volunteers (N = 29) performed controlled breathing at 0.1 Hz (6 breaths/minute) without load and with inspiratory threshold loads of 5 cmH2O and 10 cmH2O. Respiratory airflow, heart rate, and blood pressure were continuously recorded. The amplitude of the systolic blood pressure variation during respiratory cycles increased with increasing loads. Respiratory sinus arrhythmia was higher during controlled breathing at 0.1 Hz with the load of 10 cmH2O compared to without load. Baroreflex sensitivity was not affected by loads. The effect of loads on respiratory sinus arrhythmia was mediated by increasing the amplitude of systolic blood pressure variation during respiratory cycles. These results suggest that applying small inspiratory threshold loads during controlled breathing at 0.1 Hz increases cardiac vagal modulation by this breathing exercise. This effect seems to be mediated by stronger stimulation of the arterial baroreceptors because of larger systolic blood pressure swings along the respiratory cycle. The potential benefit of long‐term practice of controlled breathing at 0.1 Hz with inspiratory threshold loads on baroreflex function and cardiac vagal control needs to be investigated, particularly in pain and hypertension patients.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Influence of inspiratory threshold load on cardiovascular responses to controlled breathing at 0.1 Hz

et al. 2019

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“…Inspiratory breathing loads can be used to examine breathing difficulty and generate respiratory-related evoked potentials with several peaks that indicate the transition from an early sensory component to a later cognitive aspect [23], [24], [25], [26]. Moreover, resistive loads generate pre-motor potentials that reflect the involvement of higher cortical motor areas [27], they decrease systolic blood pressure [28], they differ for males and females [29], they are perceived less intense in older individuals [30], they generate load-dependent increases of unpleasantness [31], and the subjective effects can be modified by attentional distractions [32]. Thus, inspiratory breathing load provides a powerful experimental approach to examine how optimal performers respond to the temporary perturbation of the internal body state.…”

Section: Introductionmentioning

confidence: 99%

Subjecting Elite Athletes to Inspiratory Breathing Load Reveals Behavioral and Neural Signatures of Optimal Performers in Extreme Environments

et al. 2012

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BackgroundIt is unclear whether and how elite athletes process physiological or psychological challenges differently than healthy comparison subjects. In general, individuals optimize exercise level as it relates to differences between expected and experienced exertion, which can be conceptualized as a body prediction error. The process of computing a body prediction error involves the insular cortex, which is important for interoception, i.e. the sense of the physiological condition of the body. Thus, optimal performance may be related to efficient minimization of the body prediction error. We examined the hypothesis that elite athletes, compared to control subjects, show attenuated insular cortex activation during an aversive interoceptive challenge.Methodology/Principal FindingsElite adventure racers (n = 10) and healthy volunteers (n = 11) performed a continuous performance task with varying degrees of a non-hypercapnic breathing load while undergoing functional magnetic resonance imaging. The results indicate that (1) non-hypercapnic inspiratory breathing load is an aversive experience associated with a profound activation of a distributed set of brain areas including bilateral insula, dorsolateral prefrontal cortex and anterior cingulated; (2) adventure racers relative to comparison subjects show greater accuracy on the continuous performance task during the aversive interoceptive condition; and (3) adventure racers show an attenuated right insula cortex response during and following the aversive interoceptive condition of non-hypercapnic inspiratory breathing load.Conclusions/SignificanceThese findings support the hypothesis that elite athletes during an aversive interoceptive condition show better performance and an attenuated insular cortex activation during the aversive experience. Interestingly, differential modulation of the right insular cortex has been found previously in elite military personnel and appears to be emerging as an important brain system for optimal performance in extreme environments.

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“…Yoga and meditation are known to improve resting BP, and controlled slow breathing may be the common factor (Spicuzza, Gabutti, Porta, Montano, & Bernardi, ), and a number of experimental studies have shown benefits of slow breathing training for essential hypertension (Anderson, McNeely, & Windham, ; Grossman, Grossman, Schein, Zimlichman, & Gavish, ; Jones, Sangthong, & Pachirat, ; Logtenberg, Kleefstra, Houweling, Groenier, & Bilo, ; Mahtani, Nunan, & Heneghan, ; Meles et al, ). Although essential hypertension and ISH are assumed to have differing underlying causes, slow breathing training is also effective in reducing resting BP in ISH patients, and breathing with an inspiratory load is particularly effective (Sangthong, Ubolsakka‐Jones, Pachirat, & Jones, ).…”

Section: Introductionmentioning

confidence: 99%

“…Yoga and meditation are known to improve resting BP, and controlled slow breathing may be the common factor (Spicuzza, Gabutti, Porta, Montano, & Bernardi, 2000), and a number of experimental studies have shown benefits of slow breathing training for essential hypertension (Anderson, McNeely, & Windham, 2010;Grossman, Grossman, Schein, Zimlichman, & Gavish, 2001;Jones, Sangthong, & Pachirat, 2010;Logtenberg, Kleefstra, Houweling, Groenier, & Bilo, 2007;Mahtani, Nunan, & Heneghan, 2012;Meles et al, 2004).…”

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confidence: 99%

The effects of slow loaded breathing training on exercise blood pressure in isolated systolic hypertension

Ubolsakka-Jones

Tongdee

Jones

2019

Physiotherapy Res Intl

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Objectives Slow loaded breathing training has been shown to reduce resting blood pressure (BP) in isolated systolic hypertension (ISH), but it is not known whether this also reduces their exaggerated BP responses to exercise. Methods The study was a randomized controlled trial with block allocation stratified by sex. Twenty ISH patients (68 ± 5 yrs, 11 males) were randomized with one group undertaking 8‐weeks training with slow loaded breathing (SLB: 25% maximum inspiratory pressure, 6 breaths per minute, 60 breaths every day) or deep breathing control (CON), with 8 weeks follow‐up. Outcome measures were home BP and heart rate (HR) with laboratory measures of BP and HR responses to static handgrip and dynamic arm cranking exercise. Data were compared with a two‐week run‐in baseline. Results Home systolic BP fell by 22 mmHg (20–23; mean, 95% CI), diastolic BP by 9 mmHg (7–11), and HR by 12 bpm (9–15; all p < .001) as a result of SLB training. Systolic BP at the end of 2‐min isometric handgrip was 189 ± 10 mmHg (mean, SD) before training and 157 ± 6 mmHg following SLB training. After 4‐min arm exercise, systolic BP, measured at the ankle, was reduced from 243 ± 8 mmHg during the run‐in period to 170 ± 15 mmHg after SLB training with no change for CON. The reduction in exercise BP, in both types of exercise, was partly due to a reduction in resting BP and to a smaller increase above resting. Systolic and pulse pressures remained below run‐in values 8 weeks after the end of SLB training, and BP response to handgrip exercise remained below run‐in values at 4 weeks after SLB training. Conclusions SLB not only reduces resting BP in ISH but also the responses to both static and dynamic exercise, potentially reducing the negative aspect of exercise for cardiovascular health.

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An inspiratory load enhances the antihypertensive effects of home-based training with slow deep breathing: a randomised trial

Abstract: NCT007919689.

Cited by 31 publications

References 23 publications

Influence of inspiratory threshold load on cardiovascular responses to controlled breathing at 0.1 Hz

Influence of inspiratory threshold load on cardiovascular responses to controlled breathing at 0.1 Hz

Subjecting Elite Athletes to Inspiratory Breathing Load Reveals Behavioral and Neural Signatures of Optimal Performers in Extreme Environments

The effects of slow loaded breathing training on exercise blood pressure in isolated systolic hypertension

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