Treating hypertension with a device that slows and regularises breathing: a randomised, double-blind controlled study

Schein, M.H.; Gavish, Benjamin; Herz, Matthias; Rosner-Kahana, D.; Naveh, P.; Knishkowy, Barry; Zlotnikov, E.; Ben-Zvi, N.; Melmed, R. N.

doi:10.1038/sj.jhh.1001148

Cited by 151 publications

(143 citation statements)

References 24 publications

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“…So, either calm music or the use of BIM reduces BP, although BIM seems to be more effective. 4 We found that sympathetic nerve activity is reduced when subjects breathe slowly. The muscular sympathetic activity decreases between the fifth and tenth minutes of the BIM use.…”

Section: Discussionmentioning

confidence: 74%

“…The same investigators observed that mean arterial BP reductions occurred only in patients who had mean BP X98 mm Hg. The subjects of most papers 1,4,23 using the same device, had high BP values to start with, and also Joseph et al 15 studied untreated or patients with antihypertensive medication discontinued. We suppose that better results could be observed if baseline values from BPs were higher.…”

Section: Discussionmentioning

confidence: 99%

“…1,3,4,23 It seems unlikely that the antihypertensive drugs used in the study may have influenced the MSNA. First of all, all classes of drugs were well distributed between the two groups.…”

Section: Discussionmentioning

confidence: 99%

“…1 Of late, several articles have reported the efficacy of a new device called BIM (Breathe with Interactive Music, developed by InterCure, Ltd., Northern Industrial AreaLod, Israel) in reducing BPs [1][2][3][4] when the achieved breathing frequency was o10 breaths min -1 . In these studies, subjects used the device for 8 weeks, on a daily-based schedule from 10 to 15 min.…”

Section: Introductionmentioning

confidence: 99%

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Sympathetic nerve activity is decreased during device-guided slow breathing

et al. 2010

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It is known that slow breathing (o10 breaths min -1 ) reduces blood pressure (BP), but the mechanisms involved in this phenomenon are not completely clear. The aim of this study was to evaluate the acute responses of the muscle sympathetic nerve activity, BP and heart rate (HR), using device-guided slow breathing (breathe with interactive music (BIM)) or calm music. In all, 27 treated mild hypertensives were enrolled. Muscle sympathetic nerve activity, BP and HR were measured for 5 min before the use of the device (n¼14) or while subjects listened to calm music (n¼13), it was measured again for 15 min while in use and finally, 5 min after the interventions. BIM device reduced respiratory rate from 16 ± 3 beats per minute (b.p.m) to 5.5 ± 1.8 b.p.m (Po0.05), calm music did not affect this variable. Both interventions reduced systolic (À6 and À4 mm Hg for both) and diastolic BPs (À4 mm Hg and À3 mm Hg, respectively) and did not affect the HR (À1 and À2 b.p.m respectively). Only the BIM device reduced the sympathetic nerve activity of the sample (À8 bursts min -1 ). In conclusion, both device-guided slow breathing and listening to calm music have decreased BP but only the device-guided slow breathing was able to reduce the peripheral sympathetic nerve activity.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

“…1,3,4,23 It seems unlikely that the antihypertensive drugs used in the study may have influenced the MSNA. First of all, all classes of drugs were well distributed between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Sympathetic nerve activity is decreased during device-guided slow breathing

et al. 2010

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“…Slow breathing training has been shown to be beneficial in cardiovascular disease (Bernardi, Spadacini, Bellwon, et al, 1998;Schein, Gavish, Herz, et al, 2001), probably due to its potential to increase baroreflex PCO2 Biofeedback in Asthma 19 sensitivity (Bernardi, Porta, Spicuzza, et al, 2002;Joseph, Porta, Casucci, et al, 2005).…”

Section: Pco2 Biofeedback In Asthma 18mentioning

confidence: 99%

Targeting pCO2 in Asthma: Pilot Evaluation of a Capnometry-Assisted Breathing Training

Meuret

Ritz

Wilhelm

et al. 2007

Appl Psychophysiol Biofeedback

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Objectives: This pilot study aimed to evaluate the feasibility and potential benefits of a novel biofeedback breathing training for achieving sustained increases in pCO2 levels.Methods: Twelve asthma patients were randomly assigned to an immediate 4-week treatment group or waiting list control. Patients were instructed to modify their respiration in order to change levels of end-tidal pCO2 using a hand-held capnometer. Treatment outcome was assessed in frequency and distress of symptoms, asthma control, lung function, and variability of peak expiratory flow (PEF).Results: We found stable increases in pCO2 and reductions in respiration rate during treatment and 2-month follow-up. Mean pCO2 levels rose from a hypocapnic to a normocapnic range at follow-up. Frequency and distress of symptoms was reduced and reported asthma control increased. In addition, mean PEF variability decreased significantly in the treatment group.Conclusions: Our pilot intervention provided evidence for the feasibility of pCO2-biofeedback training in asthma patients.Response to Reviewers: Dear Dr. Gevirtz, Thank you for the latest comments on our manuscript "Targeting PCO2 in asthma: Pilot-evaluation of a capnometry-assisted breathing training" (APBI55). We have now amended the manuscript by following the reviewrs suggestions in the remaining details. The amended passages are marked in yellow.Thank you for the opportunity to have our work reviewed for your journal. We are excited that it has generated sufficient interest among our reviewers and look forward to seeing it in press. Please let us know if you need more information or materials.

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Device-Guided Breathing as Treatment for Hypertension in Type 2 Diabetes Mellitus

et al. 2013

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Biofeedback with device-guided lowering of breathing frequency could be an alternate nonpharmacologic treatment option for hypertension. Evidence from trials with high methodologic quality is lacking.OBJECTIVE To evaluate the effects of device-guided lowering of breathing frequency on blood pressure in patients with type 2 diabetes mellitus and hypertension. DESIGN Single-center, double-blind, sham-controlled trial.SETTING A large nonacademic teaching hospital in the Netherlands. PARTICIPANTS Patients with type 2 diabetes mellitus and hypertension.INTERVENTION Fifteen-minute sessions with either the device that guides breathing through musical tones to a lower breathing frequency (aiming at <10 breaths/min) or a sham device (music without aiming at lowering of breathing frequency) for an 8-week study period.MAIN OUTCOMES AND MEASURES Systolic and diastolic blood pressure measured in the physician's office.RESULTS Forty-eight patients were randomized; 21 patients (88%) in the intervention group and 24 patients (100%) in the control group completed the study. There were no significant changes in systolic and diastolic blood pressure, with a difference in systolic blood pressure of 2.35 mm Hg (95% CI, -6.50 to 11.20) in favor of the control group and a difference in diastolic blood pressure of 2.25 mm Hg (95% CI, -2.16 to 6.67) in favor of the intervention group. Three patients in the intervention group experienced adverse events. CONCLUSIONS AND RELEVANCEThis high methodologic quality study shows no significant effect of device-guided lowering of breathing frequency on office-measured blood pressure in patients with type 2 diabetes. On the basis of this study, together with results from all but one previous trial, device-guided lowering of breathing frequency does not appear to be a viable nonpharmacologic option for hypertension treatment.

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Treating hypertension with a device that slows and regularises breathing: a randomised, double-blind controlled study

Cited by 151 publications

References 24 publications

Sympathetic nerve activity is decreased during device-guided slow breathing

Sympathetic nerve activity is decreased during device-guided slow breathing

Targeting pCO2 in Asthma: Pilot Evaluation of a Capnometry-Assisted Breathing Training

Device-Guided Breathing as Treatment for Hypertension in Type 2 Diabetes Mellitus

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