Can respiratory muscle training change the blood pressure levels in hypertension? A systematic review with meta‐analysis

Abstract

The aim was to systematically review randomized controlled trials investigating the effects of respiratory training on blood pressure control in hypertensive individuals. Systematic review with meta‐analysis was coducted following the guidelines from PRISMA statement. Searches for randomized controlled trials were performed in four electronic databases (PubMed, Cochrane Library, SCOPUS, and PEDro). Studies were included if they were randomized controlled trials that examined the impact of respiratory training on blood pressure of individuals with systemic arterial hypertension and the patients had no other associated disease. Eight studies were included for final analysis (total of 270 participants; 18–85 years) and presented an average score of 6.25 in the PEDro scale, being considered of high methodological quality. The meta‐analysis showed a reduction in systolic and diastolic blood pressure for respiratory training when the load was applied [−15.72 (−18.63; −12.81) and −7.08 (−9.03; −5.13) mmHg, respectively]. There was also a reduction in systolic, but not in diastolic blood pressure when the training was performed without load [−5.08 (−7.49; −2.66) and −1.04 (−2.55; +0.46) mmHg, respectively]. The respiratory training has a positive effect in BP in hypertensive patients, however, only when performed with load seems to be able to promote some beneficial effect on diastolic blood pressure reduction.

Efficacy of Respiratory Training in Relieving Postoperative Pain in Patients with Spinal Nerve Root Entrapment Syndrome

“…Minimally invasive decompression surgery can also be used when mechanical compression of the nerve root is the main clinicopathological manifestation. The aim of treatment is to decompress and relax the mechanically compressed nerve root and to relieve the nerve root pain [24,25]. However, minimally invasive surgery is an invasive operation, which has a variety of pain symptoms, such as surgical wound, muscle traction, and postoperative abdominal pain.…”

Effects of inspiratory muscle training in patients with hypertension: a meta-analysis

“…Physical activity is one of the treatments for patients with hypertension ( 7 ). In these meta-analyses, it could be concluded that aerobic exercise ( 32 ), isometric exercise ( 32 ), breathing-control ( 33 ), and unload respiratory muscle training ( 17 ) had the effect in reducing BP in patients with hypertension. Our meta-analysis showed that IMT, an innovative physical activity, also had an active reduction in BP which was consistent with the conclusion of the analysis showing that the antihypertensive drug was effective in SBP and DBP within 6 months (−4.2/−2.0 mmHg) ( 34 ).…”

“…It ( 15 ) shows that IMT has no obvious effects on the BP of patients with hypertension, and slow breathing is more effective than IMT in lowering BP ( 16 ). Da Silva ( 17 ) has shown that loaded respiratory training can reduce BP in hypertension, however, only two RCTs were analyzed in this literature resulting in low confidence in the results. To sum up, the effects of IMT on hypertension should be further explored.…”

A hypotensive protocol of inspiratory muscle strength training: Systematic review and meta‐analysis with trial sequential analysis

“…As research has progressed, the strategies for implementing IMST have gradually diversified. Currently, they are classified mainly by maximum inspiratory pressure (MIP) into low resistance protocols (30 min/day, 30%−50% MIP) and high resistance protocols (5 min/day, 50%−75% MIP) 11 . Some regimens are combined with respiratory rate to promote the hypotensive effect of IMST by combining resistance inspiration with deep slow breathing (6, 8, 12 breaths/min) from the point of view of influencing respiratory rate.…”