Device and non-device-guided slow breathing to reduce blood pressure in hypertensive patients: a systematic review and meta-analysis

Abstract

Backgroud Hypertension (HTN) is a multifactorial chronic disease. Considering the high prevalence rates of this disease, treatment of HTN is necessary, not only to reduce BP levels, but also to prevent the development of cardiovascular, cerebrovascular and kidney diseases. This treatment can be medication and/or non-farmacological, like device-guided slow breathing (DGSB) or non-device-guided slow breathing (NDGSB). Purpose The aim of this systematic review and meta-analysis is to summarize the effects of DGSB and NDGSB on blood pressure levels of patients with hypertension. Methods This study is systematic review and meta-analysis of randomized clinical trials, about hypertensive patients, with or without comorbidity, over 18 years old, of both sexes, with or without hypertensive medication. The selected studies showed comparisons between groups that performed DGSB and/or NDGSB with control conditions. The primary outcome was the value of systolic blood pressure (SBP) and diastolic blood pressure (DBP) after the interventions. Results Twenty-two studies involving 17,214 participants were included in the quantitative analysis. Considerable heterogeneity was revealed between studies. Using random effect model, it was found that DGSB did not significantly reduce SBP and DBP compared to usual care, both in terms BP values and in relation to their variations (SBP, MD −2.13 mmHg, [95% CI −12.71 to 8.44], 288 individuals; I2=93%, high heterogenity: DBP, MD −0.90, 95% CI −3.97 to 2.11, 288 individuals; I2=63%, substantial heterogenity. SBP variations MD −2.42, 95% CI −7.24 to 2.40, 443 individuals; I2=85% high heterogenity/DBP variations MD −1.67, 95% CI −4.57 to 1.24, 443 individuals; I2=80%, high heterogenity). Conclusion Based on these results it appears that DGSB did not reduce blood pressure in hypertensive patients and NDGSB is a new path for future. Funding Acknowledgement Type of funding sources: None.