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

Abstract

ObjectiveTo explore the effects of inspiratory muscle training (IMT) on hypertension and provide guidance for its clinical application as an auxiliary approach.MethodsArticles published prior to July 2022 were searched in Cochrane Library, Web of Science, PubMed, Embase, CNKI, and Wanfang databases. Included were randomized controlled studies that used IMT to treat individuals with hypertension. The mean difference (MD) was computed using the Revman 5.4 software. In individuals with hypertension, the effects of IMT on systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and pulse pressure (PP) were compared and studied.ResultsThere were found to be eight randomized controlled trials totaling 215 patients. According to a meta-analysis, the IMT reduced the SBP (MD: −12.55 mmHg, 95% CI: −15.78, −9.33), DBP (MD: −4.77 mmHg, 95% CI: −6.00, −3.54), HR (MD: −5.92 bpm, 95% CI: −8.72, −3.12), and PP (MD: −8.92 mmHg, 95% CI: −12.08, −5.76) in patients with hypertension. In subgroup analyses, low-intensity IMT showed a better reduction in SBP (MD: −14.47 mmHg, 95% CI: −17.60, −11.34), DBP (MD: −7.70 mmHg, 95% CI: −10.21, −5.18).ConclusionIMT may become an auxiliary means to improve the four hemodynamic indexes (SBP, DBP, HR and PP) in patients with hypertension. In subgroup analyses, low-intensity IMT was more effective in regulating blood pressure than medium-high-intensity IMT.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022300908.

Inspiratory Muscle Training Intensity in Patients Living with Cardiovascular Diseases: A Systematic Review

“…IMT has also shown good effectiveness regarding the reduction in respiratory complications due to stroke [5,45] However, it has not yet shown impact on quality of life and needs to be explored more [5,45,46]. While the intensity of IMT does not seem to be as important as the duration in the first 12 weeks of IMT for stroke and HF patients, the meta-analysis conducted by Zheng et al [4] suggested that low-intensity IMT is more effective on hypertension than moderate and high intensities. However, its effect on quality of life remains uncertain [47,48].…”

“…The same authors concluded that in patients with inspiratory muscle weakness and chronic heart failure, IMT improves limb blood flow under training in these populations. Moreover, in patients with hypertension, IMT can be a complementary strategy to reduce resting heart rate, pulse pressure, systolic and diastolic blood pressures [4]. In post-stroke patients, IMT increases pulmonary function and cardiopulmonary endurance and reduces pulmonary infection incidence in this population [5].…”

Definition, diagnosis, and treatment of respiratory sarcopenia

“…IMT reduces the blood pressure, heart rate, and pulse pressure in patients with hypertension [53]. IMT improves exercise capacity, pulmonary functions, and health-related quality of life in coronary artery disease patients with stable angina [54].…”