Effects of guided breathing on blood pressure and heart rate variability in hypertensive diabetic patients

Auton Neurosci. 2013 Dec;179(1-2):131-7. doi: 10.1016/j.autneu.2013.08.065. Epub 2013 Aug 27.


Objective: Our aim was to investigate medium-term effects of device-guided breathing on blood pressure (BP) and its capacity to improve the cardiovascular autonomic balance in hypertensive diabetic patients. This feasibility study was conceived as a proof-of-concept trial under real life conditions for justification of further investigations.

Methods: A randomized, controlled study (RCT) of the effects of device-guided slow breathing on top of usual care against usual care alone (including non-pharmacological and pharmacological treatment). The intervention included 12-min sessions of guided breathing performed daily for 8 weeks. Treatment effects were assessed with ambulatory blood pressure monitoring (24h ABPM) and with spectral analysis of short-term heart rate variability (HRV) obtained during standardized modified orthostatic load. Thirty-two subjects with diabetes and antihypertensive therapy were randomly assigned to both study groups.

Results: After 8 weeks of guided breathing, significant reductions were demonstrated in 24 h systolic BP (x±SEM: 126.1±3.0 vs 123.2±2.7 mmHg, p=0.01), and in 24 h pulse pressure (PP, 53.6±2.6 vs. 51.3±2.5 mmHg, p=0.01), whereas no significant impact in the control group was shown. The differences in treatment effects (delta mmHg, RESPeRATE® vs control) were significant only for PP (-2.3±0.8 vs +0.2±1.2 mmHg, p<0.05). Strong baseline dependence of treatment effects (delta systolic BP) was observed (p<0.01). Guided breathing showed a stronger treatment effect in terms of an increase in HRV, predominantly in low frequency band (p<0.03 vs. usual care).

Conclusion: Even in well controlled hypertensive diabetic patients, guided breathing induced relevant effects on BP and HRV, finding which should be investigated further.

Keywords: Ambulatory blood pressure monitoring; Device guided breathing; Diabetes; Heart rate variability; Hypertension; RESPeRATE®; Randomized controlled study; Spectral analysis.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Pressure / physiology
  • Blood Pressure Monitoring, Ambulatory
  • Breathing Exercises / instrumentation
  • Breathing Exercises / methods*
  • Diabetes Complications / therapy*
  • Diabetes Mellitus
  • Female
  • Heart Rate / physiology
  • Humans
  • Hypertension / complications
  • Hypertension / therapy*
  • Male
  • Middle Aged
  • Respiration