Effects of long term device-guided slow breathing on sympathetic nervous activity in hypertensive patients: a randomized open-label clinical trial

Blood Press. 2017 Dec;26(6):359-365. doi: 10.1080/08037051.2017.1357109. Epub 2017 Jul 20.


Purpose: Device-guided slow breathing (DGB) is indicated as nonpharmacological treatment for hypertension. The sympathetic nerve activity (SNA) reduction may be one of the mechanisms involved in blood pressure (BP) decrease. The aim of this study is to evaluate the long-term use of DGB in BP and SNA.

Subjects and methods: Hypertensive patients were randomized to listen music (Control Group-CG) or DGB (aim to reduce respiratory rate to less than 10 breaths/minute during 15 minutes/day for 8 weeks). Before and after intervention ambulatory blood pressure monitoring (ABPM), catecholamines and muscle sympathetic nerve activity (MSNA) by microneurography were performed.

Results: 17 volunteers in the DGB and 15 in the CG completed the study. There was no change in office BP before and after intervention in both groups. There was a reduction in systolic and diastolic BP in the awake period by ABPM only in the CG (131 ± 10/92 ± 9 vs 128 ± 10/88 ± 8mmHg, p < 0.05). In relation to SNA, no difference in catecholamines was observed. In the volunteers who had a microneurography record, there was no change the MSNA (bursts/minute): DGB (17(15-28) vs 19(13-22), p = 0.08) and CG (22(17-23) vs 22(18-24), p = 0.52).

Conclusion: Long-term DGB did not reduce BP, catecholamines levels or MSNA in hypertensive patients. ClinicalTrials.gov identifier: NCT01390727.

Keywords: Device-guided slow breathing; hypertension; microneurography; nonpharmacological treatment; sympathetic nerve activity.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory
  • Breathing Exercises / methods*
  • Catecholamines / blood
  • Female
  • Heart Rate
  • Humans
  • Hypertension / blood
  • Hypertension / physiopathology*
  • Hypertension / therapy*
  • Male
  • Middle Aged
  • Respiratory Rate*
  • Sympathetic Nervous System / physiopathology*


  • Catecholamines

Associated data

  • ClinicalTrials.gov/NCT01390727