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December 6, 2022Blood Pressure Monitoring9 citationsOpen Access

Device-guided slow breathing with direct biofeedback of pulse wave velocity – acute effects on pulse arrival time and self-measured blood pressure

TMThomas MengdenMBMartin BachlerWSWalter Sehnert

Key Result

Device-guided slow breathing with biofeedback significantly increased pulse arrival time by 5 ms and reduced self-measured systolic blood pressure by 5 mmHg compared to baseline.

Study Design

Type

Observational (n=44)

Multicenter

No

Structured PICO

Does device-guided slow breathing with biofeedback improve pulse arrival time and reduce self-measured blood pressure in patients with elevated blood pressure or treated hypertension?

P
Population
44 patients (21 females, 23 males) with a systolic BP 130-160 mmHg or treated essential hypertension.
I
Intervention
Unattended device-guided slow breathing exercises with biofeedback for 10 min daily over 5 days.
C
Comparator
Baseline (pre-exercise measurements).
O
Outcome
Changes in pulse arrival time (PAT) and absolute self-measured blood pressure.surrogate

Device-guided slow breathing with biofeedback acutely and reproducibly reduces systolic blood pressure and increases pulse arrival time over a 5-day period.

Main Result

p-value: p=<0.01

Limitations

  • Using the ECG signal to determine the start time of the pulse wave includes the pre-ejection period (PEP) in the measurement, which is not ideal from a physiological point of view.

Abstract

BACKGROUND: There isevidence that device-guided slow breathing using biofeedback acutely reduces blood pressure (BP) and pulse wave velocity i.e. increased pulse arrival time (PAT). OBJECTIVES: The objectives of the study presented here were to test whether the results of changes observed in PAT in earlier studies are reproducible over 1 week and how changes in pulse wave velocity/PAT translate into absolute self-measured BP changes. METHODS: Patients with a systolic BP 130-160 mmHg or treated essential hypertension (21 females/23 males) were trained to perform unattended device-guided slow breathing exercises for 10 min daily over 5 days. Furthermore, they were skilled to perform self-measurement of BP before and after the breathing exercise using a validated upper-arm device. RESULTS: Office BP at screening median (1, 3. Q) was 137 (132, 142)/83 (79, 87) mmHg. We observed a significant ( P < 0.05) increase in PAT of 5 ms (SD 12.5 ms) on average after 10 min of guided breathing and an additional 1 ms ( P < 0.05, SD 8 ms) during the following 5 min of spontaneous breathing compared to baseline. PAT before the exercise remained constant over 5 days paralleled by constant self-measured BP before the exercise. Device-guided breathing was associated with a significant reduction of self-measured SBP of 5 mmHg ( P < 0.01, SD 8 mmHg). Data furthermore demonstrated that these changes were highly reproducible over 1 week. CONCLUSIONS: Device-guided slow breathing and biofeedback lead to reproducible and favorable changes (increase) in PAT and SBP (decrease).

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Cite This Study

Mengden et al. (2022) conducted an observational in High normal or grade I hypertension or treated essential hypertension (n=44). Device-guided slow breathing with biofeedback vs. Baseline was evaluated on Reduction in self-measured systolic blood pressure (SBP) (p=<0.01). Device-guided slow breathing with biofeedback significantly increased pulse arrival time by 5 ms and reduced self-measured systolic blood pressure by 5 mmHg compared to baseline.

synapsesocial.com/papers/6a15351ea4734e8e604e2776https://doi.org/10.1097/mbp.0000000000000628
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