Key result
Device-guided breathing reduced pulse wave velocity by 1.2 m/s (95% CI 0.9-1.4) to a greater extent than nifedipine (0.7 m/s; P<0.05), showing arterial stiffness can be modulated independently of BP.
Why the study?
Short-term changes in large-artery stiffness have mainly been attributed to blood pressure changes, but interventions altering sympathetic activity may exert specific blood pressure-independent effects.
Do lower-limb venous occlusion and device-guided breathing modulate pulse wave velocity independently of blood pressure changes in patients with essential hypertension?
RCT (n=70)
Random order
Do lower-limb venous occlusion and device-guided breathing modulate pulse wave velocity independently of blood pressure changes in patients with essential hypertension?
Arterial stiffness can be modulated by short-term interventions such as device-guided breathing and lower-limb venous occlusion independently of blood pressure changes.
May support device-guided breathing as adjunct for arterial stiffness in hypertension; confirms PWV modulation independent of BP changes.
Background Effects of short-term interventions on large-artery stiffness assessed by pulse wave velocity (PWV) have mainly been explained by concomitant changes in blood pressure (BP). However, lower body negative pressure, which increases sympathetic activity and has other hemodynamic effects, has a specific effect on PWV in healthy volunteers. Methods and Results We examined effects of lower-limb venous occlusion (LVO), a similar intervention to lower-body negative pressure that reduces BP but increases sympathetic activity and device-guided breathing (DGB), which reduces both BP and sympathetic activity, on PWV in patients with essential hypertension (n=70 after LVO, n=45 after DGB and LVO in random order). The short-acting calcium channel antagonist nifedipine was used as a control for changes in BP. LVO produced a small but significant reduction in mean arterial pressure of 1.8 (95% CI 0.3-3.4) mm Hg. Despite this, aortic and carotid-femoral PWV increased during LVO by 0.8 (0.2-1.4) m/s and 0.7 (0.3-1.05) m/s, respectively. DGB reduced PWV by 1.2 (0.9-1.4) m/s, to a greater extent than did nifedipine 10 mg (reduction of 0.7 [0.1-1.3] m/s, P<0.05 compared with reduction during DGB). This occurred despite a greater decrease in BP with nifedipine compared with DGB. Conclusions Arterial stiffness can be modulated independently of BP over the short term. The mechanism could involve alterations in sympathetic activity or other as yet uncharacterized effects of LVO and DGB.
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Faconti et al. (2019) conducted an RCT in Essential hypertension (n=70). Device-guided breathing (DGB) and lower-limb venous occlusion (LVO) vs. Nifedipine 10 mg was evaluated on Pulse wave velocity (PWV) (p=<0.05). Device-guided breathing reduced pulse wave velocity by 1.2 m/s (95% CI 0.9-1.4) to a greater extent than nifedipine (0.7 m/s; P<0.05), showing arterial stiffness can be modulated independently of BP.
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