Development and application of a respiratory device on blood pressure in adults with high blood pressure

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

Objective

To explore the effects of inspiratory muscle training (IMT) on hypertension and provide guidance for its clinical application as an auxiliary approach.

Methods

Articles 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.

Results

There 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).

Conclusion

IMT 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 Registration

https://www.crd.york.ac.uk/prospero/, identifier: CRD42022300908.

Device and nondevice‐guided slow breathing to reduce blood pressure in hypertensive patients: A systematic review and meta‐analysis

Backgroud and Aims

Hypertension (HTN) is a multifactorial chronic disease. Considering the high prevalence rates of this disease, treatment of HTN is necessary, not only to reduce blood pressure (BP) levels but also to prevent the development of cardiovascular, cerebrovascular, and kidney diseases. This treatment can be through medication, which will be determined according to the BP values, obtained either in medical consultations or at home; presence of cardiovascular risk factors, and the presence of target organ damage identified during anamnesis. The aim of this systematic review and meta‐analysis is to summarize the effects of device‐guided slow breathing (DGSB) and nondevice‐guided slow breathing (NDGSB) on BP levels of patients with HTN.

Methods

This study is a systematic review and meta‐analysis of randomized clinical trials, pertaining to hypertensive patients, with or without comorbidity, over 18 years old, of both sexes, and with or without hypertensive medication. The selected studies showed comparisons between groups that performed DGSB and/or NDGSB with control conditions. The primary outcome was the value of systolic blood pressure (SBP) and diastolic blood pressure (DBP) after the interventions.

Results

Twenty‐two studies involving 17,214 participants were included in the quantitative analysis. Considerable heterogeneity was revealed between studies. Using random effect model, it was found that DGSB did not significantly reduce SBP and DBP compared to usual care, both in terms BP values and in relation to their variations (SBP, mean difference [MD]: −2.13 mmHg, (95% confidence interval [CI]: −12.71 to 8.44), 288 individuals; I² = 93%, high heterogenity: DBP, MD: −0.90, 95% CI: −3.97 to 2.11, 288 individuals; I² = 63%, substantial heterogenity. SBP variations MD: −2.42, 95% CI: −7.24 to 2.40, 443 individuals; I² = 85% high heterogenity/DBP variations MD: −1.67, 95% CI: −4.57 to 1.24, 443 individuals; I² = 80%, high heterogenity).

Conclusion

Based on these results it appears that DGSB did not reduce BP in hypertensive patients and NDGSB is a new path for the future.