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

Autonomic Neuroscience: Basic and Clinical

Volumn 179, Issue 1-2, 2013, Pages 131-137

  Howorka, Kinga ^a,b,d   Pumprla, Jiri ^a,d   Tamm, Jennifer ^a,b   Schabmann, Alfred ^c   Klomfar, Sophie ^a,c   Kostineak, Elysee ^a,b   Howorka, Nora ^a,d   Sovova, Eliska ^e  

^a Group Education   (Austria)

^b MEDICAL UNIVERSITY OF VIENNA   (Austria)

^c UNIVERSITY OF VIENNA   (Austria)

^d Principal InvestigatorD s Clinical Office Internal Medicine and Diabetology   (Austria)

^e PALACKÝ UNIVERSITY   (Czech Republic)

Author keywords

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

Indexed keywords

ANTIHYPERTENSIVE AGENT; INSULIN;

ADULT; ANTIHYPERTENSIVE THERAPY; ARTICLE; BLOOD PRESSURE; BLOOD PRESSURE MONITORING; BREATHING; CLINICAL ARTICLE; CONTROLLED STUDY; DIABETES MELLITUS; FEASIBILITY STUDY; FEMALE; HEART RATE VARIABILITY; HUMAN; HYPERTENSION; INSULIN TREATMENT; MALE; MIDDLE AGED; PRIORITY JOURNAL; PULSE PRESSURE; RANDOMIZED CONTROLLED TRIAL; SPECTROSCOPY; SYSTOLIC BLOOD PRESSURE;

AMBULATORY BLOOD PRESSURE MONITORING; DEVICE GUIDED BREATHING; DIABETES; HEART RATE VARIABILITY; HYPERTENSION; RANDOMIZED CONTROLLED STUDY; RESPERATE®; SPECTRAL ANALYSIS;

BLOOD PRESSURE; BLOOD PRESSURE MONITORING, AMBULATORY; BREATHING EXERCISES; DIABETES COMPLICATIONS; DIABETES MELLITUS; FEMALE; HEART RATE; HUMANS; HYPERTENSION; MALE; MIDDLE AGED; RESPIRATION;

EID: 84897070655     PISSN: 15660702     EISSN: 18727484     Source Type: Journal    
DOI: 10.1016/j.autneu.2013.08.065     Document Type: Article

References (44)

1. Altena M.R., Kleefstra N., Logtenberg S.J., Groenier K.H., Houweling S.T., Bilo H.J. Effect of device-guided breathing exercises on blood pressure in patients with hypertension: a randomized controlled trial. Blood Press. 2009, 18(5):273-279.
2. American Diabetes Association Nephropathy in diabetes. Diabetes Care 2004, 27:79-83.
3. Arauz-Pacheco C., Parrott M.A., Raskin P. The treatment of hypertension in adult patients with diabetes. Diabetes Care 2002, 25(1):134-147.
4. Chobanian A.V., Bakris G.L., Black H.R., Cushman W.C., Green L.A., Izzo J.L., Jones D.W., Materson B.J., Oparil S., Wright J.T., Roccella E.J. National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee, 2003. The 7th report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003, 289(19). (Epub 2003 May 14).
5. Coats A.J., Radaelli A., Clark S.J., Conway J., Sleight P. The influence of ambulatory blood pressure monitoring on the design and interpretation of trials in hypertension. J. Hypertens. 1992, 10:385-391.
6. Dart A.M., Kingwell B.A. Pulse pressure - a review of mechanisms and clinical relevance. JACC 2001, 37(4):975-984.
7. Declaration of Helsinki: WMA Declaration of Helsinki 1964, adopted, amended Available from. http://www.wma.net/en/30publications/10policies/b3/.
8. Elliot W.J., Izzo J.L., White W.B., Rosing D.R., Snyder C.S., Alter A., Gavish B., Black H.R. Graded blood pressure reduction in hypertensive outpatients associated with use of a device to assist with slow breathing. J. Clin. Hypertens. (Greenwich) 2004, 6(10):553-559.
9. Ewing D.J., Martyn C.N., Young R.J., Clarke B.F. The value of cardiovascular autonomic function tests: 10years experience in diabetes. Diabetes Care 1985, 8:491-498.
10. Gerritsen J., Dekker J.M., TenVoorde B.J., Kostense P.J., Heine R.J., Bouter L.M., Heethaar R.M., Stehouwer C.D. Impaired autonomic function is associated with increased mortality, especially in subjects with diabetes, hypertension, or a history of cardiovascular disease: the Hoorn Study. Diabetes Care 2001, 24(10):1793-1798.
11. Howorka K. Functional Insulin Treatment. Principles, Teaching Approach and Practice. 2nd Edition. Springer-Publishers Berlin 1996, German edition: Howorka K., 1996 Funktionelle Insulintherapie. Lehrinhalte, Praxis und Didaktik, Springer-Publishers, Berlin. 4th ed.
12. Howorka K. Schulungscurricula DiabetesFIT® 2009, Kirchheim-Publishers, Mainz.
13. Howorka K., Pumprla J., Haber P., Koller-Strametz J., Mondrzyk J., Schabmann A. Effects of physical training on heart rate variability in diabetic patients with various degrees of cardiovascular autonomic neuropathy. Cardiovasc. Res. 1997, 34:206-214.
14. Howorka K., Pumprla J., Schabmann A. Influence of fasting on heart rate variability in diabetic patients with different degrees of cardiovascular autonomic neuropathy. Diabetes Nutr. Metab./Clin. Exp. 1997, 10:288-295.
15. Howorka K., Pumprla J., Schabmann A. Optimal parameters of short-term heart rate spectrogram for routine evaluation of diabetic cardiovascular autonomic neuropathy. J. Auton. Nerv. Syst. 1998, 69(2-3):164-172.
16. Howorka K., Pumprla J., Jirkovska A., Lacigova S., Nolan J. Modified orthostatic load for spectral analysis of short-term heart rate variability improves the sensitivity of autonomic dysfunction assessment. J. Diabetes Complicat. 2010, 24:48-54.
17. Joseph C.N., Porta C., Casucci G., Casiraghi N., Maffeis M., Rossi M., Bernardi L. Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. Hypertension 2005, 46(4):714-718.
18. Lenth R.V. Java Applets for Power and Sample Size (software) Available from. http://homepage.stat.uiowa.edu/rlenth/Power/#Download_to_run_locally.
19. Logtenberg S.J., Kleefstra N., Houweling S.T., Groenier K.H., Bilo H.J. Effect of device-guided breathing exercises on blood pressure in hypertensive patients with type 2 diabetes mellitus: a randomized controlled trial. J. Hypertens. 2007, 25(1):241-246.
20. Malik M., Force Task Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation 1996, 93(5):1043-1065.
21. Mancia G., Omboni S., Parati G., Ravogli A., Villani A., Zanchetti A. Lack of placebo effect on ambulatory blood pressure. Am. J. Hypertens. 1995, 8(3):311-315.
22. Meles E., Giannattasio C., Failla M., Gentile G., Capra A., Mancia G. Nonpharmacologic treatment of hypertension by respiratory exercise in the home setting. Am. J. Hypertens. 2004, 17(4):370-374.
23. Mogensen C.E. New treatment guidelines for a patient with diabetes and hypertension. J. Hypertens. Suppl. 2003, 21(1):S25-S30.
24. Morrish N.J., Wang S.L., Stevens L.K., Fuller J.H., Keen H. Mortality and causes of death in the WHO multinational study of vascular disease in diabetes. Diabetologia 2001, 44(Suppl. 2):S14-S21.
25. O'Brien E., O'Malley K., Cox J., Stanton A. Ambulatory blood pressure monitoring in the evaluation of drug efficacy. Am. Heart J. 1991, 121:999-1006.
26. Patel C., Margot M.G., Terry D.J., Carruthers M., Hunt B. Trail of relaxation in reducing coronary risk: four year follow up. Br. Med. J. (Clin. Res. Ed.) 1985, 290(6475):1103-1106.
27. Pinheiro C.H., Medeiros R.A., Pinheiro D.G., Marinho Mde J. Spontaneous respiratory modulation improves cardiovascular control in essential hypertension. Arq. Bras. Cardiol. 2007, 88(6):651-659.
28. Pitzalis M.V., Mastropasqua F., Massari F., Passantino A., Colombo R., Mannarini A., Forleo C., Rizzon P. Effect of respiratory rate on the relationships between RR interval and systolic blood pressure fluctuations: a frequency-dependent phenomenon. Cardiovasc. Res. 1998, 38(2):332-339.
29. Poluzzi E., Strahinja P., Vaccheri A., Vargiu A., Silvani M.C., Motola D., Marchesini G., De Ponti F., Montanaro N. Adherence to chronic cardiovascular therapies: persistence over the years and dose coverage. Br. J. Clin. Pharmacol. 2007, 63(3):346-355.
30. Pumprla J. Calculating the Economic Impact of Outpatient Diabetes Modular Education Programme 2008, Master thesis, Professional MBA, Donau University Krems.
31. Pumprla J., Howorka K., Groves D., Chester M., Nolan J. Functional assessment of heart rate variability: physiological basis and practical applications. Int. J. Cardiol. 2002, 84:1-14.
32. Rosenthal T., Alter A., Peleg E., Gavish B. Device-guided breathing exercises reduce blood pressure: ambulatory and home measurements. Am. J. Hypertens. 2001, 14:74-76.
33. Sackett D.L. Superiority trials, noninferiority trials, and prisoners of the 2-sided null hypothesis. Evid. Based Med. 2004, 9:38-39. (see http://ebm.bmj.com/content/9/2/38.full?sid=376dd79c-9774-4d0c-aa2a-2e74130b8899).
34. Salinger J., Pumprla J., Vychodil R., Opavsky J. Microcomputer system for telemetric assessment of short term heart rate variability in time and frequency domain, type VariaCardio TF4. IEEE Comp. Cardiol. 1999, 26:599-602.
35. Schein M.H., Gavish B., Herz M., Rosner-Kahana D., Naveh P., Knishkowy B., Zlotnikov E., Ben-Zvi N., Melmed R.N. Treating hypertension with a device that slows and regularises breathing: a randomised, double-blind controlled study. J. Hum. Hypertens. 2001, 15(4):271-8.
36. Schein M.H., Gavish B., Baevsky T., Kaufman M., Levine S., Nessing A., Alter A. Treating hypertension in type II diabetic patients with device-guided breathing: a randomized controlled trial. J. Hum. Hypertens. 2009, 23(5):325-331.
37. Slany J., Hitzenberger G., Zweiker R., Mayer G., Rosenkranz A.R., Watschinger B., Wenzel R. Practical recommendations of the Austrian Society of Hypertension (ÖGH) for medical, personal, and ambulatory 24-hour blood pressure measurement. J. Hypertonie 2008, 12(4):13-20.
38. Smith P.A., Graham L.N., Mackintosh A.F., Stoker J.B., Mary D.A. Relationship between central sympathetic activity and stages of human hypertension. Am. J. Hypertens. 2004, 17(3):217-222.
39. Strauss-Blasche G., Moser M., Voica M., McLeod D.R., Klammer N., Marktl W. Relative timing of inspiration and expiration affects respiratory sinus arrhythmia. Clin. Exp. Pharmacol. Physiol. 2000, 27(8):601-606.
40. Vinik A.I., Erbas T. Recognizing and treating diabetic autonomic neuropathy. Cleve. Clin. J. Med. 2001, 68(11):928-944.
41. Viskoper R., Shapira I., Priluck R., Mindlin R., Chornia L., Laszt A., Dicker D., Gavish B., Alter A. Nonpharmacologic treatment of resistant hypertensives by device-guided slow breathing exercises. Am. J. Hypertens. 2003, 16(6):484-487.
42. Wheeler S.G., Ahroni J.H., Boyko E.J. Prospective study of autonomic neuropathy as a predictor of mortality in patients with diabetes. Diabetes Res. Clin. Pract. 2002, 58(2):131-138.
43. Wolf-Maier K., Cooper R.S., Kramer H., Banegas J.R., Giampaoli S., Joffres M.R., Poulter N., Primatesta P., Stegmayr B., Thamm M. Hypertension treatment and control in five European countries, Canada, and the United States. Hypertension 2004, 43(1):10-17.
44. Ziegler D., Dannehl K., Mühlen H., Spüler M., Gries F.A. Prevalence of cardiovascular autonomic dysfunction assessed by spectral analysis, vector analysis, and standard tests of heart rate variation and blood pressure responses at various stages of diabetic neuropathy. Diabet. Med. 1992, 9(9):806-814.