Gijs W D Landman1, Kornelis J J van Hateren2, Peter R van Dijk2, Susan J J Logtenberg3, Sebastiaan T Houweling2, Klaas H Groenier4, Henk J G Bilo3, Nanne Kleefstra3. 1. Diabetes Centre, Isala, Zwolle, the Netherlands2Department of Internal Medicine, Gelre Hospital, Apeldoorn, the Netherlands. 2. Diabetes Centre, Isala, Zwolle, the Netherlands. 3. Diabetes Centre, Isala, Zwolle, the Netherlands3Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands. 4. Diabetes Centre, Isala, Zwolle, the Netherlands4Department of General Practice, University Medical Center Groningen, Groningen, the Netherlands.
Abstract
IMPORTANCE: Device-guided breathing (DGB) is recommended by the American Heart Association for its blood pressure-lowering effects. Most previous studies that showed beneficial effects on blood pressure had low methodological quality and only investigated short-term blood pressure effects. OBJECTIVE: To assess the efficacy of DGB on blood pressure in a meta-analysis of individual patient data from blinded, randomized controlled trials with an active control group. DATA SOURCES: MEDLINE, EMBASE, clinicaltrials.gov, and the Cochrane Library. STUDY SELECTION: Included were randomized studies of at least 4 weeks' duration, with a single- or double-blind design and an active control group. Bias was assessed with the Cochrane risk of bias tool, and analyses were performed with linear mixed models. DATA EXTRACTION AND SYNTHESIS: Articles were searched in MEDLINE (using PubMed), EMBASE, and the Cochrane Library. MAIN OUTCOMES AND MEASURES: Office blood pressure. RESULTS: From the 15 selected abstracts, 5 studies were suitable for inclusion. Individual patient data from 2 of 5 studies were not provided. The effect of DGB on office systolic blood pressure compared with music therapy or a sham device was 2.2 mm Hg (95% CI, -2.7 to 7.0) in favor of the control group; DGB did not significantly lower office diastolic blood pressure (0.2 mm Hg [95% CI, -2.8 to 3.1] in favor of DGB). CONCLUSIONS AND RELEVANCE: All trials included in the analysis had a short follow-up period; therefore, no recommendations could be made regarding hypertension treatment. Treatment with DGB did not significantly lower office blood pressure compared with a sham procedure or music therapy.
IMPORTANCE: Device-guided breathing (DGB) is recommended by the American Heart Association for its blood pressure-lowering effects. Most previous studies that showed beneficial effects on blood pressure had low methodological quality and only investigated short-term blood pressure effects. OBJECTIVE: To assess the efficacy of DGB on blood pressure in a meta-analysis of individual patient data from blinded, randomized controlled trials with an active control group. DATA SOURCES: MEDLINE, EMBASE, clinicaltrials.gov, and the Cochrane Library. STUDY SELECTION: Included were randomized studies of at least 4 weeks' duration, with a single- or double-blind design and an active control group. Bias was assessed with the Cochrane risk of bias tool, and analyses were performed with linear mixed models. DATA EXTRACTION AND SYNTHESIS: Articles were searched in MEDLINE (using PubMed), EMBASE, and the Cochrane Library. MAIN OUTCOMES AND MEASURES: Office blood pressure. RESULTS: From the 15 selected abstracts, 5 studies were suitable for inclusion. Individual patient data from 2 of 5 studies were not provided. The effect of DGB on office systolic blood pressure compared with music therapy or a sham device was 2.2 mm Hg (95% CI, -2.7 to 7.0) in favor of the control group; DGB did not significantly lower office diastolic blood pressure (0.2 mm Hg [95% CI, -2.8 to 3.1] in favor of DGB). CONCLUSIONS AND RELEVANCE: All trials included in the analysis had a short follow-up period; therefore, no recommendations could be made regarding hypertension treatment. Treatment with DGB did not significantly lower office blood pressure compared with a sham procedure or music therapy.
Authors: Ida T Fonkoue; Yingtian Hu; Toure Jones; Monica Vemulapalli; Justin D Sprick; Barbara Rothbaum; Jeanie Park Journal: Am J Physiol Regul Integr Comp Physiol Date: 2020-08-26 Impact factor: 3.619