Efficacy of device-guided breathing for hypertension in blinded, randomized, active-controlled trials: a meta-analysis of individual patient data

• Published in: JAMA internal medicine Vol. 174; no. 11; p. 1815
• Main Authors: Landman, Gijs W D, van Hateren, Kornelis J J, van Dijk, Peter R, Logtenberg, Susan J J, Houweling, Sebastiaan T, Groenier, Klaas H, Bilo, Henk J G, Kleefstra, Nanne
• Format: Journal Article
• Language: English
• Published: United States 01.11.2014
• Subjects: Blood Pressure; Breathing Exercises; Humans; Hypertension - therapy; Randomized Controlled Trials as Topic
• ISSN: 2168-6114
• DOI: 10.1001/jamainternmed.2014.4336

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. 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. MEDLINE, EMBASE, clinicaltrials.gov, and the Cochrane Library. 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. Articles were searched in MEDLINE (using PubMed), EMBASE, and the Cochrane Library. Office blood pressure. 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). 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.