The effect of breathing exercise on hemodynamics and heart rate variability parameters in hypertensive patients: A systematic review.
Level 1 - systematic review of randomized trials
Systematic review of randomized controlled trials and clinical trials
PubMed 39593619 · doi:10.1016/j.jbmt.2024.03.043
What was done
A systematic review searching six electronic databases (PubMed, ScienceDirect, Web of Science, Scopus, ProQuest, and Cochrane Library) to evaluate breathing exercises (BE) on hemodynamics and heart rate variability (HRV) in hypertensive patients. Study designs included randomized controlled trials (RCTs) and clinical trials. Risk of bias was evaluated using the modified Downs and Black checklist, and certainty of evidence was appraised using the GRADE approach. Eleven studies (8 RCTs, 3 clinical trials) were included, covering four BE categories: deep and slow breathing, manipulated nostril breathing, cycle of breathing, and prolonged expiration breathing.
What was found
The abstract reports no numerical values, effect sizes, or confidence intervals. All 11 included studies were rated as high quality. By GRADE assessment, evidence certainty was low to moderate for reductions in systolic and diastolic blood pressure, low to high for heart rate reduction, and moderate for lowering mean arterial blood pressure and modulating HRV parameters.
Why it matters
This review synthesizes clinical trial evidence showing that structured breath-control techniques can improve hemodynamic parameters and autonomic modulation in hypertension.
Limits
The abstract reports no numerical data, pooled effect sizes, or total participant sample size. The synthesis combined randomized trials with non-randomized clinical trials, and the GRADE certainty for blood pressure lowering was limited to low-to-moderate quality.
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