Device-Guided Paced Respiration as an Adjunctive Therapy for Hypertension in Obstructive Sleep Apnea: A Pilot Feasibility Study |
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Authors: | Suzanne M. Bertisch Ashley Schomer Erin E. Kelly Leonardo A. Baloa Lauren E. Hueser Stephen D. Pittman Atul Malhotra |
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Affiliation: | (1) Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 1309 Beacon Street, 2nd floor, Brookline, Boston, MA 02446, USA;(2) Division of Sleep Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA;(3) Philips Home Healthcare Solutions, Boston, MA, USA |
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Abstract: | Data suggest that device-guided paced respiration (<10 breaths/min) may reduce blood pressure in hypertensive patients. We hypothesized that daily device-guided slow breathing may lower blood pressure in patients with hypertension and obstructive sleep apnea (OSA). In this one-arm pilot study, we enrolled 25 subjects with hypertension and OSA. Subjects were asked to perform device-guided paced respiration 30 min a day for 8 weeks. Our primary outcome was change in office systolic and diastolic blood pressures from baseline to 8 weeks. Twenty-four subjects completed the study. Mean baseline blood pressure was 140.0 ± 10.2 mmHg systolic and 82.7 ± 8.9 mmHg diastolic. Complete device data were available for 17 subjects. Mean device adherence was 81 ± 24% and 51% achieved a mean breath rate ≤10 breaths/min over 8 weeks. Three subjects had changes in their anti-hypertensive medications during the study. Among the remaining 21 subjects, mean difference in office blood pressure from baseline to 8 weeks was −9.6 ± 11.8 mmHg systolic (p ≤ 0.01) and −2.52 ± 8.9 mmHg diastolic (p = 0.21). Device-guided paced respiration may lower systolic blood pressure in patients with hypertension and OSA; however, our findings need to be confirmed with larger randomized controlled trials. |
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