Title: Device and non-device-guided slow breathing to reduce blood pressure in hypertensive patients: A systematic review and meta-analysis

Abstract

Objectives: What is the impact of prolonged use of device or non-device guided slow breathing compared to usual care, on the BP values of hypertensive patients? Design: Systematic review and meta-analysis of randomized clinical trials. Participants: Hypertensive patients, with or without comorbidity, over 18 years old, of both sexes, with or without hypertensive medication. Intervention: The selected studies showed comparisons between groups that performed device-guided and/or non-device-guided slow breathing with control conditions. Outcome measures: The primary outcome was the value of systolic blood pressure (SBP) and diastolic blood pressure (DBP) after the interventions. The secondary outcome was the reduction in the quantity/dosage of drugs administered to control hypertension. Results: Twenty-two studies involving 17,214 participants were included in the quantitative analysis. Considerable heterogeneity was revealed between studies. Using random effect model, it was found that device-guided slow breathing did not significantly reduce SBP and DBP compared to usual care, both in terms BP values and in relation to their variations (SBP, MD -2.13 mmHg, [95% CI -12.71 to 8.44], 288 individuals; I2 = 93%, high heterogenity : DBP, MD -0.90, 95% CI -3.97 to 2.11, 288 individuals; I2 = 63%,substantial heterogenity . SBP variations MD - 2.42, 95% CI -7.24 to 2.40, 443 individuals; I2 = 85% high heterogenity / DBP variations MD -1.67, 95% CI -4.57 to 1.24, 443 individuals; I2 = 80%, high heterogenity ). Conclusion: Based on these results it appears that device-guided slow breathing did not reduce blood pressure in hypertensive patients. Registration: PROSPERO CRD42020147554

Biography

Kamila Shelry de Freitas Gonçalves, Postdoctoral fellow at the University of São Paulo (USP- RibeirãoPreto). PhD in Health Sciences from UNICAMP (2015), she carries out her research activity at UNICAMP in the Blood Pressure Study and Research Group (GEPPA) and at USP in the Interdisciplinary Research Group on Hypertension (GIPHA). Master in Health Sciences from UNICAMP (2009) she is specialist in Physiotherapy applied to Orthopedics and Traumatology by UNICAMP (2005). She was graduated in Physiotherapy from UniversidadePaulista (2004) and has experience in Hospital Physiotherapy (Cardiology, Pulmonology, Neurology, Orthopedics, Traumatology, Pediatrics, Neonatal ICU and Adult ICU). Professor of the Physiotherapy course at UniversidadePaulista (since 2015) and Coordinator of the LatoSensu Postgraduate course in Neurofunctional Rehabilitation at UniversidadePaulista (since 2017).