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Medicine Science

Daily 'Breath Training' Can Work As Well As Medicine To Reduce High Blood Pressure (npr.org) 56

An anonymous reader quotes a report from NPR: It's well known that weightlifting can strengthen our biceps and quads. Now, there's accumulating evidence that strengthening the muscles we use to breathe is beneficial too. New research shows that a daily dose of muscle training for the diaphragm and other breathing muscles helps promote heart health and reduces high blood pressure. "The muscles we use to breathe atrophy, just like the rest of our muscles tend to do as we get older," explains researcher Daniel Craighead, an integrative physiologist at the University of Colorado Boulder. To test what happens when these muscles are given a good workout, he and his colleagues recruited healthy volunteers ages 18 to 82 to try a daily five-minute technique using a resistance-breathing training device called PowerBreathe. The hand-held machine -- one of several on the market -- looks like an inhaler. When people breathe into it, the device provides resistance, making it harder to inhale.

"We found that doing 30 breaths per day for six weeks lowers systolic blood pressure by about 9 millimeters of mercury," Craighead says. And those reductions are about what could be expected with conventional aerobic exercise, he says -- such as walking, running or cycling. A normal blood pressure reading is less than about 120/80 mmHg, according to the Centers for Disease Control and Prevention. These days, some health care professionals diagnose patients with high blood pressure if their average reading is consistently 130/80 mmHg or higher, the CDC notes. The impact of a sustained 9 mmHg reduction in systolic blood pressure (the first number in the ratio) is significant, says Michael Joyner, a physician at the Mayo Clinic who studies how the nervous system regulates blood pressure. "That's the type of reduction you see with a blood pressure drug," Joyner says. Research has shown many common blood pressure medications lead to about a 9 mmHg reduction. The reductions are higher when people combine multiple medications, but a 10 mmHg reduction correlates with a 35% drop in the risk of stroke and a 25% drop in the risk of heart disease.

So, how exactly does breath training lower blood pressure? Craighead points to the role of endothelial cells, which line our blood vessels and promote the production of nitric oxide -- a key compound that protects the heart. Nitric oxide helps widen our blood vessels, promoting good blood flow, which prevents the buildup of plaque in arteries. "What we found was that six weeks of IMST [inspiratory-muscle strength training] will increase endothelial function by about 45%," Craighead explains. [...] There may also be benefits for elite cyclists, runners and other endurance athletes, he says, citing data that six weeks of IMST increased aerobic exercise tolerance by 12% in middle-aged and older adults. "So we suspect that IMST consisting of only 30 breaths per day would be very helpful in endurance exercise events," Craighead says. It's a technique that athletes could add to their training regimens. Craighead, whose personal marathon best is 2 hours, 21 minutes, says he has incorporated IMST as part of his own training.

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Daily 'Breath Training' Can Work As Well As Medicine To Reduce High Blood Pressure

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  • Air resistance on inhale doesn't require a fancy device, just close your lips most of the way and inhale through your mouth. Can someone less lazy than me RTFA and tell me what kind of resistance I want and how well-supported the conclusion is?
    • Any bets on who paid for the study?

    • by hey! ( 33014 )

      Yes, there are techniques like Pranayama in yoga. If you like a *little* less woo-woo, there's the Wim Hof method. If you prefer to avoid woo-woo altogether, you get a device like the one they used in this study; or one of the many inspiratory-muscle strength training (IMST) devices you can purchase on Amazon.

      • by mspohr ( 589790 )

        Yoga breathing and exercises such as meditation have been shown to reduce blood pressure. I studied this in medical school over 40 years ago. I even wrote a pharmacology paper on it and found that breathing exercises were as effective as drugs for blood pressure.
        There's no money in just telling people to meditate or do yoga exercises so most doctors just push pills.

    • by e3m4n ( 947977 ) on Wednesday September 21, 2022 @11:04AM (#62901467)
      A spirometer is good for tracking progress. Its the litlte device hopsitals give you to hopefully prevent pneumonia from too much shallow breathing. Singing is another way to strengthen. Sing loudly in the shower. Tibetan chants. Those Ahhmms. Opera singers have been strengthening their diaphragms for centuries. Its also one reason why churches promote singing in the congregation. There is a measurable health benefit. Not only in diaphragm strengthening, but the reverberation helps with other circulatory and respiratory aspects.
    • Air resistance on inhale doesn't require a fancy device, just close your lips most of the way and inhale through your mouth. Can someone less lazy than me RTFA and tell me what kind of resistance I want and how well-supported the conclusion is?

      You don't need a gym membership, just go and lift your car is that what you're saying?

      You don't need to know anything about your lungs (other than the diaphragm is a muscle) to understand that to train and strengthen a muscle you need to actually move it and not just load it statically.
      A better option would be breathing through different sized straws.

  • I know high blood pressure correlates with heart disease, but how much evidence is there of a causal link? Obesity and diabetes share common causes, leading many people to mistakenly believe obesity causes diabetes way more than it does. How about heart disease and blood pressure?
    • Okay, to answer my own question there seems to be good evidence of a causal link. DNA associated with high blood pressure represents a significantly higher risk of heart disease and associated morbidity. https://pubmed.ncbi.nlm.nih.go... [nih.gov]
      • by hey! ( 33014 )

        Well, technically that particular result just moves the correlation one step further away, from high blood pressure per se to DNA that causes high blood pressure. But the link between high blood pressure and a wide array of diseases is well established. In particular systematic literature reviews (e.g., [1]) conclude that *interventions to lower blood pressure* reduce mortality from various causes like heart disease.

        That's really the most useful kind of evidence, the evidence that shows *interventions* wo

        • A systematic review published in a leading journal is the minimal source of evidence a layman should ever consult in making a decision.
          It would be much simpler to consult a qualified doctor.
          Or how exactly would a layman judge a systematic reviewed paper?

    • by Malc ( 1751 )

      High blood pressure can lead to an enlarge heart, which can suffer complications.

      • by tsqr ( 808554 )

        I undergo yearly magnetic resonance angiograms to monitor for enlargement of my aorta, as a result of the emergency repair of an aortic dissection that nearly killed me a few years back. The first thing the thoracic surgeon told me in my post-op debrief was to get my blood pressure below 120/80 and keep it there. Well okay, that was the second thing he told me. The first thing was, "I hope you understand how lucky you are to be alive."

    • by e3m4n ( 947977 )
      High BP can cause you to throw a clot. That becomes a heart attack, stroke, and PE risk.
    • Mistakenly think obesity causes diabetes way more than it does, huh lol? Sure, sure. You keep on thinking that.

      People eat too much food, they get fat. Fat is hormonally active endocrine organ and this leads to insulin insensitivity. There's nothing to debate here - it's already known you can go read about it.

      Only two types of people are fat T2 diabetes deniers - the "muh carbs!" weirdos who think it's just all about those ebil carbs, and the "muh fat is beautiful" people who just don't want to admit it.

    • There is quite a bit of understanding of the mechanisms behind how high blood pressure damages your arteries and organs. Of course, the amount of damage depends on how high it is. 150/95 won't damage your organs, but it will damage your arteries.

  • CPAP? (Score:5, Interesting)

    by Hodr ( 219920 ) on Wednesday September 21, 2022 @08:26AM (#62901019) Homepage

    Interesting. There's a correlation between CPAP use and lowering blood pressure. I think most assume that is because you are treating the sleep apnea.

    What if sleep apnea isn't the cause, or only cause given that a large percentage of those with the condition have other health issues known to be associated with hypertension, but the CPAP directly treats the hypertension regardless of source?

    • As someone who uses a cpap, one of the hardest things to deal with it the resistance to breathing at times.

      My device is set to a low 6 psi to start. When it was set to ramp up, sometimes, it was like sucking air through a straw. Once up to 6, breathing normalizes. On those days when I felt the ramp up pressure, I was stressed before I put on the mask.

      I have had a heart valve repair and two ablations over the course of the past year. The ablations were needed to fix a-fib and then a stuck high heart rat

      • by hey! ( 33014 )

        Yeah, I don't know why they set the ramp up start so low. The rationale for sleep ramp is that the therapeutic pressure *might* interfere with falling asleep, but that's something you can learn to adapt to. Setting the pressure so low that the patient feels like they're suffocating also interferes with falling asleep, although again you can train yourself to tolerate this.

        I think it's just the cost of doing adequate follow up. They don't want to give patients control of their machines, but they don't wan

        • I've been on a BiPAP to treat sleep apnea for a few years. The thing I've really noticed (besides the improved sleep) is it's seemingly helped my asthma quite a bit.

          • by hey! ( 33014 )

            Yeah. I know this guy who clearly has obstructive sleep apnea. His reason for not going to the doctor: it'd be too much trouble to clean out the CPAP mask once a week. My response, dude, the reason that seems like an overwhelming obstacles is that you never get a good night's sleep.

            • I have to admit putting it off for quite a few years, mainly because I was in denial about the apnea - after all, I didn't fall asleep at odd times during the day, I didn't feel tired all the time, etc. etc. I just "snored a little", and when I felt tired it was because I didn't allow enough time for sleep (which was true).

              Looking back, I was being an idiot for no good reason. Unfortunately I can't say this was the only time that's been the case. ;-)

    • Re:CPAP? (Score:4, Informative)

      by LatencyKills ( 1213908 ) on Wednesday September 21, 2022 @08:57AM (#62901093)

      CPAP can be used to treat many of the ailments that fall under the COPD umbrella. You have to remember that inhaling is an active process - the diaphragm contracts and pulls down, increasing the volume of the chest cavity and reducing the pressure causing the air to flow in (there are other muscles involved as well, but that's the simple explanation). Exhaling is a passive process, at least for people without COPD. People who suffer from COPD can have difficulty inhaling, but often the real suffering is from their need to work to exhale - it's exhausting. The failure of the lungs to fully deflate results in a barrel chest - you can see old emphysema patients with big barrel chests - and a reduced exchange of gases, thus a decrease in blood oxygen and increase in blood CO2 levels. Serious COPD patients use BiPAP (which increases inhaled pressure, and decreases exhaled pressure). The body, living in this carbon dioxide increased, low oxygen environment can frankly go a little haywire - reduced organ function, impaired brain function, crappy blood ph, increased return pulmonary pressure, CHF (COPD sucks big time - think of how many times you breath during the day, and now make it a hard job) - which in turn can result in reduced blood flow to the extremities and increased blood pressure to compensate. Any ailment that reduces the ability of the lungs to properly ventilate - be it chronic asthma or just a fat, obstructive neck - can benefit from CPAP reducing the overall workload of breathing. So, sure, I can see CPAP use as possibly reducing hypertension in some patients as a standalone treatment, though other overlapping ailments may cause the blood pressure to continue to be abnormally high. But hey, with stroke on the table, even if bp only goes down ten points, ten points is ten points, and there are few if any side effects to CPAP. Can't say the same of other bp medications.

      • Exhaling is a passive process

        It's funny you mention this. I've been an avid cyclist for years, but only so-so on hills; not really going out of my way to avoid them, but not really seeking them out. This year, I decided to add them as a large portion of my road work. My usual ride, now, is an 18 mile loop, with 2000' of elevation, most of which is greater than 5% grade. At first, I was sucking air to get enough oxygen, but at some point I found pushing air out with my stomach muscles made it easier to breathe while climbing. It s

        • I think professional athletes do this. I recall reading somewhere that most of us have about 10% lung dead space - air space that is not exchanged on inhale and exhale - and much of that space is out at the end of the respiratory passages - down at the aveoli where the blood/air exchange takes place. The ability to force CO2 heavy air out of this space and replenish it with fresh oxygenated air would be a huge boost to respiratory efficiency.

    • I think the correlation is probably that inefficient lung exchange or low blood oxygenation requires high blood pressure to get oxygen circulated to the brain. So if you train yourself to breathe more deeply and fully you can get enough oxygen circulating without the body releasing stress hormones and raising blood pressure.

      I'm a CPAP user who had high blood pressure and occasional atrial fibrilation before having the CPAP. There's no question that it's related to stress hormones - and I think it's well s

      • The lungs oxygenate the blood to about 95%. Anything below that you are generally dead. Some high-level runners intentionally slow their breathing and get a 90% oxygenation rate. It works for them because their running economy is good enough that, unlike normal people, they aren't oxygen limited. And of course they have higher VO2 max. Even at 90% SPO2, the brain gets enough oxygen.

        That's not to say that you aren't onto something. If deep breathing lowers blood pressure, do we really care to argue a

        • The lungs oxygenate the blood to about 95%. Anything below that you are generally dead.

          Anything below that and your blood pressure increases to keep the level as high as it can.

          But no - you can be way below 95%. Below 90 might be a warning but it's 80% that is a bad sign.

          But there's also a difference between SpO2 and SaO2. What's measured at the pulse oximeter is peripheral and can be unreliable in critical health situations. During COVID, there were people who were on oxygen who were measuring SpO2 in the 60s. Many of them felt fine and were not struggling to breathe. They should have b

          • Higher blood pressure would *not* increase blood oxygenation as that's a function of the blood in the lungs. I think what you are trying to say is that the body would compensate for low blood oxygenation via increased blood flow. Increased blood flow requires higher blood pressure. That's very basic fluid mechanics. (Which is good since I don't know much fluid mechanics).

            You will go unconscious and/or have brain damage and an oxygen saturation around 85-90%. But that's *brain* oxygen saturation not bl

            • Higher blood pressure does change the gas exchange in the lungs. It's very bad for you but it does help keep the oxygen.

              I don't know if CPAP machines affect things like mortality. But I assume the improved sleep has a quality of life benefit?

              Absolutely. The hypoxia from not breathing cause high blood pressure and atrial fibrilation - increasing risk of things like heart attack and stroke. CPAPs have far less to do with quality of sleep than they do with making sure you don't die. CPAPs don't do a lot for lung exchange unless you have supplemental oxygen. Otherwise they just apply pressure to keep the airways from closing

        • Normal respiratory function keeps blood oxygenation levels at or above 95% (that's the number we in EMTland reach for when we give hypoxic patients O2), but you don't flat die below that. 80-ish % is, for short periods of time (hours), entirely common, though you'll feel pretty listless at that level. Some COPD patients reside in the 80s essentially all the time.

        • by Hodr ( 219920 )

          On the other hand, lowering blood pressure isn't the goal. The goal is improved health and longevity. Lowering blood pressure via proper exercise and lowering blood pressure through special breathing are not likely to have equal therapeutic benefits.

          Sure, because most CPAP users can just go for a jog instead. The real comparison should be between "special breathing" and "special medication", and in that instance the breathing is probably the better choice.

          • TFA was not about CPAP users. CPAP users most certainly cannot go for a jog because they have an actual pathology. For those who have high blood pressure due to lifestyle issues (rather than an actual physical ailment), the choices are deep breathing, medicine, or making better choices.
  • by geckoFeet ( 139137 ) <gecko@dustyfeet.com> on Wednesday September 21, 2022 @08:32AM (#62901039)

    I dunno. There's a big picture of the Queen on PowerBreathe's homepage, and my understanding is that she hasn't been too healthy recently.

    • She made it to 96, and was still active; although she had been cutting back on travel, she made the ceremonial meeting with the new Prime Minister two days before her death, although they did it in Balmoral instead of have her go to London. I'll be plenty happy if I make it that far.

  • You get the resistance work out plus you exercise your mind with the music training.

    • by svr0002 ( 536813 )

      Bagpipes not recommended if you care about the people nearby. My wife (accomplished recorder and flute player with great breath control) once tried bagpipes at a Highland Games event which made me run away screaming.

      • Re: (Score:3, Funny)

        by Biljrat ( 45007 )

        I consider the keeping people away one of the benefits of the pipes.
        But almost any wind will do.

  • by notaspy ( 457709 )

    just do 30 bong rips every day.

  • "I don't need to take meds, I'll just do breathing!" Said the crowd. How many will be disciplined enough to do it, and how many will die because of it? I'm betting you have to actually - do it?
  • Why not just practice a wind instrument? Clarinet, trumpet, or something like that.

    Singing lessons also might do the trick.

    • The usual advice is martial arts. But of course cycling or jogging, or particularly swimming is fine, too.

      Just avoid Gyms and do something simple - even Yoga would do it.

      • by BranMan ( 29917 )

        Martial arts might seem like strange advice - but back when I was doing Karate, part of every session's warm up was breathing exercises - mainly focused on a controlled, FULL exhale. Trying to get every ounce of air out of your lungs.

  • When I read "A normal blood pressure reading is less than about 120/80 mmHg", I can recommend an even easier method to reach a "normal" blood pressure: Just consult >=40 years old medical science books. Apparently, the "normal" is not defined by what is found in average healthy humans, but decreased year after year to accommodate the needs of an industry who wants to sell medication to an ever growing majority of people. Some day there will be studies showing if you lower the blood pressure to zero by us
    • Apparently, the "normal" is not defined by what is found in average healthy humans, but decreased year after year to accommodate the needs of an industry who wants to sell medication to an ever growing majority of people.

      If you actually meant, decreased year after year to accommodate the science that has linked different levels of blood pressure to adverse health effects while also finding the majority of the population that doesn't sit on their fat cheeto filled arse all day actually has a 120/80 then I completely agree with you. Just FYI, there's more to the world than the USA, and most of it doesn't medicate the population while still meeting the same definition of normal.

      By the way, along with recognition of the problem

      • High blood pressure is a gentle death to many bodily functions that we don't even think about.. My brother's wife kept postponing research even though her family doctor recommended it.. And one day she noticed that her vision began to deteriorate despite expensive soft lenses. She had to order comfortable classic glasses from Ocuwear [ocuwear.com] because she was banned from wearing lenses for the next year. And this is just one of the options. It seems to me that having a blood pressure monitor at home is a must for eve

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