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. 2023 Dec 27:20:200232.
doi: 10.1016/j.ijcrp.2023.200232. eCollection 2024 Mar.

Effect of breathing exercises on blood pressure and heart rate: A systematic review and meta-analysis

Piyush Garg  1   2 , Ayushi Mendiratta  2   3 , Akshat Banga  2   4 , Anna Bucharles  2   5 , Piccoli Victoria  2   5 , Balakrishnan Kamaraj  2   6 , Rakhtan K Qasba  2   7 , Vikas Bansal  2   8 , Jayaraman Thimmapuram  9 , Robert Pargament  9 , Rahul Kashyap  2   8   10   11
Affiliations

Effect of breathing exercises on blood pressure and heart rate: A systematic review and meta-analysis

Piyush Garg et al. Int J Cardiol Cardiovasc Risk Prev. .

Abstract

Background: Breathing exercises have been reported to have positive physiological effects on the body. The incidence of hypertension has become a major risk factor for cardiac complications leading to higher morbidity and mortality. Our aim was to conduct a systematic review and meta-analysis to study the effect of breathing exercises on blood pressure (BP) and heart rate (HR).

Methods: A systematic review and meta-analysis analyzing randomized clinical trials (RCTs) about the effect of breathing exercises on blood pressure was conducted (PROSPERO Registration ID: CRD42022316413). PubMed, ScienceDirect, WebofScience, and Cochrane Library databases were screened for RCTs from January 2017 to September 2022. The main search terms included "breathing exercise", "Pranayam", "Bhramari", "alternate nostril breathing", "deep breathing", "slow breathing", "hypertension", and "high blood pressure". The primary outcome was the value of the systolic blood pressure and diastolic blood pressure after the intervention. The effect on heart rate was also analyzed as a secondary outcome.

Results: A total of 15 studies were included in the meta-analysis. Breathing exercises have a modest but significant effect on decreasing systolic blood pressure (-7.06 [-10.20, -3.92], P = <0.01) and diastolic blood pressure (-3.43 [-4.89, -1.97], P = <0.01) mm Hg. Additionally, breathing exercises were also observed to cause a significant decrease in the heart rate (-2.41 [-4.53, -0.30], P = 0.03) beats/minute.

Conclusion: In a comprehensive systematic review and meta-analysis of breathing exercises and its effect on BP and HR, there is a moderate but significant positive effect. The studies are not deprived of bias.

Keywords: Blood pressure; Breathing exercises; Hypertension; Pranayam; Systematic review.

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Figures

Fig. 1
Fig. 1
PRISMA flow diagram.
Fig. 2
Fig. 2
Characteristics baseline SBP.
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Characteristics baseline DBP
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Fig. 4
Characteristics baseline heart rate.
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SBP variation in intervention group.
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SBP variation in control group.
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Dbp variation in intervention group.
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Fig. 8
Dbp variation in control group.
Fig. 9
Fig. 9
Heart rate variation in intervention group.
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Fig. 10
Heart rate variation in control group.
See this image and copyright information in PMC

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