Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
Complement Ther Med. 2019 Aug;45:179-184. doi: 10.1016/j.ctim.2019.03.005. Epub 2019 Mar 15.
Interest is increasing in nonpharmacological interventions to treat blood pressure in hypertensive and prehypertensive patients at low cardiac risk. This meta-analysis of randomized controlled trials assesses the impact of device-guided and non-device-guided (pranayama) slow breathing on blood pressure reduction in these patient populations.
We searched PubMed, EMBASE, CINAHL, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, Web of Science, BIOSIS (Biological Abstracts) Citation Index and Alt HealthWatch for studies meeting these inclusion criteria: randomized controlled trial or first phase of a randomized cross-over study; subjects with hypertension, prehypertension or on antihypertensive medication; intervention consisting of slow breathing at ≤10 breaths/minute for ≥5 min on ≥3 days/week; total intervention duration of ≥4 weeks; follow-up for ≥4 weeks; and a control group. Data were extracted by two authors independently, the Cochrane Risk of Bias Tool assessed bias risk, and data were pooled using the DerSimonian and Laird random effects model. Main outcomes included changes in systolic (SBP) and/or diastolic blood pressure (DBP), heart rate (HR), and/or decreased antihypertensive medication.
Of 103 citations eligible for full-text review, 17 studies were included in the meta-analysis. Overall, slow breathing decreased SBP by -5.62 mmHg [-7.86, -3.38] and DBP by -2.97 mmHg [-4.28, -1.66]. Heterogeneity was high for all analyses.
Slow breathing showed a modest reduction in blood pressure. It may be a reasonable first treatment for low-risk hypertensive and prehypertensive patients who are reluctant to start medication.
对于低心脏风险的高血压和高血压前期患者，人们越来越感兴趣的是采用非药物干预措施来治疗血压。本项随机对照试验的荟萃分析评估了设备指导和非设备指导（腹式呼吸）的缓慢呼吸对这些患者人群血压降低的影响。
我们检索了 PubMed、EMBASE、CINAHL、Cochrane 中心对照试验数据库、Cochrane 系统评价数据库、Web of Science、BIOSIS（生物文摘）引文索引和 Alt HealthWatch，以纳入符合这些纳入标准的研究：随机对照试验或随机交叉研究的第一阶段；高血压、高血压前期或服用抗高血压药物的患者；干预措施包括≤10 次/分钟的缓慢呼吸，每周≥3 天，持续≥5 分钟；总干预时间≥4 周；随访时间≥4 周；和对照组。两名作者独立提取数据，使用 Cochrane 偏倚风险工具评估偏倚风险，并使用 DerSimonian 和 Laird 随机效应模型对数据进行合并。主要结局包括收缩压（SBP）和/或舒张压（DBP）、心率（HR）和/或降压药物减少的变化。
在 103 篇符合全文审查条件的引用中，有 17 项研究被纳入荟萃分析。总的来说，缓慢呼吸使 SBP 降低了-5.62mmHg[-7.86，-3.38]，DBP 降低了-2.97mmHg[-4.28，-1.66]。所有分析的异质性都很高。
缓慢呼吸显示出血压适度降低。对于不愿意开始服药的低风险高血压和高血压前期患者，它可能是一种合理的首选治疗方法。
