de Freitas Gonçalves Kamila S, Queiroz Godoy Daniel Ana C, Tatagiba Lamas José L, Oliveira Henrique C, Cloutier Lyne, De Campos Pereira Silveira Renata C, Veiga Eugenia V
WHO Collaborating Centre for Nursing Research Development, College of Nursing University of São Paulo Ribeirão Preto Brazil.
School of Nursing University of Campinas Campinas Brazil.
Health Sci Rep. 2022 May 16;5(3):e636. doi: 10.1002/hsr2.636. eCollection 2022 May.
Hypertension (HTN) is a multifactorial chronic disease. Considering the high prevalence rates of this disease, treatment of HTN is necessary, not only to reduce blood pressure (BP) levels but also to prevent the development of cardiovascular, cerebrovascular, and kidney diseases. This treatment can be through medication, which will be determined according to the BP values, obtained either in medical consultations or at home; presence of cardiovascular risk factors, and the presence of target organ damage identified during anamnesis. The aim of this systematic review and meta-analysis is to summarize the effects of device-guided slow breathing (DGSB) and nondevice-guided slow breathing (NDGSB) on BP levels of patients with HTN.
This study is a systematic review and meta-analysis of randomized clinical trials, pertaining to hypertensive patients, with or without comorbidity, over 18 years old, of both sexes, and with or without hypertensive medication. The selected studies showed comparisons between groups that performed DGSB and/or NDGSB with control conditions. The primary outcome was the value of systolic blood pressure (SBP) and diastolic blood pressure (DBP) after the interventions.
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 DGSB did not significantly reduce SBP and DBP compared to usual care, both in terms BP values and in relation to their variations (SBP, mean difference [MD]: -2.13 mmHg, (95% confidence interval [CI]: -12.71 to 8.44), 288 individuals; = 93%, high heterogenity: DBP, MD: -0.90, 95% CI: -3.97 to 2.11, 288 individuals; = 63%, substantial heterogenity. SBP variations MD: -2.42, 95% CI: -7.24 to 2.40, 443 individuals; = 85% high heterogenity/DBP variations MD: -1.67, 95% CI: -4.57 to 1.24, 443 individuals; = 80%, high heterogenity).
Based on these results it appears that DGSB did not reduce BP in hypertensive patients and NDGSB is a new path for the future.
高血压（HTN）是一种多因素慢性疾病。鉴于该疾病的高患病率，高血压的治疗不仅对于降低血压水平是必要的，而且对于预防心血管、脑血管和肾脏疾病的发生也是必要的。这种治疗可以通过药物进行，药物将根据在医疗咨询或家中获得的血压值、心血管危险因素的存在情况以及在问诊过程中确定的靶器官损伤情况来确定。本系统评价和荟萃分析的目的是总结设备引导式慢呼吸（DGSB）和非设备引导式慢呼吸（NDGSB）对高血压患者血压水平的影响。
本研究是一项对随机临床试验的系统评价和荟萃分析，涉及年龄在18岁以上、有或无合并症、男女皆有、有或无高血压药物治疗的高血压患者。所选研究显示了进行DGSB和/或NDGSB的组与对照条件之间的比较。主要结局是干预后收缩压（SBP）和舒张压（DBP）的值。
定量分析纳入了22项涉及17214名参与者的研究。研究之间存在相当大的异质性。使用随机效应模型发现，与常规护理相比，DGSB在血压值及其变化方面均未显著降低SBP和DBP（SBP，平均差值[MD]：-2.13 mmHg，（95%置信区间[CI]：-12.71至8.44），288人；I² = 93%，高度异质性；DBP，MD：-0.90，95% CI：-3.97至2.11，288人；I² = 63%，实质性异质性。SBP变化MD：-2.42，95% CI：-7.24至2.40，443人；I² = 85%，高度异质性/DBP变化MD：-1.67，95% CI：-4.57至1.24，443人；I² = 80%，高度异质性）。
基于这些结果，似乎DGSB并未降低高血压患者的血压，而NDGSB是未来的一条新途径。
