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Cited by 92Heart Rate Variability and Autonomic ControlBlood Pressure and Hypertension StudiesCardiovascular Health and Disease Prevention

Effects of slow breathing rate on heart rate variability and arterial baroreflex sensitivity in essential hypertension

Open access
Li, Changjun, Chang, Qinghua, Zhang, Jia, Chai, Wenshu·2018·Medicine
DOI 10.1097/md.0000000000010639PMC PMC6392805
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Abstract

This study is to investigate the effects of slow breathing on heart rate variability (HRV) and arterial baroreflex sensitivity in essential hypertension.We studied 60 patients with essential hypertension and 60 healthy controls. All subjects underwent controlled breathing at 8 and 16 breaths per minute. Electrocardiogram, respiratory, and blood pressure signals were recorded simultaneously. We studied effects of slow breathing on heart rate, blood pressure and respiratory peak, high-frequency (HF) power, low-frequency (LF) power, and LF/HF ratio of HRV with traditional and corrected spectral analysis. Besides, we tested whether slow breathing was capable of modifying baroreflex sensitivity in hypertensive subjects.Slow breathing, compared with 16 breaths per minute, decreased the heart rate and blood pressure (all P < .05), and shifted respiratory peak toward left (P < .05). Compared to 16 breaths/minute, traditional spectral analysis showed increased LF power and LF/HF ratio, decreased HF power of HRV at 8 breaths per minute (P < .05). As breathing rate decreased, corrected spectral analysis showed increased HF power, decreased LF power, LF/HF ratio of HRV (P < .05). Compared to controls, resting baroreflex sensitivity decreased in hypertensive subjects. Slow breathing increased baroreflex sensitivity in hypertensive subjects (from 59.48 ± 6.39 to 78.93 ± 5.04 ms/mm Hg, P < .05) and controls (from 88.49 ± 6.01 to 112.91 ± 7.29 ms/mm Hg, P < .05).Slow breathing can increase HF power and decrease LF power and LF/HF ratio in essential hypertension. Besides, slow breathing increased baroreflex sensitivity in hypertensive subjects. These demonstrate slow breathing is indeed capable of shifting sympatho-vagal balance toward vagal activities and increasing baroreflex sensitivity, suggesting a safe, therapeutic approach for essential hypertension.

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  • Breathing acts directly on the autonomic nervous system as a bottom-up approach to stress reduction, so its benefits likely persist across diverse populations.

    “Because breathing acts directly on the autonomic nervous system as a “bottom-up” approach to stress reduction [113,114,115,116,117,118], its benefits likely persist across diverse populations.”

    From Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature (2023) · cites this paper as [114]

    The Discussion (page unavailable) reports that slow breathing shifted heart-rate-variability measures toward greater vagal activity in patients with essential hypertension, supporting an effect on autonomic regulation. The paper does not test stress reduction or characterize breathing as a “bottom-up” stress-reduction approach. The statement about benefits across diverse populations follows the citations as the citing authors’ inference, rather than a finding attributed specifically to this source. (LLM, conf=0.85)

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  • Heart rate and blood pressure decrease with slow breath in patients with essential hypertension compared with higher-frequency breathing.

    “Heart rate and blood pressure decrease with slow breath in patients with essential hypertension compared with higher-frequency breathing.4”

    From Brief structured respiration practices enhance mood and reduce physiological arousal (2023) · cites this paper as [4]

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Cited by

Sorted by citations

Authors
Li, C., Chang, Q., Zhang, J., & Chai, W.
Affiliations
Jinzhou Medical University (CN)
Corresponding author
Chai, Wenshu
ORCID
Venue
Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2018-05
Volume
97
Issue
18
Pages
e0639
ISSN
0025-7974 (ISSN-L)
DOI
10.1097/md.0000000000010639
PMC
PMC6392805
OpenAlex
W2803084015
Cited by
92
References
0
Citations by year
2026: 4 · 2025: 9 · 2024: 16 · 2023: 21 · 2022: 14 · 2021: 12 · 2020: 10 · 2019: 3 · 2018: 2
FWCI
5.11
Type
journal article
Language
en
Open access
Licence
cc-by-nd
Locations
  • Medicine (publishedVersion, cc-by-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nd)
  • PubMed Central (publishedVersion, cc-by-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
slow-paced breathing, essential hypertension, heart rate variability, baroreflex sensitivity, respiratory sinus arrhythmia, sympathovagal balance, blood pressure, LF/HF ratio, parasympathetic activity
MeSH terms
Essential Hypertension, Arteries, Autonomic Nervous System, Blood Pressure, Blood Pressure Determination, Electrocardiography, Female, Heart Rate, Humans, Male, Middle Aged, Respiration, Statistics as Topic, Baroreflex, Respiratory Rate

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