Preliminary study of Slow Deep Breathing in Mindfulness Exercise Effects on Physical Health Outcome among Hypertensive Patients
Article Sidebar
Published:
Sep 20, 2018
Keywords:
slow breathing, mindfulness, physical health outcome, hypertension
Main Article Content
Abstract
OBJECTIVE:
The aim of this study is to examine the effect of slow deep breathing in mindfulness exercises on physical health outcome among hypertensive patients.
MATERIALS AND METHODS:
Two primary health care units (PCU) were selected as control and intervention groups. Samples were patients aged 35 - 59 years old, diagnosed with stage I hypertension. Both groups received the standard for hypertension guidelines treatment. The experimental group was added as a drill in observational breathing in mindfulness skills, which recognizes the feeling of adaptation to everyday life.
RESULTS:
The physical outcomes were measured on the 6th week as follows: respiratory rate (RR); blood pressure (BP); and heart rate (HR) test. Those that were statistically significantly different in RR 4.7 (p = 0.007), diastolic blood pressure (DBP) 6.7 (p = 0.008), HR 7.1 (p = 0.018), on the 12th week RR 9.0 (p < 0.001), and DBP 5.6 (p = .002) when compared to the control group. However there was no statistically significant difference in systolic blood pressure (SBP) (6th and 12th week) and heart rate (HR) (12th week).
CONCLUSIONS:
Slow breathing in mindfulness training should be introduced as a counterpart to modern medicine and promoted to stage I hypertensive patients for resting cardiovascular and blood pressure disease.
Article Details
How to Cite
1.
Sangprasert P, Palangrit S, Pattaraarchachai J, Tiyoa N. Preliminary study of Slow Deep Breathing in Mindfulness Exercise Effects on Physical Health Outcome among Hypertensive Patients. BKK Med J [Internet]. 2018 Sep. 20 [cited 2024 Nov. 22];14(2):48. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/222536
Section
Original Article
This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
1. Centers for disease control and prevention. A public health action plan to prevent Heart disease and stroke fact sheet, [Internet]. National center for chronic disease prevention and health promotion, Division for Heart Disease and Stroke Prevention, 2016. (Accessed May 26, 2018, at https://www. cdc.gov/dhdsp/data_statistics/fact_sheets/fs_bloodpressure. htm).
2. Centers for disease control and preventions. Healthy People 2020. CDC/National for health Statistics, 2011. (Accessed April 10, 2018, at https:/ /www. cdc.gov/dhdsp/hp2020.html).
3. Mancia G, De Backer G, Dominiczak A, et al. ESH and ESC. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007;25(6) :1105-87.
4. Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health Epidemiological surveillance report weekly: Chronic non-communicable disease surveillance report 2011. 2013:44(10):146-59.
5. Kabat-Zinn J. Mindfulness-Based Interventions in Context: Past, Present, and Future.2003:144-56.
6. Siegel RD, Germer CK, Olendzki A. Mindfulness: What Is It? Where Did It Come From? In F. Didonna (Ed.), Clinical handbook of mindfulness 2009:17-35.
7. Silpakit O, Silpakit C, Chomchan R. Mindfulness-based care for dementia. J Mental Health Thailand 2014;22(1):26-37.
8. D’Silva F, Vinay H, Muninarayanappa NV. Effectiveness of deep breathing exercise (DBE) on the heart rate variability, BP, anxiety & depression of patients with coronary artery disease. NUJHS 2014;4:35-41.
9. Yan Zou., Xin Zhao, Yun-Ying Hou, et al. Meta-analysis of effects of voluntary slow breathing exercise for control of heart rate and blood pressure in patients with cardiovascular disease. Am J Cardilol 2017;120:148-53.
10. Oneda B, Ortega KC, Gusmao JL, et al. Sympathetic nerve activity is decrease during device-guided slow breathing. Hypertens Res 2010;33:708-12.
11. Rebecca A, Abbott A, Whear A, et al. Effectiveness of mindfulness based stress reduction and mindfulness based cognitive therapy in vascular disease: A systematic review and meta-analysis of randomized controlled trials. J Psychosom Res 2014;76(5):341-51.
12. Sangprasert P, Palangrit S, Buranatrevedh S, et al. A systematic review of the effectiveness of mindfulness meditation and contemplation upon vascular disease patients. Thammasat Med J 2018;18(1):79-92.
13. Benson H, Rosner BA, Marzetta BR, Klemchuk HM. Decrease blood pressure in pharmacologically treated hypertensive patients who regularly elicited the relaxation response. Lancet 1974;1:289-291.
14. Nyklicek I, Dijksman SC, Lenders PJ, et al. A brief mindfulness based intervention to increase emotional well-being and quality of life in percutaneous coronary intervention (PCI) patients: the Mindful Heart randomized controlled trial. J Behav Med 2014 Feb;37(1): 135-44.
15. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289(19):2560-72.
16. Faul F, Erdfelder E, Lang A, et al. G*power 3: a flexible statistical power analysis program for the social, behavior and biomedical sciences. Behav Res Methods 2007;39(2):175-91.
17. Townsend RR, Sica DA. Beyond conventional considerations: newer devices used in blood pressure measurement and management. Adv Chronic Kidney Dis 2011;18(1):48-54.
18. Bloom B. The Properties of Bloom’s Taxonomy of Educational Objectives for the cognitive domain. Seddon. JSTOR 1978;48(2):303-423.
19. Sangprasert P, Wiroj J. The predict factors of health promotion behaviors among a population living in the urban community metropolitan Bangkok. Thammasat Science Tech 2014; 23(1):113-26.
20. Thongkhum K, Ruchiwit M, Somprasert C. The Effect of Meditation Training together with a Biofeedback Training Program on the Stress Levels of Chronic Disease Patients. Nurs J 2015;42(1):24-37.
21. Tobin MJ, Chadha TS, Jenouri G, et al. Breathing patterns. Part 1: Normal subjects. Chest 1983;84:202-5.
22. Schelegle ES, Green JF. An overview of the anatomy and physiology of slowly adapting pulmonary stretch receptors. Respir Physiol 2001;125:17-31.
23. Unger T, Paulis L, Sica DA. Therapeutic perspectives in hypertension: novel means for renin-angiotensin-aldosterone system modulation and emerging device-based approaches. Eur Heart J 2011;32(22):2739-47.
24. Oneda B, Ortega KC, Gusmao JL, et al. Sympathetic nerve activity is decreased during device-guided slow breathing. Hypertens Res 2010;33(7):708-12.
25. Brook RD, Apple LJ, Rubenfire M, et al. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the american heart association. Hypertension 2013;61(6):1360-83.
26. Elliott WJ, Lzzo JL. Device-Guided Breathing to Lower Blood Pressure: Case Report and Clinical Overview. Med Gen Med 2006;8(3):23.
27. Elliott WJ, Lzzo JL, WhiteWB, et al. Graded blood pressure reduction in hypertensive outpatients associated with use of a device to assist with slow breathing. J Clin Hypertens 2004;6(10):553-9.
28. Zou Y, Zhao X, Hou YY, et al. Meta-analysis of effects of voluntary slow breathing exercise for control of heart rate and blood pressure in patients with cardiovascular disease. Am J Cardiol 2017;120(1):148-53.
29. Irvine MJ, Johnston DW, Jenner DA, et al. Relaxation and stress management in the treatment of essential hypertension. J Psychosom Res 1986;30(4)437-50.
30. Yu X, Fumoto M, Nakatani Yet, et al. Activation of the anterior prefrontal cortex and serotonergic system is associated with improvements in mood and EEG changes induced by Zen meditation practice in novices. Int J Psychophysiol 2011;80(2):103-11.
31. Hughes JW, Fresco DM, Myerscough R, et al. Randomized controlled trial of mindfulness-based stress reduction for prehypertension. Psychosom Med 2013;75:721-8.
32. Barnes VA, Davis HC, Murzynowski JB, et al. Impact of meditation on resting and ambulatory blood pressure and heart rate in youth. Psychosom Med 2004;66:909-14.
33. Gregoski MJ, Barnes VA, Tingen MS, et al. Breathing awareness meditation and LifeSkills Training programs influence upon ambulatory blood pressure and sodium excretion among African American adolescents. J Adolesc Health 2011;48(1):59-64.
2. Centers for disease control and preventions. Healthy People 2020. CDC/National for health Statistics, 2011. (Accessed April 10, 2018, at https:/ /www. cdc.gov/dhdsp/hp2020.html).
3. Mancia G, De Backer G, Dominiczak A, et al. ESH and ESC. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007;25(6) :1105-87.
4. Bureau of Epidemiology, Department of Disease Control, Ministry of Public Health Epidemiological surveillance report weekly: Chronic non-communicable disease surveillance report 2011. 2013:44(10):146-59.
5. Kabat-Zinn J. Mindfulness-Based Interventions in Context: Past, Present, and Future.2003:144-56.
6. Siegel RD, Germer CK, Olendzki A. Mindfulness: What Is It? Where Did It Come From? In F. Didonna (Ed.), Clinical handbook of mindfulness 2009:17-35.
7. Silpakit O, Silpakit C, Chomchan R. Mindfulness-based care for dementia. J Mental Health Thailand 2014;22(1):26-37.
8. D’Silva F, Vinay H, Muninarayanappa NV. Effectiveness of deep breathing exercise (DBE) on the heart rate variability, BP, anxiety & depression of patients with coronary artery disease. NUJHS 2014;4:35-41.
9. Yan Zou., Xin Zhao, Yun-Ying Hou, et al. Meta-analysis of effects of voluntary slow breathing exercise for control of heart rate and blood pressure in patients with cardiovascular disease. Am J Cardilol 2017;120:148-53.
10. Oneda B, Ortega KC, Gusmao JL, et al. Sympathetic nerve activity is decrease during device-guided slow breathing. Hypertens Res 2010;33:708-12.
11. Rebecca A, Abbott A, Whear A, et al. Effectiveness of mindfulness based stress reduction and mindfulness based cognitive therapy in vascular disease: A systematic review and meta-analysis of randomized controlled trials. J Psychosom Res 2014;76(5):341-51.
12. Sangprasert P, Palangrit S, Buranatrevedh S, et al. A systematic review of the effectiveness of mindfulness meditation and contemplation upon vascular disease patients. Thammasat Med J 2018;18(1):79-92.
13. Benson H, Rosner BA, Marzetta BR, Klemchuk HM. Decrease blood pressure in pharmacologically treated hypertensive patients who regularly elicited the relaxation response. Lancet 1974;1:289-291.
14. Nyklicek I, Dijksman SC, Lenders PJ, et al. A brief mindfulness based intervention to increase emotional well-being and quality of life in percutaneous coronary intervention (PCI) patients: the Mindful Heart randomized controlled trial. J Behav Med 2014 Feb;37(1): 135-44.
15. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003;289(19):2560-72.
16. Faul F, Erdfelder E, Lang A, et al. G*power 3: a flexible statistical power analysis program for the social, behavior and biomedical sciences. Behav Res Methods 2007;39(2):175-91.
17. Townsend RR, Sica DA. Beyond conventional considerations: newer devices used in blood pressure measurement and management. Adv Chronic Kidney Dis 2011;18(1):48-54.
18. Bloom B. The Properties of Bloom’s Taxonomy of Educational Objectives for the cognitive domain. Seddon. JSTOR 1978;48(2):303-423.
19. Sangprasert P, Wiroj J. The predict factors of health promotion behaviors among a population living in the urban community metropolitan Bangkok. Thammasat Science Tech 2014; 23(1):113-26.
20. Thongkhum K, Ruchiwit M, Somprasert C. The Effect of Meditation Training together with a Biofeedback Training Program on the Stress Levels of Chronic Disease Patients. Nurs J 2015;42(1):24-37.
21. Tobin MJ, Chadha TS, Jenouri G, et al. Breathing patterns. Part 1: Normal subjects. Chest 1983;84:202-5.
22. Schelegle ES, Green JF. An overview of the anatomy and physiology of slowly adapting pulmonary stretch receptors. Respir Physiol 2001;125:17-31.
23. Unger T, Paulis L, Sica DA. Therapeutic perspectives in hypertension: novel means for renin-angiotensin-aldosterone system modulation and emerging device-based approaches. Eur Heart J 2011;32(22):2739-47.
24. Oneda B, Ortega KC, Gusmao JL, et al. Sympathetic nerve activity is decreased during device-guided slow breathing. Hypertens Res 2010;33(7):708-12.
25. Brook RD, Apple LJ, Rubenfire M, et al. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the american heart association. Hypertension 2013;61(6):1360-83.
26. Elliott WJ, Lzzo JL. Device-Guided Breathing to Lower Blood Pressure: Case Report and Clinical Overview. Med Gen Med 2006;8(3):23.
27. Elliott WJ, Lzzo JL, WhiteWB, et al. Graded blood pressure reduction in hypertensive outpatients associated with use of a device to assist with slow breathing. J Clin Hypertens 2004;6(10):553-9.
28. Zou Y, Zhao X, Hou YY, et al. Meta-analysis of effects of voluntary slow breathing exercise for control of heart rate and blood pressure in patients with cardiovascular disease. Am J Cardiol 2017;120(1):148-53.
29. Irvine MJ, Johnston DW, Jenner DA, et al. Relaxation and stress management in the treatment of essential hypertension. J Psychosom Res 1986;30(4)437-50.
30. Yu X, Fumoto M, Nakatani Yet, et al. Activation of the anterior prefrontal cortex and serotonergic system is associated with improvements in mood and EEG changes induced by Zen meditation practice in novices. Int J Psychophysiol 2011;80(2):103-11.
31. Hughes JW, Fresco DM, Myerscough R, et al. Randomized controlled trial of mindfulness-based stress reduction for prehypertension. Psychosom Med 2013;75:721-8.
32. Barnes VA, Davis HC, Murzynowski JB, et al. Impact of meditation on resting and ambulatory blood pressure and heart rate in youth. Psychosom Med 2004;66:909-14.
33. Gregoski MJ, Barnes VA, Tingen MS, et al. Breathing awareness meditation and LifeSkills Training programs influence upon ambulatory blood pressure and sodium excretion among African American adolescents. J Adolesc Health 2011;48(1):59-64.