Comparison of Lowering Blood Pressure and Heart Rate Variability Between Slow and Diaphragmatic Breathing Exercises in Male Prehypertensive Persons Aged 18-25 Years
Keywords:
Risk of Hypertension, Slow Breathing, Diaphragmatic Breathing, Heart Rate VariabilityAbstract
This randomized controlled experimental study aimed to examine changes in blood pressure (BP) and heart rate variability (HRV) following diaphragmatic breathing and slow breathing exercises. The sample consisted of 27 males aged 18–25 years at risk of hypertension. Stratified random sampling was used to divide participants equally into three groups: the control group, the slow breathing exercise (SBE) group, and the diaphragmatic breathing exercise (DBE) group. Data were collected over four weeks. Research instruments included an OMRON blood pressure monitor to assess BP changes and a Polar Team 2 device to measure HRV changes. Data were analyzed using Two-way Mixed ANOVA.
The study found that both breathing exercises effectively reduced systolic blood pressure (SBP) and pulse pressure (PP) from weeks 2 to 4. Diaphragmatic breathing significantly decreased SBP (p-value = 0.041, 0.047, 0.018) and PP (p-value = 0.006, 0.003, 0.043), while slow breathing significantly reduced SBP (p-value = 0.018, 0.009, 0.004) and PP (p-value = 0.003, 0.001, 0.001). In conclusion, practicing breathing exercises for at least two weeks can lower blood pressure without affecting heart rate variability in males aged 18-25 years at risk of hypertension.
References
กองโรคไม่ติดต่อ. (2566). จำนวนและอัตราตายด้วย 5 โรคไม่ติดต่อ (ปี 2560-2564). สืบค้นเมื่อ 12 ธันวาคม 2566 จาก http://www.thaincd.com/2016/mission/documents-detail.php?id=14480&tid=32&gid=1-020.
ชุติพงษ์ เติมเพ็ชร, สุวัฒน์ จิตรดำรงค์, มีน พรหมมนตรี, สุวิรา วงษ์ชื่น, อรอุมา ถานทองดี และประภาวดี ภิรมย์พล. (2559). การศึกษานำร่อง: เทคนิคการฝึกหายใจแบบใช้กล้ามเนื้อกระบังลม มีประสิทธิภาพในการลดความดันซีสโตลิก เมื่อเปรียบเทียบกับเทคนิคการหายใจแบบช้า ในกลุ่มเสี่ยงต่อความดันโลหิตสูงวัยหนุ่มสาว. วารสารกายภาพบำบัด, 38(2), 81-92.
Adhana, R., Gupta, R., Dvivedii, J., & Ahmad, S. (2013). The influence of the 2:1 yogic breathing technique on essential hypertension. Indian Journal of Physiology and Pharmacology, 57(1), 38-44.
Aekplakorn, W., et al. (2008). Prevalence and management of prehypertension and hypertension by geographic regions of Thailand: The Third National Health Examination Survey, 2004. Journal of Hypertension, 26(2), 191-198. https://doi.org/10.1097/HJH.0b013e3282f09f57
Al-Majed, H. T., & Sadek, A. A. (2012). Pre-hypertension and hypertension in college students in Kuwait: A neglected issue. Journal of Family & Community Medicine, 19(2), 105-112. https://doi.org/10.4103/2230-8229.98296
Ali, N., Mohanto, N. C., Nurunnabi, S. M., Haque, T., & Islam, F. (2022). Prevalence and risk factors of general and abdominal obesity and hypertension in rural and urban residents in Bangladesh: A cross-sectional study. BMC Public Health, 22(1), 1707. https://doi.org/10.1186/s12889-022-14087-8
Anderson, D. E., McNeely, J. D., & Windham, B. G. (2009). Device-guided slow-breathing effects on end-tidal CO(2) and heart-rate variability. Psychology, Health & Medicine, 14(6), 667-679. https://doi.org/10.1080/13548500903322791
Bernardi, L., et al. (2002). Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure. Circulation, 105(2), 143-145. https://doi.org/10.1161/hc0202.103311
Bundy, J. D., et al. (2017). Systolic blood pressure reduction and risk of cardiovascular disease and mortality: A Systematic review and network meta-analysis. JAMA Cardiology, 2(7), 775-781. https://doi.org/10.1001/jamacardio.2017.1421
Charoendee, K., Sriratanaban, J., Aekplakorn, W., & Hanvoravongchai, P. (2018). Assessment of population coverage of hypertension screening in Thailand based on the effective coverage framework. BMC Health Services Research, 18(1), 208. https://doi.org/10.1186/s12913-018-2996-y
De Venecia, T., Lu, M., & Figueredo, V. M. (2016). Hypertension in young adults. Postgraduate Medicine, 128(2), 201-207. https://doi.org/10.1080/00325481.2016.1147927
Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191. https://doi.org/10.3758/bf03193146
Flack, J. M., & Adekola, B. (2020). Blood pressure and the new ACC/AHA hypertension guidelines. Trends in Cardiovascular Medicine, 30(3), 160-164. https://doi.org/10.1016/j.tcm.2019.05.003
Fuchs, F. D., & Whelton, P. K. (2020). High blood pressure and cardiovascular disease. Hypertension (Dallas, Tex. : 1979), 75(2), 285-292. https://doi.org/10.1161/HYPERTENSIONAHA.119.14240
Hagins, M., Rundle, A., Consedine, N. S., & Khalsa, S. B. (2014). A randomized controlled trial comparing the effects of yoga with an active control on ambulatory blood pressure in individuals with prehypertension and stage 1 hypertension. Journal of Clinical Hypertension (Greenwich, Conn.), 16(1), 54-62. https://doi.org/10.1111/jch.12244
Huikuri, H. V., et al. (1996). Heart rate variability in systemic hypertension. The American journal of cardiology, 77(12), 1073-1077. https://doi.org/10.1016/s0002-9149(96)00135-x
Joseph, C. N., et al. (2005). Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. Hypertension (Dallas, Tex. : 1979), 46(4), 714-718. https://doi.org/10.1161/01.HYP.0000179581.68566.7d
Lin, G., et al. (2012). Heart rate variability biofeedback decreases blood pressure in prehypertensive subjects by improving autonomic function and baroreflex. Journal of Alternative and Complementary Medicine (New York, N.Y.), 18(2), 143-152. https://doi.org/10.1089/acm.2010.0607
Lin, I. M., Tai, L. Y., & Fan, S. Y. (2014). Breathing at a rate of 5.5 breaths per minute with equal inhalation-to-exhalation ratio increases heart rate variability. International Journal of Psychophysiology : Official Journal of the International Organization of Psychophysiology, 91(3), 206-211. https://doi.org/10.1016/j.ijpsycho.2013.12.006
Liu, J., et al. (2020). Association between pulse pressure and carotid intima-media thickness among low-income adults aged 45 years and older: A population-based cross-sectional study in rural China. Frontiers in Cardiovascular Medicine, 7, 547365. https://doi.org/10.3389/fcvm.2020.547365
Ma, X., et al. (2017). The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in psychology, 8, 874. https://doi.org/10.3389/fpsyg.2017.00874
Manios, E., et al. (2009). Impact of prehypertension on common carotid artery intima-media thickness and left ventricular mass. Stroke, 40(4), 1515-1518. https://doi.org/10.1161/STROKEAHA.108.528174
World Health Organization. (2013). Global action plan for the prevention and control of NCDs 2013-2020. Retrieved December 12, 2023 from http://www.who.int/nmh/publications/ncd-action-plan/en/.
Pal, G. K., Velkumary, S., & Madanmohan (2004). Effect of short-term practice of breathing exercises on autonomic functions in normal human volunteers. The Indian Journal of Medical Research, 120(2), 115-121.
Peltzer, K., et al. (2017). Prehypertension and psychosocial risk factors among university students in ASEAN countries. BMC Cardiovascular Disorders, 17(1), 230. https://doi.org/10.1186/s12872-017-0666-3
Pongwecharak, J., & Treeranurat, T. (2010). Screening for pre-hypertension and elevated cardiovascular risk factors in a Thai community pharmacy. Pharmacy World & Science : PWS, 32(3), 329-333. https://doi.org/10.1007/s11096-010-9373-1
Rafan, S. N., Zakaria, R., Ismail, S. B., & Muhamad, R. (2018). Prevalence of prehypertension and its associated factors among adults visiting outpatient clinic in Northeast Malaysia. Journal of Taibah University Medical Sciences, 13(5), 459-464. https://doi.org/10.1016/j.jtumed.2018.06.005
Sansanayudh, N., Luvira, V., Woracharoensri, N., Phulsuksombati, D., & Sripen, R. (2009). Prevalence of prehypertensive state and other cardiovascular risk factors in the First Infantry Regiment, the King's own bodyguard. Journal of the Medical Association of Thailand, 92 Suppl 1, S28-S38.
Shaffer, F., & Ginsberg, J. P. (2017). An overview of heart rate variability metrics and norms. Frontiers in Public Health, 5, 258. https://doi.org/10.3389/fpubh.2017.00258
Sikora, M., et al. (2024). Influence of the breathing pattern on the pulmonary function of endurance-trained athletes. Scientific Report, 14(1), 1113. https://doi.org/10.1038/s41598-024-51758-5
Singh, J. P., Larson, M. G., Tsuji, H., Evans, J. C., O'Donnell, C. J., & Levy, D. (1998). Reduced heart rate variability and new-onset hypertension: insights into pathogenesis of hypertension: The Framingham Heart Study. Hypertension (Dallas, Tex. : 1979), 32(2), 293-297. https://doi.org/10.1161/01.hyp.32.2.293
Terathongkum, S., & Pickler, R. H. (2004). Relationships among heart rate variability, hypertension, and relaxation techniques. Journal of Vascular Nursing : Official Publication of the Society for Peripheral Vascular Nursing, 22(3), 78-84. https://doi.org/10.1016/j.jvn.2004.06.003
Tremongkontip, S., Kiettinun, S., Pawa, Kummal K. P., & Pattaraarchachai, J. (2012). Prevalence and risk factors of prehypertensive people in the community. Thammasat Medical Journal 12(4), 688-697.
Vanderlei, L. C., Pastre, C. M., Hoshi, R. A., Carvalho, T. D., & Godoy, M. F. (2009). Basic notions of heart rate variability and its clinical applicability. Revista brasileira de Cirurgia Cardiovascular : Orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular, 24(2), 205-217. https://doi.org/10.1590/s0102-76382009000200018
Wang, S. et al. (2010). Effect of slow abdominal breathing combined with biofeedback on blood pressure and heart rate variability in prehypertension. Journal of Alternative and Complementary Medicine (New York, N.Y.), 16(10), 1039-1045. https://doi.org/10.1089/acm.2009.0577
Yau, K. K., & Loke, A. Y. (2021). Effects of diaphragmatic deep breathing exercises on prehypertensive or hypertensive adults: A literature review. Complementary Therapies in Clinical Practice, 43, 101315. https://doi.org/10.1016/j.ctcp.2021.101315
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Journal of Nursing and Public Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
1. บทความหรือข้อคิดเห็นใด ๆ ที่ปรากฏในวารสารวิจัยการพยาบาลและการสาธารณสุข ที่เป็นวรรณกรรมของผู้เขียน บรรณาธิการไม่จำเป็นต้องเห็นด้วย
2. บทความที่ได้รับการตีพิมพ์ถือเป็นลิขสิทธิ์ของ วารสารวิจัยการพยาบาลและการสาธารณสุข
