OBJECTIVE: To examine the efficacy of a new device, which slows and regularises breathing, as a non-pharmacological treatment of hypertension and thus to evaluate the contribution of breathing modulation in the blood pressure (BP) reduction. DESIGN AND SETTING: Randomised, double-blind controlled study, carried out in three urban family practice clinics in Israel. PATIENTS: Sixty-five male and female hypertensives, either receiving antihypertensive drug therapy or unmedicated. Four patients dropped out at the beginning of the study. INTERVENTION: Self treatment at home, 10 minutes daily for 8 consecutive weeks, using either the device (n = 32), which guides the user towards slow and regular breathing using musical sound patterns, or a Walkman, with which patients listened to quiet music (n = 29). Medication was unchanged 2 months prior to and during the study period. MAIN OUTCOME MEASURES: Systolic BP, diastolic BP and mean arterial pressure (MAP) changes from baseline. RESULTS: BP reduction in the device group was significantly greater than a predetermined 'clinically meaningful threshold' of 10.0, 5.0 and 6.7 mmHg for the systolic BP, diastolic BP and MAP respectively (p = 0.035, p = 0.0002 and p = 0.001). Treatment with the device reduced systolic BP, diastolic BP and MAP by 15.2, 10.0 and 11.7 mmHg respectively, as compared to 11.3, 5.6 and 7.5 mmHg (p = 0.14, p = 0.008, p = 0.03) with the Walkman. Six months after treatment had stopped, diastolic BP reduction in the device group remained greater than the 'threshold' (p < 0.02) and also greater than in the walkman group (p = 0.001). CONCLUSIONS: The device was found to be efficacious in reducing high BP during 2 months of self-treatment by patients at home. Breathing pattern modification appears to be an important component in this reduction.
Reprinted by permission from Journal of Human Hypertension, Macmillan Publishers Ltd.

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