OBJECTIVE: To evaluate whether device-guided breathing (DGB) lowers blood pressure (BP) in adults. DESIGN: Systematic review and meta-analysis. DATA SOURCES: We searched Medline (1950 to 2010), Embase (1980 to 2010), the Cochrane Library including the Cochrane Central register of Controlled Trials (CENTRAL), AMED (1985 to 2010), CINAHL (1980 to 2010) and the Current Controlled Trials registry (as of October 2010). OUTCOME MEASURES: Primary outcomes included the mean change in SBP and DBP. Secondary outcomes included change in heart rate, quality of life, compliance with the device and any side effects of the device. RESULTS: We included eight trials of the Resperate device (InterCure Ltd, Lod, Israel), consisting of 494 adult patients. Use of this device resulted in significantly reduced SBP by 3.67 mmHg (95% confidence interval (CI) -5.99 to -1.39; p = 0.002) and decreased DBP by 2.51 mmHg (95% CI -4.15 to -0.87; p = 0.003). However, sensitivity analysis was carried out excluding the five trials sponsored by or involving the manufacturers of the device, which revealed no overall effect on BP using the device. The maximum trial duration was 9 weeks and no overall effect was seen on heart rate or quality of life using the device. CONCLUSION: There is evidence that short-term use of DGB may reduce both DBP and DBP. However, five of the eight trials were sponsored by or involved the manufactures of the device. When these trials were excluded we found no overall effect. We conclude that longer term, independent trials are required to validate this intervention.
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