PURPOSE: Baroreflex emerges as a therapeutic target of hypertension. We investigated blood pressure (BP) lowering effect of the combined passive head-up and -down movement with device-guided slow breathing in untreated mild hypertension or high-normal BP. METHODS: In a randomized, cross-over trial, untreated subjects with an ambulatory systolic/diastolic BP of 125 to 140/80 to 90 mmHg and a clinic BP of 130 to 150/80 to 90 mmHg were randomized to intervention treatment with head movement and slow breathing or sham control, and then crossed over. Both treatments consisted of 1-week preparation, 2-week treatment, and 1-week recovery. During the 2-week treatment, subjects were treated for a session of 20 min/day. BP, pulse rate and respiration were measured before and after each treatment session. Ambulatory BP monitoring was performed at baseline and the end of the 2-week treatments' period, and home BP monitoring in the morning and evening for the whole 8-week follow-up period. RESULTS: 14 subjects completed the study. The intervention treatment, compared to control, reduced respiration rate by -2.1 breaths/min (95% CI -2.9 to -1.2, p = 0.0001), but not clinic BP and pulse rate (p >= 0.67). The intervention treatment, compared to control, significantly reduced nighttime systolic/diastolic blood pressure by -5.63/-3.82 mmHg (p <= 0.01) but not 24-h or daytime ambulatory blood pressure (p >= 0.69). Home BP decreased with the intervention treatment, but the between-treatment difference was not statistically significant (p >= 0.27). CONCLUSIONS: The combined head movement with slow breathing did not influence 24-h BP, but reduced nighttime BP in untreated mild hypertension or high-normal BP.

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