0
Original Investigation |

Device-Guided Breathing as Treatment for Hypertension in Type 2 Diabetes Mellitus:  A Randomized, Double-blind, Sham-Controlled Trial

Gijs W. D. Landman, MD, PhD1,3; Iefke Drion, MD1; Kornelis J. J. van Hateren, MD, PhD1; Peter R. van Dijk, MD1; Susan J. J. Logtenberg, MD, PhD3; Jan Lambert, MD, PhD2; Klaas H. Groenier, PhD1,4; Henk J. G. Bilo, MD, PhD, FRCP1,2,3; Nanne Kleefstra, MD, PhD1,3,5
[+] Author Affiliations
1Diabetes Centre, Isala Clinics, the Netherlands University Medical Center, Zwolle
2Department of Internal Medicine, Isala Clinics, the Netherlands University Medical Center, Zwolle
3Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands
4Department of General Practice, University Medical Center Groningen, Groningen, the Netherlands
5Langerhans Medical Research Group, Zwolle, the Netherlands
JAMA Intern Med. 2013;173(14):1346-1350. doi:10.1001/jamainternmed.2013.6883.
Text Size: A A A
Published online

Importance  Biofeedback with device-guided lowering of breathing frequency could be an alternate nonpharmacologic treatment option for hypertension. Evidence from trials with high methodologic quality is lacking.

Objective  To evaluate the effects of device-guided lowering of breathing frequency on blood pressure in patients with type 2 diabetes mellitus and hypertension.

Design  Single-center, double-blind, sham-controlled trial.

Setting  A large nonacademic teaching hospital in the Netherlands.

Participants  Patients with type 2 diabetes mellitus and hypertension.

Intervention  Fifteen-minute sessions with either the device that guides breathing through musical tones to a lower breathing frequency (aiming at <10 breaths/min) or a sham device (music without aiming at lowering of breathing frequency) for an 8-week study period.

Main Outcomes and Measures  Systolic and diastolic blood pressure measured in the physician’s office.

Results  Forty-eight patients were randomized; 21 patients (88%) in the intervention group and 24 patients (100%) in the control group completed the study. There were no significant changes in systolic and diastolic blood pressure, with a difference in systolic blood pressure of 2.35 mm Hg (95% CI, –6.50 to 11.20) in favor of the control group and a difference in diastolic blood pressure of 2.25 mm Hg (95% CI, –2.16 to 6.67) in favor of the intervention group. Three patients in the intervention group experienced adverse events.

Conclusions and Relevance  This high methodologic quality study shows no significant effect of device-guided lowering of breathing frequency on office-measured blood pressure in patients with type 2 diabetes. On the basis of this study, together with results from all but one previous trial, device-guided lowering of breathing frequency does not appear to be a viable nonpharmacologic option for hypertension treatment.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

Figures

Place holder to copy figure label and caption
Figure.
Participant Flow Diagram
Graphic Jump Location

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 2

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles
Inhaled insulin for diabetes mellitus. N Engl J Med 2007;356(5):497-502.
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Scenario

Users' Guides to the Medical Literature
Example 1: Diabetes and Target Blood Pressure

brightcove.createExperiences();