¹Family Medicine Unit, Hadassah University Hospital, Israel

²InterCure, Neve Ilan, Israel

³Department of Family Medicine, Tel Aviv University and Kupat Holim Clalit, Israel

⁴Unit of Behavioural Medicine in Internal Medicine, Department of Medicine, Hadassah University Hospital, Israel

Correspondence to: Dr Moshe Schein, Family Medicine Unit, Hadassah University Hospital, PO Box 12000, Jerusalem 91120, Israel. E-mail:beny@intercure.co.il (via Dr B Gavish)

^aRequest for reprints: Dr Benjamin Gavish, InterCure, Communication Park, Neve Ilan, 90850, Israel

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 mm Hg 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 mm Hg respectively, as compared to 11.3, 5.6 and 7.5 mm Hg (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.

Journal of Human Hypertension (2001) 15, 271-278

high blood pressure; non-pharmacological therapy; device; breathing exercises