Ahead of print
Original Article
Published online: 2024-02-13
Acute effects of the 4-4-8 breathing technique on arterial stiffness in healthy young men
DOI: 10.5603/cj.96299
Pubmed: 38348911
Abstract
Background: Increased arterial stiffness is a risk factor for cardiovascular disease. Slow, deep breathing decreases blood pressure related to arterial stiffness. The objective of the present study was to determine the acute effects of a single session of slow breathing on arterial stiffness, blood pressure, and cardiac autonomic function. Methods: Fifteen healthy men (20 ± 0 years) were administered (a) a slow breathing condition (12 consecutive breaths of 4 s of inhalation, 4 s of pause, and 8 s of exhalation through the nose, approximately 5 min per breath) and (b) a control, two-condition crossover design. Carotid-femoral artery pulse wave velocity (cfPWV), brachial-ankle PWV (baPWV), brachial blood pressure, high frequency (HF) and low frequency (LF) were measured at baseline, 30 min, 60 min and 24 h after respiratory control. Results: Brachial-ankle PWV and brachial systolic pressure on the 4-4-8 breathing trial decreased after 30 min of respiratory control compared to baseline (p < 0.05), but did not change on the CON trial. Carotid-femoral PWV on both trials was unchanged; HF on the 4-4-8 breathing trial increased (p < 0.05) and LF decreased (p < 0.05) after 30 min of respiratory control compared to baseline, but was unchanged on the CON trial. Conclusions: These results suggest that slow breathing techniques may be effective in modulating autonomic function and improving arterial stiffness in healthy young adults.
Keywords: arterial stiffness4-4-8 breathing techniqueheart rate variabilityblood pressurehealthy young men
References
- Ohkuma T, Ninomiya T, Tomiyama H, et al. Collaborative Group for J-BAVEL (Japan Brachial-Ankle Pulse Wave Velocity Individual Participant Data Meta-Analysis of Prospective Studies). Brachial-Ankle Pulse Wave Velocity and the Risk Prediction of Cardiovascular Disease: An Individual Participant Data Meta-Analysis. Hypertension. 2017; 69(6): 1045–1052.
- van Sloten TT, Protogerou AD, Henry RMA, et al. Association between arterial stiffness, cerebral small vessel disease and cognitive impairment: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2015; 53: 121–130.
- Miyoshi T, Ito H. Arterial stiffness in health and disease: The role of cardio-ankle vascular index. J Cardiol. 2021; 78(6): 493–501.
- Russo MA, Santarelli DM, O'Rourke D. The physiological effects of slow breathing in the healthy human. Breathe (Sheff). 2017; 13(4): 298–309.
- Gerritsen RJS, Band GPH. Breath of life: the respiratory vagal stimulation model of contemplative activity. Front Hum Neurosci. 2018; 12: 397.
- Zaccaro A, Piarulli A, Laurino M, et al. How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing. Front Hum Neurosci. 2018; 12: 353.
- Aysin B, Aysin E. Effect of respiration in heart rate variability (HRV) analysis. Conf Proc IEEE Eng Med Biol Soc. 2006; 2006: 1776–1779.
- Bernardi L, Gabutti A, Porta C, et al. Slow breathing reduces chemoreflex response to hypoxia and hypercapnia, and increases baroreflex sensitivity. J Hypertens. 2001; 19(12): 2221–2229.
- Zhang PZ, Tapp WN, Reisman SS, et al. Respiration response curve analysis of heart rate variability. IEEE Trans Biomed Eng. 1997; 44(4): 321–325.
- Magnon V, Dutheil F, Vallet GT. Benefits from one session of deep and slow breathing on vagal tone and anxiety in young and older adults. Sci Rep. 2021; 11(1): 19267.
- Chang Q, Liu R, Shen Z. Effects of slow breathing rate on blood pressure and heart rate variabilities. Int J Cardiol. 2013; 169(1): e6–e8.
- Herawati I, Mat Ludin AF, Mutalazimah M, et al. Breathing exercise for hypertensive patients: A scoping review. Front Physiol. 2023; 14: 1048338.
- Malpas SC. Neural influences on cardiovascular variability: possibilities and pitfalls. Am J Physiol Heart Circ Physiol. 2002; 282(1): H6–H20.
- Chen YF, Huang XY, Chien CH, et al. The effectiveness of diaphragmatic breathing relaxation training for reducing anxiety. Perspect Psychiatr Care. 2017; 53(4): 329–336.
- Joseph CN, Porta C, Casucci G, et al. Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. Hypertension. 2005; 46(4): 714–718.
- Mitchell G. Arterial stiffness and hypertension. Hypertension. 2014; 64(2): 210–214.
- Heusser K, Tank J, Engeli S, et al. Carotid baroreceptor stimulation, sympathetic activity, baroreflex function, and blood pressure in hypertensive patients. Hypertension. 2010; 55(3): 619–626.
- Negoro H. Harvard & Sorbonne University Dr. Negoro’s Special Class Cellular Breathing Lesson to Avoid Disease. SHUEISHA Inc. 2019.
- Negoro H. Negoro H Harvard & Sorbonne Professor Negoro’s Super Breathing Method. KADOKAWA 2018.
- Zhang J. Effect of age and sex on heart rate variability in healthy subjects. J Manipulative Physiol Ther. 2007; 30(5): 374–379.
- Sugawara J, Hayashi K, Yokoi T, et al. Brachial-ankle pulse wave velocity: an index of central arterial stiffness? J Hum Hypertens. 2005; 19(5): 401–406.
- Fryer S, Stone K, Paterson C, et al. Central and peripheral arterial stiffness responses to uninterrupted prolonged sitting combined with a high-fat meal: a randomized controlled crossover trial. Hypertens Res. 2021; 44(10): 1332–1340.
- Kobayashi R, Sakazaki M, Nagai Y, et al. Effects of different types of carbohydrates on arterial stiffness: a comparison of isomaltulose and sucrose. Nutrients. 2021; 13(12).
- Shaffer F, Ginsberg JP. An overview of heart rate variability metrics and norms. Front Public Health. 2017; 5: 258.
- Laborde S, Mosley E, Thayer JF. Heart rate variability and cardiac vagal tone in psychophysiological research - recommendations for experiment planning, data analysis, and data reporting. Front Psychol. 2017; 8: 213.
- Lombardi F, Malliani A, Pagani M, et al. Heart rate variability and its sympatho-vagal modulation. Cardiovasc Res. 1996; 32(2): 208–216.
- Moore T. Respiratory assessment in adults. Nurs Stand. 2007; 21(49): 48–56; quiz 58.
- Vierra J, Boonla O, Prasertsri P. Effects of sleep deprivation and 4-7-8 breathing control on heart rate variability, blood pressure, blood glucose, and endothelial function in healthy young adults. Physiol Rep. 2022; 10(13): e15389.
- Elliot WJ, Izzo JL, White WB, et al. Graded blood pressure reduction in hypertensive outpatients associated with use of a device to assist with slow breathing. J Clin Hypertens (Greenwich). 2004; 6(10): 553–560.
- Li C, Chang Q, Zhang J, et al. Effects of slow breathing rate on heart rate variability and arterial baroreflex sensitivity in essential hypertension. Medicine (Baltimore). 2018; 97(18): e0639.
- Lin IM, Tai LY, Fan SY. Breathing at a rate of 5.5 breaths per minute with equal inhalation-to-exhalation ratio increases heart rate variability. Int J Psychophysiol. 2014; 91(3): 206–211.
- Bae D, Matthews JJL, Chen JJ, et al. Increased exhalation to inhalation ratio during breathing enhances high-frequency heart rate variability in healthy adults. Psychophysiology. 2021; 58(11): e13905.
- Brozovich FV, Nicholson CJ, Degen CV, et al. Mechanisms of vascular smooth muscle contraction and the basis for pharmacologic treatment of smooth muscle disorders. Pharmacol Rev. 2016; 68(2): 476–532.
- Lantelme P, Mestre C, Lievre M, et al. Heart rate: an important confounder of pulse wave velocity assessment. Hypertension. 2002; 39(6): 1083–1087.
- Soltani M, Baluchi MJ, Boullosa D, et al. Effect of intensity on changes in cardiac autonomic control of heart rate and arterial stiffness after equated continuous running training programs. Front Physiol. 2021; 12: 758299.
- Nakao M, Nomura K, Karita K, et al. Relationship between brachial-ankle pulse wave velocity and heart rate variability in young Japanese men. Hypertens Res. 2004; 27(12): 925–931.
- Ahn JH, Kong M. The relationship among pulse wave velocity, ankle-brachial pressure index and heart rate variability in adult males. Korean J Fam Med. 2011; 32(7): 406–411.
- Mäki-Petäjä KM, Barrett SML, Evans SV, et al. The role of the autonomic nervous system in the regulation of aortic stiffness. Hypertension. 2016; 68(5): 1290–1297.
- Chirinos JA, Segers P, Hughes T, et al. Large-Artery stiffness in health and Disease: JACC state-of-the-art review. J Am Coll Cardiol. 2019; 74(9): 1237–1263.
- Bank AJ, Wilson RF, Kubo SH, et al. Direct effects of smooth muscle relaxation and contraction on in vivo human brachial artery elastic properties. Circ Res. 1995; 77(5): 1008–1016.
- Zanella S, Doi A, Garcia AJ, et al. When norepinephrine becomes a driver of breathing irregularities: how intermittent hypoxia fundamentally alters the modulatory response of the respiratory network. J Neurosci. 2014; 34(1): 36–50.
- Hwang CL, Piano MR, Thur LA, et al. The effects of repeated binge drinking on arterial stiffness and urinary norepinephrine levels in young adults. J Hypertens. 2020; 38(1): 111–117.
- Safar ME, Asmar R, Benetos A, et al. French Study Group on Arterial Stiffness. Interaction between hypertension and arterial stiffness. Hypertension. 2018; 72(4): 796–805.
- Engström G, Hamrefors V, Fedorowski A, et al. Cardiovagal function measured by the deep breathing test: relationships with coronary atherosclerosis. J Am Heart Assoc. 2022; 11(7): e024053.
- Chen Y, Zhao X, Wu H. Arterial stiffness: a focus on vascular calcification and its link to bone mineralization. Arterioscler Thromb Vasc Biol. 2020; 40(5): 1078–1093.
- Omar NM, Marshall JM. Age-related changes in the sympathetic innervation of cerebral vessels and in carotid vascular responses to norepinephrine in the rat: in vitro and in vivo studies. J Appl Physiol (1985). 2010; 109(2): 314–322.
- Nagarajan S. Effect of slow breathing training for a month on blood pressure and heart rate variability in healthy subjects. Natl J Physiol Pharm Pharmacol. 2014; 4(3): 245.
