Effect of Buteyko breathing technique in hypertensive patient thesis

Abstract

BACKGROUND: Hypertension can be defined as persistent low blood pressure. It is considered an invisible silent killer as symptoms are usually invisible until a heart attack. Slow breathing has clinical effects on the cardiovascular system, respiratory function, and exercise tolerance.

Buteyko breathing exercise is a type of nasal breathing which has beneficial effects on cardiorespiratory parameters. It was found by Dr. K.P. Buteyko in the year 1950. The program is designed to help  people o enhance how h they breathe. It includes a  sequence of lectures and practical training periods along with breathing  exercises. 

AIM: The projects aim was to see how successful the Buteyko  breathing technique was in reducing diastolic blood pressure in  hypotensive patients of stage 1 and stage 2

METHOD: It is an interventional study conducted on 20 hypotensive stages 1 and stages 2 patients. The inclusion criteria were recruited from a sample population (10 males and 10 females) in this study. Outcome measures such as systolic and diastolic blood pressure, pulse rate,  respiratory rate, vital capacity, breath-holding time, and inspiratory and expiratory time were recorded pre and post-intervention. The duration of the intervention was for 2 weeks. The Buteyko breathing technique was explained to the individuals by demonstrating them and showing videos of the same. Each session lasted for about 20 to 50 minutes with 3 sets of 10 repetitions. 

RESULT: When distinguishing the pre and post-interventional values of the final result, it calculated the statistically significant differences in systolic blood pressure, pulse rate, respiratory rate, vital capacity,  breath-holding time, and I: E Ratio by the Buteyko breathing technique. It proved to be meaningful. Whereas diastolic blood pressure did not  show any significant changes

Introduction

Hypertension is the medical term for elevated blood pressure that persists over time. Hypertension affects more than a  billion people all over the world. Since the signs are normally to detectable before a heart attack, it is referred to as the silent unseen killer. 

Globally, about 17 million people die each year as a result of cardiovascular disease. Of those with hypertension, almost  22% are still unaware of their hypertension, 32% are not on treatment, and only 64% of those treated have BP under control. About 69% of people who have a first heart attack,  77% who have a first stroke, and 74% who have CHF have  BP >140/90 mmHg HTN is directly responsible for  57percent of all stroke deaths and 24 percent of all coronary heart disease in India. HTN and its complications are responsible for 9.4 million deaths worldwide per year One in our men and in one in five women are affected with hypertension. There is an association between coronary artery try disease, congestive heart failure, peripheral arterial diseases,  sleep disorder, breathing difficulty, sleep apnea etc. due to  hypertension. Some environmental factors include g  socioeconomic factors including factors, health system factors, and physical actor t ay facilitate or constrain an individual’s hypertension. There is now accumulating scientific evidence suggesting that slow breathing has many favorable clinical effects on the cardiovascular system, respiratory function, and exercise tolerance.

A combination of both pharmacological and nonpharmacological interventions is required for optimal BP control in most patients. Most hypertensive patients need two or more drugs for blood-pressure control and concomitant statin treatment for risk factor reduction. Despite the availability of effective.

and safe antihypertensive drugs, hypertension, and its concomitant risk factors remain uncontrolled in most patients. The frequency of drug dosing, cost, and side effects often compromise long-term compliance with antihypertensive medications, making the use of nonpharmacological interventions even more attractive Slow, device-guided breathing has been shown to effectively reduce blood pressure. It increases the tidal volume while maintaining minute ventilation. 

This results in increased cardiopulmonary stretch receptor stimulation, which reduces the sympathetic efferent discharge, resulting in vasodilation. BBT was developed in the 1950s and is named after its founder, Dr. K. P. Buteyko. This respiratory technique is a  unique form of breathing as human beings are requested to much less rather than more and holding is as essential as breathing. Research into the Buteyko technique tested its scientific effectiveness in the treatment of bronchial allergies and recently sleep apnea (persistent over-breathing), with a few studies exploring healing mechanisms however only a fewbreathstudies have been carried out on hypertension. The Buteyko breathing technique allows you to reduce the intensity of your attacks as well as the number of medications you take. The  Buteyko Breathing Method is a herbal manner of correcting  terrible fitness and different problems because of a  dysfunctional respiratory pattern

The beauty of the Buteyko breathing technique is that it is easy to remember and patients can carry out this exercise easily and comfortably This technique targets reversing persistent hyperventilation. The most important purpose of  the Buteyko Breathing Technique is long-term period  normalization and optimization of automatic respiratory

styles thru slow physiological habituation to breath much less, ultimately preventing hyperventilation and normalizing  CO2 ranges.Buteyko Breathing Technique is  supposed to lower pulmonary airflow which increases the carbon dioxide level withinside the alveolar body. The increase in the carbon dioxide range causes an increase in the oxygen partial pressure forcing oxygen to be released from hemoglobin (Bohr Effect). This approach focuses on correcting  hyperventilation by emphasizing shallow breathing patterns.  It focuses on nasal breathing and holding the breath, as well as relaxation which is a great start to enhancing fitness.

In a  formal exercise consultation, reduced-volume breathing is carried out in combination with breath-holding techniques,  the two maximum essentials being a short breath-hold, known as the Control Pause, and an extended breath-hold, known as the Maximum Pause. Maximum Pause is normally double the time of Control Pause. A formal exercise session takes approximately 40-50 minutes. This is carried out way if means sitting with an upright posture and relaxing the muscles of respiration until one senses a slight loss of air. Patients are requested to take a shallow breath thru the nose. The  breath is held after a mild exhalation until the first desire to  breathe or a little discomfort is felt by the patient

During Control Pause breath is held for a shorter period until the path tient feels the first urge of breathing back while the  Maximum Pause, is normally held longer, as long as one can. There are several studies done and claimed successful effects of the Buteyko Breathing Technique on Bronchial  Asthma, Asthma, Chronic Obstructive Pulmonary Disease,  sleep apnea, etc. Some of the studies showing the effects of the Buteyko Breathing Technique on patients with the above-mention have shown conditions have shown to give positive results.  Some studies have also claimed that there is a positive impact 

on the body by the effect of the Buteyko Breathing Technique use on Cardiorespiratory parameters in adult patients. But there are very few studies showing the effects of the Buteyko Breathing  Technique on Hypertensive patients. Thus our  study aims to get the estimation of the Effects of Buteyko  Breathing Technique on Pulse Rate, Respiratory Rates, Blood  Pressure, Vital Capacity, and Breath Holding Time in  Hypertensive patients

Need of study

•  The foundation of the Buteyko method is to breathe only through its nose.
• At its core, it focuses on nasal breathing, breath-holding, and relaxation. 
• It aims to reverse chronic hyperventilation.
• The cardiovascular system can be regulated by using the Buteyko breathing technique and may have a positive impact on one’s overall health and improve the health of hypertensive patients.
• The technique focuses on maximum CO2 preservation, which leads to vasodilatory effects and a decrease in respiratory rate and systolic blood pressure,e and increases in Vital Capacity and Breath  Holding Time. 
• Thus, this study is performed to find out the effectiveness of the Buteyko  Breathing Technique in reducing Systolic Blood Pressure in  Hypertensive patients

Aims and objectives

Aims

• The aim of our study is to check the effectiveness of Buteyko Breathing Technique in reducing Systolic Blood Pressure in Hypertensive stage 1 and 2 patient

objectives

• To improve systolic blood pressure of the hypertensive patients.
• To increase Breath Holding Time in patients.
• To improve hyperventilation in patients.
• To increase Vital Capacity of patients.
• To teach an effective breathing to patients

Hypothesis

Null Hypothesis

Buteyko Breathing Technique would have no meaningful impact, according to the null hypothesis, in reducing systolic blood pressure in patients suffering from stage1and 2 of hypertension for more than the past 1 year with ongoing medications in both males and females.

Alternative Hypothesis

Buteyko Breathing Technique would have a meaningful impact, according to the alternate hypothesis, in reducing systolic blood pressure in patients suffering from stages 1 and 2 of hypertension for more than the past 1 year with ongoing medications in both males and females patient

Review of literature:

• Dr. Sarika Chaudhary et.al conducted a study on the “Effect of Physiological and psychological effects of Buteyko breathing technique in university football player” in the year 2021. It was an experimental study where 40 male footballers aged between 18 to 25 years were included and randomly divided into two groups. Group A received 6 weeks of Buteyko breathing technique (5 sessions/week) whereas group B continued with regular training. Resting heart rate, blood pressure, VO2 max, control pause test, and anxiety was measured pre and post-test as an outcome measure. Results were obtained that paired t-test revealed a significant decrease in resting heart rate and anxiety by 5.76 % and 12.4% respectively. Resting systolic and diastolic blood pressure reduced by 4.26% and 5% respectively, while massive improvement was noted in control pause through 134.2% and VO2 max by 15.54% in group A. No significant difference had been noted in group B. they concluded that Buteyko breathing technique was found to be a useful technique to enhance the endurance of the players and showed positive improvements in cardiorespiratory t-tests parameters test was. It was also helping for reducing anxiety
• samiksha Sanjiv sathe et.al, in the year 2020 conducted a study on” Immediate of the effect of Buteyko breathing in hypertension patients; An experimental prospective study” where 50 patients were screened and meeting the inclusion criteria were recruited. The participants were randomly divided into two groups- the experimental and the control group. Pre and post-vitals were measured in terms of systolic BP, diastolic BP, heart rate, and SPO2. They observed that there was a significant difference seen in systolic BP, heart rate, and SPO2 in the experimental group, whereas there was a significant difference seen in any measure taken in the control group. Hence, they conclude and the quasi-experimental that the Buteyko breathing technique has an immediate positive response on O2 saturation level in hypertensives
• H. Vaish et.al, in the year 2020 conducted a study on “The effect of Buteyko breathing on cardiorespiratory parameters in obese young adults: A pre-test post-test the test and the pilot study.15 asymptomatic obese adults were recruited and practiced the Buteyko breathing technique twice daily for one week. Heart rate, blood pressure, rate of perceived exertion, and lung function were noted at the pre-and post-, as outcome measures. They concluded that there was a significant improvement in heart rate, systolic blood pressure and rate of perceived exertion. The impact on blood pressure, and heart rate is similar to slow breathing but improvements in various pulmonary functions are in need to be explored in obese subjects
• Visalakshi H Subramanian et.al in the year 2020 conducted a” Study on the effect of Buteyko breathing technique in patients with hypertension”. They aimed to assess hemodynamical changes following Buteyko breathing Technique for 2 weeks which included pulse rate, blood pressure and control pause as their parameters to measure. They concluded that there was a reduction in pulse and blood pressure following 2 weeks of Buteyko training and an increase in control pause duration in patients

• Kinga howerka et.al in the year 2013 conducted a study on the “Effects of guided breathing on blood pressure and heart rate variability in hypertensive diabetic patients”. They aimed to investigate immediate-term effects on blood pressure and its capacity to improve cardiovascular autonomic balance. 32 subjects with diabetes and hypertensive therapy were randomly assigned for both study groups. The investigation included a 12-minute session of guided breathing performed daily for 8 weeks. Treatment effects were assessed with ambulatory blood pressure monitoring and with spectral analysis of short-term heart rate variability. They concluded that there was a significant reduction in 24 hours systolic blood pressure and pulse pressure whereas there was no significant change in the control group

• Zahra Mohamed Hassan et.al in the year 2012 conducted a study on “Effects of Buteyko breathing on patients with bronchial asthma”. 40 patients participated in this study, their ages ranged from 30 and 50 years. The program of Buteyko breathing was given for 6 weeks {2 sessions/ week except for the first week and four sessions per week}. peak expiratory flow rate, control pause, and asthma daily symptoms (asthma control questionnaire) were measured at the beginning and after the treatment. The result of the study revealed a significant decrease in asthma daily symptoms, improvement in peak expiratory flow rate, and control pause test in one group while there were insignificant changes in the other group

• BMY Cheung et.al in the year 2005 conducted a study on” Randomised control trial of Qi gong in the treatment of mild essential hypertension”. 88 patients were included in the study and randomized to Guolin Qi gong and conventional exercises for 16 weeks. The main outcome measures were blood pressure health status (SF-36), Beck anxiety and depression inventory scores. In both, the group’s blood pressure decreases significantly. General health, bodily pain, social functioning, and depression also improved in both groups. No significant difference between Qi gong and conventional exercise was found. In conclusion, Guolin Qi gong and conventional exercises have similar effects on blood pressure in patients with mild hypertension. While no additional benefits were identified, it is nevertheless an alternative to conventional exercise in the non-drug treatment of hypertension.

• Rashmi Kumari hembrom et.al conducted a study on “Immediate effect of Buteyko breathing technique during submaximal exercise on cardiorespiratory parameters in young adults” in the year 2018. 80 subjects were recruited for the study and thought Buteyko breathing technique. Baseline heart rate, blood pressure, rate of perceived exertion, and pulmonary function test were taken as outcome measures pre and post-test. The subjects were asked to do brisk walking on a treadmill with and without performing the Buteyko breathing technique. Results showed that there were significant changes in the rate of perceived exertion in both males and females to perform the Buteyko breathing technique with submaximal exercises on the treadmill and also those who did not perform the Buteyko breathing technique along with submaximal exercises. they concluded that the Buteyko breathing technique used during submaximal exercise did not have any significant immediate effect on cardiorespiratorythose parameters in young adults

Methodology and materials

Inclusion Criteria

• Both males and females
• Patients from rural-urban and suburban areas.
• Patients with a history of hypertension for more than 1 year.
• Patients clinically diagnosed with stage 1 and 2 hypertension.
• Age group between 40-80 years
• Sample size: As required for intervention analysis, 30 patients have included Source of sampling: Ahmadabad
• Duration of study: 5 weeks

Materials

• Sphygmomanometer
• Pulse oximeter
• Spirometer
• Stopwatch
• Stethoscope
• Chair
• Pen and pencil
• Paper

Procedure

All the patients have been concerned about inclusion and exclusion criteria. the tools used for this study Sphygmomanometer and pulse oximeter. these tools provide oxygenation for patients To measure blood pressure and pulse rate. A spirometer which is a valuable and reliable screening test for general respiratory health information was used to measure the vital capacity of the patient.11 Before the Buteyko breathing technique, the patient’s blood pressure, pulse rate, oxygen saturation, and vital capacity were measured. The technique was explained to the patient by demonstrating and then made them perform. Videos were shown for a better explanation for home program sessions. To achieve thee
goals blood pressure, pulse rate, respiratory rate, breath-holding time, I:E Ratio, d vital capacity was also measured 5- at minute interval speed and post performing Buteyko breathing technique. there are two phases

1)control pause phase

Have the patient sit upright in a chair and take a deep breath, relax for 30 seconds, andthen breathe normally through the nose (keep the mouth closed)

instructions to the patient:

• Change the breathing mode only after the control pause
• Breathe in slowly, hold the nose on the breath out with empty lungs but not too empty. (To prevent air from entering your respiratory tract)
• Before you have to breathe again, count the few seconds you can comfortably hold on
• Hold your breath until you feel the urge to breathe in for the first time
• Release the nose and inhale

Step 2: Shallow breathing

• Ask the patient to sit upright, place your fingers horizontally under the nose and observe the airflow through the nostrils.
• The patient’s fingers should be directly under the nostrils so that the airflow can be felt without obstructing the airflow.10Repetition into 3 sets each session takes 30-50 mins.
• After preliminary and subsequent measurements of blood pressure, pulse rate, respiratory rate, vital capacity, breath-holding time, and I: E ratio of each outcome parameter was calculated.

Statistical analysis

The present study aimed to observe the effect of the Buteyko breathing technique in reducing systolic blood pressure in hypertensive patients. The data was analyzed using SPSS. The data were presented as the mean and standard deviation for all continuous variables. The data were performed using the paired T-test. A value of p <0.05 was considered statistically significant performed using Microsoft Excel 2007

Results

The software SPSS (version) was used in our study. Outcome measures used were Systolic and Diastolic Blood Pressure, Pulse Rate, Vital Capacity, Respiratory Rate, Breath Holding Time, and Inspiratory: Expiratory Ratio. Variables were defined using statistics like Mean and Standard Deviation. Paired T- tesT-testt was used to simplify differences between pre and post-interventiona . Table 2.0 The statistical analysis was performed at 95% confidence level where p<0.05 was stated as statistically significant

On differentiating pre and post interventional values of final result measures, it modified that statistically sizable distinction seen in Systolic Blood Pressure, Pulse Rate, Respiratory Rate, Vital Capacity, Breath Holding Time, Inspiratory: Expiratory Ratio by Buteyko Breathing Technique was proven to be Significant

On differentiating pre and post interventional values of final result measures, it modified that statistically sizable distinction seen in Diastolic Blood Pressure by Buteyko Breathing Technique was proven to be non-Significant

Table 1.0 Base line comparison of pre and post-intervention of paired sample test

Table 2.0 Mean and Std. Deviation of pre and post intervention

Table 3: Mean

• To study the effectiveness of BBT on PR. PR was measured before and after the intervention and paired T-TEST was performed. Since the p-value for PR is 0.000<0.05, hence the test is significant and the technique is effective in reducing PR
• To study the effectiveness of BBT on RR. RR was measured before and after the intervention and paired T-TEST was performed
• Since the p-value for RR is 0.000<0.05, hence the test is significant and the technique is effective in reducing RR

Discussion

This study showed that the Buteyko breathing technique measured physiological parameters such as Blood Pressure, Pulse Rate, Respiratory Rate, Vital Capacity, Breath Holding Time and Inspiratory and Expiratory ratio.

The Buteyko Method is based on the idea that hyperventilation is the root cause of all diseases and a wide variety of medical conditions. The main goal of the Buteyko kit is to minimize hyperventilation by reducing the amount of oxygen in the blood.12 There are positive changes compared to the Buteyko breathing technique in systolic blood pressure, respiratory rate, breath-holding, and time in hypertensive patients. This is due to vasodilation due to carbon dioxide retention, this results in cardiopulmonary stretch receptor stimulation, which reduces the sympathetic efferent discharge, ensuing in vasodilation which further leads to decreased partial pressure and hence decreased blood pressure.2 A review
published in 2003 found that reducing blood pressure by 5 mmHg can reduce the risk of ischemic stroke by 34%. Heart disease is reduced by 21%, as is the risk of heart failure, dementia, and death from cardiovascular disease.

The physiological function of the arterial baroreflex is usually to change the pulse rate and blood pressure due to changes in the tension of the arterial wall. Regular slow breathing is likely to improve arterial baroreflex sensitivity and lower blood pressure in the long term. Buteyko breathing reduces respiratory rate, changes airway pattern, and lowers blood pressure

Scientists have observed that people with high blood pressure have dramatically higher respiratory rates than people with normal blood
pressure, indicating an acute response to stress. (Mckeown, 2015) In the scientific text, it is common knowledge that the fact, physical exercise will help lower blood pressure In addition, slow breathing resulted in further reductions in respiratory rate and blood pressure.

The present study showed a huge increase in the control pause. Reversing chronic hyperventilation by relaxing the respiratory muscles, resulted in a decrease in minute ventilation and, over time, a feeling of a slight lack of air.Cells manage to absorb oxygen from the blood during abreath-holdbreath-holding resultingd, but oxygen levels are not replenished. The breath holding exercise causes a decrease in blood acidosis, greater tolerance to anoxia, a slowed metabolism, and an increase in lung volume.

A typical routine of formal Buteyko practice that begins and ends with a control pause is an integral part of this technique as it increases the state of health and breathing, and reduces the degree of hyperventilation. Repeated use of breath-holding after exhalation during training has been shown to increase the duration of control pause. The Buteyko method teaches people to voluntarily monitor for minor air shortages during breathing exercises. If it increases spontaneously during exercise, this will lead to positive changes in people’s response to shortness of breath. Repeated use of prolonged breathing will increase the production of endogenous antioxidants in the body. And increase the anaerobic threshold, thereby improving physical performance at higher training levels.

This study showed that there are positive changes seen in patients’ inspiratory and expiratory ratios due to the retention of oxygen in the lungs in the patients performing the Buteyko breathing exercises.

According to Richa et al, Buteyko carried out for 5 min at relaxation confirmed a massive growth in pulse rate and decrease in systolic blood pressure, that’s a normal physiological response. However, they’ve not noted any instantaneous modifications in aerobic respiration parameters between the instances of “submaximal exercise with Buteyko” and “submaximal exercise without Buteyko”. The motive for this will be that deep inspiration is required to carry out a lung function test that may cause bronchoconstriction and negate the benefits of the Buteyko breathing technique This may explain why diastolic blood pressure does not alter significantly.

According to Ritu et al(2013) Buteyko breathing exercising is useful in control of respiratory rate and pulse rate in chronic obstructive pulmonary diseased patients.

In a study by Opat et al., the results showed a significant improvement in the quality of life in BBT patients compared to placebo. This study was designed to investigate whether BBT, as taught in a video was productive in 36 adult subjects with mild to moderate asthma. They were randomized to receive a video of BBT or placebo that they could watch at home twice a day for 4 weeks. ), Symptoms, and asthma medication were assessed both before and after the procedure. The percentage change from the control pause test was 69% in Group A and 8% in Group B. This came in support of the Buteyko et al. in the Medical Institute of Sechenov, Moscow that the mean breath holding time increased from about 3–6 s to more than 30 s.

Bowler et al. The study showed a 54% improvement in the questionnaire on quality of life after 6 weeks. Cowie et al. A 2008 study in Canada, enrolled 129 asthma patients and randomized them to receive a series of breathing exercises. In Buteyko’s group, the proportion of patients who achieved good asthma control increased from 40% at the beginning to 79% after 6 months. The David Holmes study carried out an assessment of the Buteyko and the chest physiotherapy, the starting level of Disease control was greater than expected, with 40% of the Buteyko groups and 44% of the control groups displaying disease control as assessed via way of means of the questionnaire.

After 6 months, the percentage of asthma controlled patients had improved to 79% in the Buteyko group and 72% in the control group, and the study concluded that the Buteyko technique or an intensive program appeared to be performed by a chest physiotherapist Provides an added benefit to adult asthma patients treated with inhaled corticosteroids. This study builds on a study by Robert Cowie in which Buteyko techniques were used for 6 months and asthma control was improved from 41% to 75%.

In our previous study, when a subject did Buteyko for 5 minutes at rest, it was observed that BHT increased and SBP decreased significantly, which is a normal response. The good thing is that it doesn’t have any side effects and it is safe and easy to understand. The Buteyko technique has certainly proven to be an important addition to treatment

Conclusion

It may be terminated from the current study that the Buteyko breathing technique has a right away positive response and a long-term effect on reducing RR and SYBP and a rise in CPduration in hypertensive patients following 2 weeks program. Hence this study concludes that BUTEYKO BREATHING TECHNIQUE is effective in reducing systolic blood pressure in hypertensive patients in stage 1and 2

Summary

Previously studies have been done on the effectiveness of BBT on asthmatic individuals by using questionnaire method and interventional method. Very few interventional studies have been done on its effect on hypertension patients. The present study was conducted to examine the effectiveness of BBT in reducing systolic blood pressure in hypertensive patients of stage 1 and stage 2.

Participants were randomly selected from Mumbai city having a count of 30. They were randomly selected according to the inclusion criteria. Individuals aged 30 to 70 were included. Outcome measures like SYBP/DYBP, RR, PR, VC, BHT, and I: E RATIO were measured pre and post-intervention for differentiating the result. Exclusion criteria included patients having any neurological or physiological problem, no willingness, and a lesser age group.

Patients were given an intervention of 2 weeks of BBT. The result shows that BBT has significant improvement in SYBP, PR, RR, VC, BHT, I: E RATIO, whereas it was not significant for DYBP

Limitation and further Recommendation

Limitation

• Less number of patients were included in the study
• Limited accessibility due to COVID 19 outbreak.
• Less several participants also because people refuse to give consent for treatment.
• Difficulty in assessing the participants due to mandatory social distancing.
• Long term follow up was not considered

Recommendation

• More studies should be performed on the effectiveness of BBT on hypertensive patients
• To create awareness regarding a proper or correct way of breathing, so hyperventilation can be prevented
• To use BBT along with medications as a non-pharmacological approach for patients with mild hypertension or who have developed HTN very recently

Annexure

• Evaluation form
• DEMOGRAPHIC DATA Date:
• Name:
• Age:
• Gender:
• Mobile No:
• Address:
• Occupation:
• Diagnosis:
• Medical History:
• Surgical History:
• History of any breathing exercise:

Consent form

• Introduction: To be a participant in a study on Effect of Buteyko breathing technique in hypertensive patient thesis
• Purpose of the study: effect of buteyko breathing technique in hhypertensive patient
• Benefits: reduction of blood pressure
• Risk: there are no risk of this study
• Financial incentive for participation: this is voluntary study
• Authorization to publish results: Results in this study may be published for scientific purposes and/or presented to scientific groups; however, your identity will not be disclosed

Patient information form

INTRODUCTION

Hypertension is a condition characterized by raised pressure in the blood vessels. Hypertension can be treated pharmacologically and non-pharmacologically. Nonpharmacological approaches include Diet, sodium intake, physical activity, weight loss, relaxation techniques, breathing techniques, music therapy, lifestyle modifications, etc. Buteyko breathing is a breathing technique that emphasizes the breathing pattern which corrects the hyperventilation (deeper breathing rate). The Buteyko breathing technique has a vasodilatory effect, because of which there is a reduction in the pulse rate. The Buteyko Method incorporates reduced-volume breathing as its fundamental technique, which is done
by sitting in an erect posture. Preparations before performing the Buteyko breathing technique:

• Sit in a comfortable position,
• Stay hydrated, calm and relaxed
• breathe normally through the nose for 30 seconds or so.

Technique

• Take a normal breath through your nose.
• Allow a normal breath to come out through your nose
• Now gently close your nose with your thumb and forefinger and count the seconds
• Hold the breath until you feel the urge for the next breath or a step before discomfort.
• Release the nose and take a new breath, Repeat the cycle and remember to keep the mouth
• closed throughout the technique

Master chart

References

• Sathe SS, Rajandekar T, Hadake S, Shegaonkar V. Immediate Effect of Buteyko Breathing in Hypertensive Patients: An Experimental Prospective Study. Indian Journal of Forensic Medicine & Toxicology. 2020 Oct 1;14(4)
• Subramanian VH, Arora RD. Study of the effect of Buteyko breathing technique in patients with hypertension–A case series. Journal of Society of Indian Physiotherapists
• Sharma M, Frishman WH, Gandhi K. RESPeRATE: nonpharmacological treatment of hypertension. Cardiology in review. 2011 Mar 1;19(2):47-
• Herakova N, Nwobodo NH, Wang Y, Chen F, Zheng D. Effect of respiratory pattern on automated clinical blood pressure measurement: an observational study with normotensive subjects. Clinical hypertension
• Lazer D. Breathe Better, Be Healthier
• Manivannan S, Mohanraj KG, Thamaraiselvan M. AWARENESS, KNOWLEDGE AND PREVALENCE OF HYPERTENSION, SLEEP APNEA AND SLEEP-DISORDERED BREATHING DIFFICULTIES IN MALES AMONG CHENNAI POPULATION. European Journal of Molecular & Clinical Medicine. 2020 Nov 22;7(1):810-21.
• Mourya M, Mahajan AS, Singh NP, Jain AK. Effect of slow-and fast-breathing exercises on autonomic functions in patients with essential hypertension. The journal of alternative and complementary medicine. 2009 Jul 1;15(7):711-7. Courtney R, Cohen M. Investigating the claims of Konstantin Buteyko, MD, Ph. D.: the relationship of breath holding time to end-tidal CO2 and other proposed measures of dysfunctional breathing. The Journal of Alternative and Complementary Medicine. 2008 Mar 1;14(2):115-23
• McKeown P. Buteyko Breathing Clinic Worldwide Training for Buteyko Practitioners.
• Miller MR, Hankinson JA, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, Van Der Grinten CP, Gustafsson P, Jensen R. Standardisation of spirometry. European respiratory journal. 2005 Aug 1;26(2):319-38.
• Chaitow L, Bradley D, Gilbert C. Recognizing and Treating Breathing Disorders E-Book. Elsevier Health Sciences; 2014 Jul 7.
• Hering D, Kucharska W, Kara T, Somers VK, Parati G, Narkiewicz K. Effects of acute and long-term slow breathing exercise on muscle sympathetic nerve activity in untreated male patients with hypertension. Journal of hypertension. 2013 Apr 1;31(4):739-46.
• Modesti PA, Ferrari A, Bazzini C, Costanzo G, Simonetti I, Taddei S, Biggeri A, Parati G, Gensini GF, Sirigatti S. Psychological predictors of the antihypertensive effects of music-guided slow breathing. Journal of hypertension. 2010 May 1;28(5):1097-103.
• McHugh P, Duncan B, Houghton F. Buteyko breathing technique and asthma in children: a case series. The New Zealand Medical Journal (Online). 2006 May 19;119(1234). Bartley J. Physiology, pseudoscience, and Buteyko. The New Zealand Medical Journal (Online). 2004 Sep 10;117(1201).
• Vaish H, Sharma D. Effect of Buteyko Breathing Technique on Cardiorespiratory Parameters in Obese Young Adults: A Pretest Post Test Quasi-Experimental Pilot Study. Int. J. Sci. Res. in Multidisciplinary Studies Vol. 2020 Jul;6(7)
• Howorka K, Pumprla J, Tamm J, Schaumann A, Klomfar S, Kostineak E, Howorka N, Sovova E. Effects of guided breathing on blood pressure and heart rate variability in hypertensive diabetic patients. Autonomic Neuroscience. 2013 Dec 1;179(1-2):131-7.
• Li C, Chang Q, Zhang J, Chai W. Effects of slow breathing rate on heart rate variability and arterial baroreflex sensitivity in essential hypertension. Medicine. 2018 May;97(18).
• Hassan ZM, Riad NM, Ahmed FH. Effect of Buteyko breathing technique on patients with bronchial asthma. Egyptian Journal of Chest Diseases and Tuberculosis. 2012 Oct 1;61(4):235-41.
• Sakharoff M. Buteyko Breathing Technique and Ketogenic Diet as Potential Hormetins in Nonpharmacological Metabolic Approaches to Health and Longevity. InThe Science of Hormesis in Health and Longevity 2019 Jan 1 (pp. 257-274). Academic Press.
• Li C, Chang Q, Zhang J, Chai W. Effects of slow breathing rate on heart rate variability and arterial baroreflex sensitivity in essential hypertension. Medicine. 2018 May;97(18).
• Afshan N, Ahmad S, Shahid S, Fatima A. Effect of Buteyko Breathing Technique and incentive spirometer on breath control pause in Post Cardiac Surgery patients. Rawal Medical Journal. 2020 Oct;45(4):970-3.
• Easter N. Buteyko Breathing Technique Versus Incentive Spirometer on Breath Holding Time after Coronary Artery Bypass Graft (Doctoral dissertation, Nandha College of Physiotherapy, Erode).
• Buteyko KP. Basic Principles of Buteyko therapy.
• Katz DH, Sella O, Golan H, Banai K, Van Swearingen J, Krisciunas GP, Abbott VK. Buteyko breathing technique for exertion-induced paradoxical vocal fold motion (EI-PVFM). Journal of Voice. 2019 Aug 12.
• Chaudhary D, Khanna S, Maurya UK, Shenoy D. Effects of Buteyko Breathing Technique on Physiological and Psychological Parameters among University Football Players. European Journal of Molecular & Clinical Medicine. 2021 Feb 9;8(2):1790-800
• Hembrom RK, Rai RH, Chugh P, Gupta VP. A Study on Immediate Effect of Buteyko Breathing Technique during Submaximal Exercise on Cardio-Respiratory Parameters in Young Adults
• Naanyu V, Vedanthan R, Kamano JH, Rotich JK, Lagat KK, Kiptoo P, Kofler C, Mutai KK, Bloomfield GS, Menya D, Kimaiyo S. Barriers influencing linkage to hypertension care in Kenya: qualitative analysis from the LARK hypertension study. Journal of general internal medicine. 2016 Mar 1;31(3):304-14