RESPeRATE: the role of paced breathing in hypertension treatment

Despite a good adherence to lifestyle modifications and antihypertensive drugs, hypertension remains resistant in more than one–third of patients, thus creating the need for additional strategies, including non–pharmacologic approaches. Slow and deep breathing (“paced breathing”) associated in the past with meditation has a direct antihypertensive effect by increasing baroreflex sensitivity. With the method of guiding the pace of breathing, a US Food and Drug Administration–certified device, RESPeRATE, may offer an easy, efficient, inexpensive, and noninvasive option for treating hypertension. Multiple studies showed a significant reduction of blood pressure when RESPeRATE was evaluated in a home and office setting. In conclusion, this review outlines the pathophysiologic background of paced respiration, describes RESPeRATE clinical trials, and presents briefly other guided breathing alternatives.