Table of ContentsView AllTable of ContentsBreathing ExercisesWho Are They Right For?
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Table of Contents
Breathing Exercises
Who Are They Right For?
Several breathing techniques can temporarily lower blood pressure, and some, like inspiratory muscle strength training, may even have longer-lasting effects to help lower blood pressure in people with hypertension. However, breathing techniques should not replace the treatment plan and medication your healthcare provider prescribes.
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1. 4-7-8 Breathing
The 4-7-8 breathing technique involves breathing in through the nose for four seconds, holding your breath for seven seconds, and exhaling through the mouth for eight seconds while making an audible “whooshing” sound. This method may be beneficial for calming feelings of anxiety and helping people to fall asleep.
Not many high-quality, published studies look specifically at this technique’s effect on lowering blood pressure. However, one small study found that the systolic blood pressure was slightly lower (3 to 4 mm/Hg) after participants performed the 4-7-8 technique.
2. Diaphragmatic Breathing
Diaphragmatic breathing, sometimes referred to as belly breathing, is a technique that involves slow, deep breaths. This practice activates the diaphragm, which is a muscle that sits between the lungs and the abdomen.
Studies suggest that diaphragmatic breathing may help those with lung diseases like chronic obstructive lung disease and asthma. Fewer studies have looked at its effect on blood pressure, but one study found lower blood pressure after diaphragmatic breathing sessions, particularly when combined with mindfulness exercises.
Another study evaluated the use of a breathing and mindfulness phone app in adults with elevated blood pressure and found that participants had lower blood pressure after one year of using the app.
3. Alternate Nostril Breathing
This technique involves breathing into one nostril while the other is held closed, and then alternating nostrils. There are various patterns for performing alternate nostril breathing. One technique is to hold the right nostril closed while exhaling and inhaling through the left nostril. Then switch to hold the left nostril closed while exhaling and inhaling through the right nostril.
Research has shown mixed results on the effect of nostril breathing on blood pressure, though some studies demonstrated a decrease in blood pressure in adults with hypertension.
4. Box Breathing
Box breathing, also known as tactical breathing, is a technique that involves breathing in, holding the breath, exhaling, and holding it again for the same amount of time, such as four seconds. It is taught to military members due to its effect on enhancing performance during stress.However, there is a lack of high-quality research on its blood pressure-lowering effects specifically.
5. Equal Breathing (Sama Vritti)
Equal breathing, known as sama vritti, is a practice that involves breathing in for counts (such as four seconds), then exhaling for the same number of counts. This is similar to the box breathing technique, though it does not have the pause after each inhale and exhale.
Breath work techniques with slow breathing can lower stress and temporarily lower blood pressure. Still, evidence does not support that one breath ratio (duration of inhale versus exhale) is better than another.One small study of 10 people on dialysis for chronic kidney disease found lower blood pressure in those performing sama vritti between dialysis sessions.
6. Pursed-Lip Breathing
Pursed-lip breathing is a technique in which a prolonged exhalation is performed through pursed lips. To perform pursed-lip breathing, inhale slowly through the nose for two counts and exhale slowly for four counts, blowing air through the lips in a puckered position.
The American Lung Association describes pursed-lip breathing as a technique that can help people with lung disease who are experiencing shortness of breath.One randomized control trial looked at the effectiveness of pursed-lip breathing in patients undergoing emergency room treatment for hypertensive urgency. The group of patients who performed the technique for 15 minutes each hour had significantly lower blood pressure after three hours.
7. Inspiratory Muscle Strength Training (IMST)
Should You Try Breathing Techniques?
If you have high blood pressure, breathing techniques may help temporarily lower your blood pressure. However, there is currently little compelling evidence to suggest that breathing exercises can help maintain an overall lower blood pressure or treat hypertension.
People should not perform certain breathing techniques during situations in which it would be dangerous to fall asleep, such as while driving. Additionally, people with chronic lung disease should speak with their healthcare provider before doing breathing exercises because techniques that involve prolonged breath holding may not be recommended. Stop the exercise if you feel lightheaded, dizzy, or otherwise unwell while performing breathing techniques.
Treating high blood pressure requires a multipronged approach. Lifestyle interventions such as a heart-healthy diet (such as the DASH diet orMediterranean diet) and regular physical exercise are recommended to help manage hypertension. Medications are recommended if lifestyle changes alone do not sufficiently lower blood pressure.Talk with your healthcare provider about an individualized treatment plan. Breathing exercises should never replace the medications your healthcare provider prescribes.
Summary
Breathing exercises can temporarily lower blood pressure and heart rate through activation of the parasympathetic nervous system. Some studies suggest that certain techniques can help with hypertension. For example, pursed-lip breathing can help lower blood pressure in people experiencing hypertensive urgency, while inspiratory muscle strength training (IMST) may help lower blood pressure in the longer term with regular practice.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fincham GW, Strauss C, Montero-Marin J, Cavanagh K.Effect of breathwork on stress and mental health: a meta-analysis of randomised-controlled trials.Sci Rep. 2023;13(1):432. doi:10.1038/s41598-022-27247-yVierra 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. doi:10.14814/phy2.15389Hamasaki H.Effects of diaphragmatic breathing on health: a narrative review.Medicines (Basel). 2020;7(10):65. Published 2020 Oct 15. doi:10.3390/medicines7100065Chandler J, Sox L, Diaz V, et al.Impact of 12-month smartphone breathing meditation program upon systolic blood pressure among non-medicated stage 1 hypertensive adults.Int J Environ Res Public Health. 2020;17(6):1955. Published 2020 Mar 17. doi:10.3390/ijerph17061955Nivethitha L, Mooventhan A, Manjunath NK.Effects of variousPrānāyāmaon cardiovascular and autonomic variables.Anc Sci Life. 2016;36(2):72-77. doi:10.4103/asl.ASL_178_16Balban MY, Neri E, Kogon MM, et al.Brief structured respiration practices enhance mood and reduce physiological arousal.Cell Rep Med. 2023;4(1):100895. doi:10.1016/j.xcrm.2022.100895Birdee G, Nelson K, Wallston K, et al.Slow breathing for reducing stress: the effect of extending exhale.Complement Ther Med. 2023;73:102937. doi:10.1016/j.ctim.2023.102937Dalvi MA, Afle GM.Effect of sama vritti pranayama on intradialytic hypertension in patients with chronic kidney disease: a pilot study.International Journal Of Community Medicine And Public Health.2023;10(11):4431-4434. doi:10.18203/2394-6040.ijcmph20233490American Lung Association.Pursed lip breathing.Mitsungnern T, Srimookda N, Imoun S, et al.The effect of pursed-lip breathing combined with number counting on blood pressure and heart rate in hypertensive urgency patients: a randomized controlled trial.J Clin Hypertens (Greenwich). 2021;23(3):672-679. doi:10.1111/jch.14168Craighead DH, Heinbockel TC, Freeberg KA, et al.Time-efficient inspiratory muscle strength training lowers blood pressure and improves endothelial function, NO bioavailability, and oxidative stress in midlife/older adults with above-normal blood pressure.J Am Heart Assoc. 2021;10(13):e020980. doi:10.1161/JAHA.121.020980Whelton PK, Carey RM, Aronow WS, et al. 2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fincham GW, Strauss C, Montero-Marin J, Cavanagh K.Effect of breathwork on stress and mental health: a meta-analysis of randomised-controlled trials.Sci Rep. 2023;13(1):432. doi:10.1038/s41598-022-27247-yVierra 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. doi:10.14814/phy2.15389Hamasaki H.Effects of diaphragmatic breathing on health: a narrative review.Medicines (Basel). 2020;7(10):65. Published 2020 Oct 15. doi:10.3390/medicines7100065Chandler J, Sox L, Diaz V, et al.Impact of 12-month smartphone breathing meditation program upon systolic blood pressure among non-medicated stage 1 hypertensive adults.Int J Environ Res Public Health. 2020;17(6):1955. Published 2020 Mar 17. doi:10.3390/ijerph17061955Nivethitha L, Mooventhan A, Manjunath NK.Effects of variousPrānāyāmaon cardiovascular and autonomic variables.Anc Sci Life. 2016;36(2):72-77. doi:10.4103/asl.ASL_178_16Balban MY, Neri E, Kogon MM, et al.Brief structured respiration practices enhance mood and reduce physiological arousal.Cell Rep Med. 2023;4(1):100895. doi:10.1016/j.xcrm.2022.100895Birdee G, Nelson K, Wallston K, et al.Slow breathing for reducing stress: the effect of extending exhale.Complement Ther Med. 2023;73:102937. doi:10.1016/j.ctim.2023.102937Dalvi MA, Afle GM.Effect of sama vritti pranayama on intradialytic hypertension in patients with chronic kidney disease: a pilot study.International Journal Of Community Medicine And Public Health.2023;10(11):4431-4434. doi:10.18203/2394-6040.ijcmph20233490American Lung Association.Pursed lip breathing.Mitsungnern T, Srimookda N, Imoun S, et al.The effect of pursed-lip breathing combined with number counting on blood pressure and heart rate in hypertensive urgency patients: a randomized controlled trial.J Clin Hypertens (Greenwich). 2021;23(3):672-679. doi:10.1111/jch.14168Craighead DH, Heinbockel TC, Freeberg KA, et al.Time-efficient inspiratory muscle strength training lowers blood pressure and improves endothelial function, NO bioavailability, and oxidative stress in midlife/older adults with above-normal blood pressure.J Am Heart Assoc. 2021;10(13):e020980. doi:10.1161/JAHA.121.020980Whelton PK, Carey RM, Aronow WS, et al. 2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Fincham GW, Strauss C, Montero-Marin J, Cavanagh K.Effect of breathwork on stress and mental health: a meta-analysis of randomised-controlled trials.Sci Rep. 2023;13(1):432. doi:10.1038/s41598-022-27247-yVierra 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. doi:10.14814/phy2.15389Hamasaki H.Effects of diaphragmatic breathing on health: a narrative review.Medicines (Basel). 2020;7(10):65. Published 2020 Oct 15. doi:10.3390/medicines7100065Chandler J, Sox L, Diaz V, et al.Impact of 12-month smartphone breathing meditation program upon systolic blood pressure among non-medicated stage 1 hypertensive adults.Int J Environ Res Public Health. 2020;17(6):1955. Published 2020 Mar 17. doi:10.3390/ijerph17061955Nivethitha L, Mooventhan A, Manjunath NK.Effects of variousPrānāyāmaon cardiovascular and autonomic variables.Anc Sci Life. 2016;36(2):72-77. doi:10.4103/asl.ASL_178_16Balban MY, Neri E, Kogon MM, et al.Brief structured respiration practices enhance mood and reduce physiological arousal.Cell Rep Med. 2023;4(1):100895. doi:10.1016/j.xcrm.2022.100895Birdee G, Nelson K, Wallston K, et al.Slow breathing for reducing stress: the effect of extending exhale.Complement Ther Med. 2023;73:102937. doi:10.1016/j.ctim.2023.102937Dalvi MA, Afle GM.Effect of sama vritti pranayama on intradialytic hypertension in patients with chronic kidney disease: a pilot study.International Journal Of Community Medicine And Public Health.2023;10(11):4431-4434. doi:10.18203/2394-6040.ijcmph20233490American Lung Association.Pursed lip breathing.Mitsungnern T, Srimookda N, Imoun S, et al.The effect of pursed-lip breathing combined with number counting on blood pressure and heart rate in hypertensive urgency patients: a randomized controlled trial.J Clin Hypertens (Greenwich). 2021;23(3):672-679. doi:10.1111/jch.14168Craighead DH, Heinbockel TC, Freeberg KA, et al.Time-efficient inspiratory muscle strength training lowers blood pressure and improves endothelial function, NO bioavailability, and oxidative stress in midlife/older adults with above-normal blood pressure.J Am Heart Assoc. 2021;10(13):e020980. doi:10.1161/JAHA.121.020980Whelton PK, Carey RM, Aronow WS, et al. 2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066
Fincham GW, Strauss C, Montero-Marin J, Cavanagh K.Effect of breathwork on stress and mental health: a meta-analysis of randomised-controlled trials.Sci Rep. 2023;13(1):432. doi:10.1038/s41598-022-27247-y
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. doi:10.14814/phy2.15389
Hamasaki H.Effects of diaphragmatic breathing on health: a narrative review.Medicines (Basel). 2020;7(10):65. Published 2020 Oct 15. doi:10.3390/medicines7100065
Chandler J, Sox L, Diaz V, et al.Impact of 12-month smartphone breathing meditation program upon systolic blood pressure among non-medicated stage 1 hypertensive adults.Int J Environ Res Public Health. 2020;17(6):1955. Published 2020 Mar 17. doi:10.3390/ijerph17061955
Nivethitha L, Mooventhan A, Manjunath NK.Effects of variousPrānāyāmaon cardiovascular and autonomic variables.Anc Sci Life. 2016;36(2):72-77. doi:10.4103/asl.ASL_178_16
Balban MY, Neri E, Kogon MM, et al.Brief structured respiration practices enhance mood and reduce physiological arousal.Cell Rep Med. 2023;4(1):100895. doi:10.1016/j.xcrm.2022.100895
Birdee G, Nelson K, Wallston K, et al.Slow breathing for reducing stress: the effect of extending exhale.Complement Ther Med. 2023;73:102937. doi:10.1016/j.ctim.2023.102937
Dalvi MA, Afle GM.Effect of sama vritti pranayama on intradialytic hypertension in patients with chronic kidney disease: a pilot study.International Journal Of Community Medicine And Public Health.2023;10(11):4431-4434. doi:10.18203/2394-6040.ijcmph20233490
American Lung Association.Pursed lip breathing.
Mitsungnern T, Srimookda N, Imoun S, et al.The effect of pursed-lip breathing combined with number counting on blood pressure and heart rate in hypertensive urgency patients: a randomized controlled trial.J Clin Hypertens (Greenwich). 2021;23(3):672-679. doi:10.1111/jch.14168
Craighead DH, Heinbockel TC, Freeberg KA, et al.Time-efficient inspiratory muscle strength training lowers blood pressure and improves endothelial function, NO bioavailability, and oxidative stress in midlife/older adults with above-normal blood pressure.J Am Heart Assoc. 2021;10(13):e020980. doi:10.1161/JAHA.121.020980
Whelton PK, Carey RM, Aronow WS, et al. 2017ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Hypertension. 2018;71(6):1269-1324. doi:10.1161/HYP.0000000000000066
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