Voluntary Slow Breathing Exercise on Cardiovascular Parameters in Patients With Hypertension: A Systematic Review and Meta-Analysis

Abstract

Background: Non-pharmacological interventions are increasingly recognized as complementary approaches in the management of hypertension. Among various non-pharmacological interventions, voluntary slow breathing exercise has been proposed as a simple and accessible approach, but its comprehensive effects on cardiovascular parameters in hypertensive patients remain to be systematically summarized. Aim: This systematic review and meta-analysis aims to quantitatively assess the effects of voluntary slow breathing exercise on cardiovascular parameters in individuals with hypertension. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted literature searches in four major databases (PubMed, Web of Science, Embase, and the Cochrane Library) to identify eligible studies. Meta-analysis was conducted using RevMan 5.4 software. Effect sizes were pooled by calculating mean differences (MDs) and their 95% confidence intervals (CIs). A fixed-effects or random-effects model was used according to the results of the heterogeneity test. Results: A total of thirteen studies met the predefined inclusion criteria. The pooled analysis demonstrated that voluntary slow breathing exercise significantly reduced systolic blood pressure (MD = −7.68; 95% CI: −9.87, −5.49; p < 0.001), diastolic blood pressure (MD = −4.02; 95% CI: −5.44, −2.60; p < 0.001), and heart rate (MD = −1.15; 95% CI: −1.73, −0.56; p < 0.001) compared to control conditions. Additionally, a significant reduction in the low-frequency to high-frequency power ratio (LF/HF) was observed (MD = −1.09; 95% CI: −1.94, −0.23; p = 0.01), indicating improved autonomic modulation. Conclusion: Voluntary slow breathing exercise appears to be an effective adjuvant non-pharmacological intervention for improving cardiovascular function, particularly in reducing blood pressure and heart rate, in patients with hypertension. These findings support its potential integration into hypertension management strategies.