What are the best ways to improve your vascular health? We know that exercise is one of the important lifestyle interventions we can take, along with eating a heart-healthy diet, not smoking, managing blood pressure, and so on.
But what is the easiest way to boost vascular health? The answer to that question might surprise you. According to a new study out of the University of Colorado, Boulder (UCB), it may not involve running or lifting weights, changing your diet, or taking a pill. In fact, for many people, a simple 5-minute breathing exercise with a hand-held device can lower blood pressure and improve markers of vascular health better than aerobic exercise.
This is key, note the study authors, because 65% of American adults over the age of 50 have above-normal blood pressure, putting them at greater risk of cardiovascular disease—which is still the leading cause of death in the United States. And yet, fewer than 40% meet recommended aerobic exercise guidelines.
Here’s what the researchers found, along with details on additional health benefits that breathing exercises can bring.
Is breathing better than a workout?
In a study published in the Journal of the American Heart Association (JAHA) in June, researchers set out to investigate whether a training protocol called high-resistance inspiratory muscle strength training (IMST), performed for 6 weeks (30 breaths/day 6 days/week), could improve blood pressure, endothelial function, and arterial stiffness in middle-aged to older adults. They found that training the breathing muscles for just 5 minutes a day can lower blood pressure and improve other indicators of vascular health just as well as (or even potentially more than) a session of aerobic exercise or taking medication.
IMST is a technique developed in the 1980s to help patients with respiratory diseases strengthen their diaphragms and other breathing muscles. The protocol involves inhaling vigorously through a hand-held device that provides resistance. In the beginning, physicians recommended 30 minutes per day at low resistance, for those with breathing disorders. But in recent years, UCB investigators have been studying whether a more efficient technique could also bring about improvements in cardiovascular and cognitive function, and even sports performance.
Researchers used a cohort of 36 adults (aged 50-79), all of whom had above-normal systolic blood pressure. Half of this group was tasked with completing 6 weeks of IMST, while the other half was given placebo treatment.
On average, the IMST group experienced a nine-point dip in blood pressure. This was a greater improvement than has been seen in studies examining a regimen of walking 30 minutes per day for 5 days a week, and equal to the effects one could expect from taking certain blood pressure-lowering drugs. Remarkably, study participants maintained most of this reduction in blood pressure for 6 weeks after the study’s conclusion.
The IMST group exhibited a 45% improvement in vascular endothelial function (the arteries’ ability to expand) and a significant increase in levels of nitric oxide, a molecule that plays a vital role in dilating and preventing plaque buildup in arteries. Additionally, they showed far lower markers of inflammation and oxidative stress, both of which are indicators of the risk of heart failure. Encouragingly, participants in the IMST cohort completed 95% of the sessions.
While the mechanisms behind these benefits remain somewhat unclear, researchers hypothesized that the technique prompts the cells lining blood vessels to produce more nitric acid, which allows them to relax.
IMST showed promise for improving measures of physical fitness, leading researchers to conclude that the technique could be used for improving sports performance. The NIH has since provided funding for researchers to pursue a larger follow-up study, involving a cohort of 100 people, which will compare IMST with an aerobic exercise program.
“We have identified a novel form of therapy that lowers blood pressure without giving people pharmacological compounds and with much higher adherence than aerobic exercise,” said senior author Doug Seals, a distinguished professor of integrative physiology at UCB, in a release.
Lead author Daniel Craighead, assistant research professor in UCB’s Department of Integrative Physiology, added: “There are a lot of lifestyle strategies that we know can help people maintain cardiovascular health as they age. But the reality is, they take a lot of time and effort and can be expensive and hard for some people to access. MST can be done in 5 minutes in your own home while you watch TV.”
The research group is working on a smartphone app to enable people to do the protocol at home using commercially available devices, according to the release.
Using the breath to conquer stress and anxiety
Breathing exercises don’t just improve vascular health, they can also help ameliorate conditions like chronic stress. As pointed out in an article published by Harvard Health, stress is associated with various health problems, including high blood pressure, suppression of the immune system, and an increased risk of anxiety and depression.
One of the better ways to combat stress is by breathing deeply, which allows for a greater exchange of incoming oxygen for outgoing carbon dioxide. This, in turn, can slow the heart rate and stabilize blood pressure.
According to an article published by Scientific American, relaxed responses to stimuli are a result of the activation of the parasympathetic nervous system, whereas stressed responses are a result of the activation of the sympathetic nervous system. Controlling your breathing so that it’s slower and deeper can induce a response from the parasympathetic nervous system.
Slow, deep breaths can increase the activity of the vagus nerve (a part of the parasympathetic nervous system), which influences the activity of various internal organs. This lowers heart rate, relaxes muscles, and reduces blood pressure. It also activates the dorsomedial prefrontal cortex and reduces activity in the amygdala, which ultimately eases stress and reduces negative emotions.
The authors write that respiratory techniques can help tackle stress, sleep problems, and chronic anxiety—and they’re highly effective for patients with psychiatric disorders like phobias, depression, or post-traumatic stress disorder.
Additional benefits of breathing exercises
There are various other health benefits to engaging in deep breathing exercises, many of which are listed in a review published in Breathe.
Various studies have shown that slow, deep breathing has positive impacts on respiratory, cardiovascular, cardiorespiratory, and autonomic nervous systems. Specifically, beneficial effects have been observed on respiratory muscle activity, ventilation efficiency, chemoreflex and baroreflex sensitivity, heart rate variability, blood flow dynamics, respiratory sinus arrhythmia, cardiorespiratory coupling, and sympathovagal balance.
For example, one study cited in the review found that patients with chronic heart failure who practiced slow respiration (at 6 breaths per minute) exhibited improved alveolar ventilation and increased arterial oxygen saturation. Ultimately, these patients demonstrated increased exercise performance and motivation.
While further research is required, the use of slow breathing techniques appears to be an effective means of “optimizing physiological parameters that appear to be associated with health and longevity.”
Learn more about breathing exercises and other clinically proven relaxation methods on our blog, PhysicianSense.