Slow breathing has unequal effects on prehypertensives from different ethnic/racial groups
Effect of slow breathing in different ethnic groups
In this study, we investigated whether slow breathing reduces blood pressure (BP) in individuals at risk of developing hypertension and if slow breathing has the same effect on Caucasian, African, Arabian and Indian subjects. Also we assessed ethnic/racial differences in low frequency (LF) power and high frequency (HF) power of heart rate variability (HRV). A total of 40 Caucasian men from Ukraine, 39 West African men mostly from Nigeria, 38 Arabic men from Palestine and Israel and 41 South Asian men from India studying at V. N. Karazin Kharkiv National University were recruited in this study. The subjects were further classified into normotensive and prehypertensive groups. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), LF power, HF power of HRV were recorded at spontaneous breathing and at paced breathing of 10 and 6 breaths per minute. It was found that slowing respiratory rate to 6 breaths per minute reduces SBP in prehypertensive Caucasians, Arabs, Indians, but not in Africans. At 6 breaths per minute, natural logarithm of HF (LnHF) power indicating cardiovagal activity was less in normotensive Arabs than in Caucasians, Africans and Indians possibly suggesting an increased risk of developing hypertension; while prehypertensive Africans demonstrated LnHF power higher than Arabs and Indians. When covariates like age and body mass index (BMI) were considered, prehypertensive Africans demonstrated LnHF power higher than in Caucasians also. It is suggested that in prehypertensive Africans the control of autonomic nervous activity is reset to a higher level of parasympathetic outflow.
- Ogunlade O, Ayoka AO, Akintomide A, Akomolafe RO, Akinsomisoye OS, Oyebola DO. Non-invasive assessment of cardiac autonomic functions in healthy young adults in Ile-Ife, South-Western Nigeria. Int J Clin Cardiol. 2015 Jun; 2:3. [Crossref]
- Mensah GA, Mokdad AH, Ford ES, Greenlund KJ, Croft JB. State of disparities in cardiovascular health in the United States. Circulation. 2005 Mar 15; 111(10):1233–41. [Pubmed] [Crossref]
- Hill LK, Hu DD, Koenig J, Sollers JJ 3rd, Kapuku G, Wang X, Snieder H, Thayer JF. Ethnic differences in resting heart rate variability: a systematic review and meta-analysis. Psychosom Med. 2015 Jan; 77(1):16–25. [Pubmed] [Crossref]
- Onwuchekwa AC, Mezie-Okoye MM, Babatunde S. Prevalence of hypertension in Kegbara-Dere, a rural community in the Niger Delta region, Nigeria. Ethn Dis. 2012 Summer; 22(3):340–6. [Pubmed]
- Adeloye D, Basquill C, Aderemi AV, Thompson JY, Obi FA. An estimate of the prevalence of hypertension in Nigeria: a systematic review and meta-analysis. J Hypertens. 2015 Feb; 33(2):230–42. [Pubmed] [Crossref]
- Khdour MR, Hallak HO, Shaeen M, Jarab AS, Al-Shahed QN. Prevalence, awareness, treatment and control of hypertension in the Palestinian population. J Hum Hypertens. 2013 Oct; 27(10): 623–8. [Pubmed] [Crossref]
- Tailakh A, Evangelista LS, Mentes JC, Pike NA, Phillips LR, Morisky DE. Hypertension prevalence, awareness, and control in Arab countries: A systematic review. Nurs Health Sci. 2014 Mar; 16(1):126–30. [Pubmed] [Crossref]
- Agyemang C, Bhopal RS. Hypertension and coronary heart disease in South Asians. In: Patel KCR, Bhopal RS (eds). The epidemic of coronary heart disease in south Asian populations: causes and consequences, 1st ed, South Asian Health Foundation, pp.110-120, 2004.
- Joseph CN, Porta C, Casucci G, Casiraghi N, Maffeis M, Rossi M, Bernardi L. Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. Hypertension. 2005 Oct; 46(4):714–8. [Pubmed] [Crossref]
- Bernardi L, Porta C, Spicuzza L, Bellwon J, Spadacini G, Frey AW, Yeung LY, Sanderson JE, Pedretti R, Tramarin R. Slow breathing increases arterial baroreflex sensitivity in patients with chronic heart failure. Circulation. 2002 Jan; 105(2):143–5. [Pubmed] [Crossref]
- Raupach T, Bahr F, Herrmann P, Luethje L, Heusser K, Hasenfuss G, Bernardi L, Andreas S. Slow breathing reduces sympathoexcitation in COPD. Eur Respir J. 2008 Aug; 32(2):387–92. [Pubmed] [Crossref]
- Task Force of the European Society of Cardiology, and the North American Society of Pacing and Electrophysiology. Heart rate variability. Standards of measurement, physiological interpretation, and clinical use. Eur Heart J. 1996 Mar; 17(3):354–81. [Pubmed] [Crossref]
- Goldstein DS, Bentho O, Park MY, Sharabi Y. Low-frequency power of heart rate variability is not a measure of cardiac sympathetic tone but may be a measure of modulation of cardiac autonomic outflows by baroreflexes. Exp Physiol. 2011 Dec; 96(12):1255–61. [Pubmed] [Crossref]
- Reyes Del Paso GA, Langewitz W, Mulder LJ, van Roon A, Duschek S. The utility of low frequency heart rate variability as an index of sympathetic cardiac tone: A review with emphasis on a reanalysis of previous studies. Psychophysiol. 2013 May; 50(5):477–87. [Pubmed] [Crossref]
- Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003 Dec; 42(6):1206–52. [Pubmed] [Crossref]
- Shekh VE. Sex and ethnic/racial differences in blood pressure and heart rate variability during orthostatic testing in young healthy individuals. J Phys Pharm Adv. 2016 Mar; 6(3):846–59. [Crossref]
- Novak V, Novak P, de Champlain J, Nadeau R. Altered cardiorespiratory transfer in hypertension. Hypertension. 1994 Jan; 23(1):104–13. [Pubmed] [Crossref]
- Brown TE, Beightol LA, Koh J, Eckberg DL. Important influence of respiration on human R-R interval power spectra is largely ignored. J Appl Physiol (1985). 1993 Nov; 75(5):2310–7. [Pubmed]
- Pitzalis MV, Mastropasqua F, Massari F, Passantino A, Colombo R, Mannarini A, Forleo C, Rizzon P. Effect of respiratory rate on the relationships between RR interval and systolic blood pressure fluctuations: a frequency-dependent phenomenon. Cardiovasc Res. 1998 May; 38(2):332–9. [Pubmed] [Crossref]
- Liao D, Cai J, Barnes RW, Tyroler HA, Rautaharju P, Holme I, Heiss G. Association of cardiac autonomic function and the development of hypertension: the ARIC study. Am J Hypertens. 1996 Dec; 9(12 Pt 1):1147–56. [Pubmed] [Crossref]
- Patel PA, Diwan JS, Shah CJ, Mehta HB. Study of heart rate variability in hypertensive subjects. Natl J Integr Res Med. 2015 Jan; 6(1):1–6.
- Liao D, Barnes RW, Chambless LE, Simpson RJ Jr, Sorlie P, Heiss G. Age, race, and sex differences in autonomic cardiac function measured by spectral analysis of heart rate variability-the ARIC study. Atherosclerosis Risk in Communities. Am J Cardiol. 1995 Nov 1; 76(12): 906–12. [Pubmed] [Crossref]
- Bathula R, Francis DP, Hughes A, Chaturvedi N. Ethnic differences in heart rate: can these be explained by conventional cardiovascular risk factors? Clin Auton Res. 2008 Apr; 18(2):90-5. [Pubmed] [Crossref]
- Nama V, Onwude J, Manyonda IT, Antonios TF. Is capillary rarefaction an independent risk marker for cardiovascular disease in South Asians? J Hum Hypertens. 2011 Jul; 25(7):465-6. [Pubmed] [Crossref]
- Hughes AD, Bathula R, Park C, Tillin T, Wit N, McG Thom S, Chaturvedi N. Microcirculatory rarefaction in south Asians - a potential mechanism for increased cardiovascular risk and diabetes. PLoS One. 2013 Oct 7; 8(10):e76680 [Pubmed] [Crossref]
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors warrants and represents that the submitted MANUSCRIPT is an original work and has not been published before in any form, and that it does not infringe upon any copyright or other right(s), that it does not contain infringing, libelous, obscene or other unlawful matter, that he/she is the sole and exclusive owner of the rights here-in conveyed to the Publisher, and that he/she has obtained the customary permission from the copyright owner or his legal representative whenever a text/passage from copyrighted material is quoted or a table or illustration from such material is used. The Author(s) will indemnify the Publisher for, and hold the Publisher harmless from any loss, expense or damage occasioned by any claim or suit by a third party for copyright infringement or arising out of any breach of the foregoing warranties as a result of publication of the Article. The Article shall be delivered to the Publisher free of copyright charges. In the event that the Article is not accepted and published by Publisher, this agreement becomes null and void.