3/19/2023 0 Comments Retrospective data![]() Measurements were taken in triplicate and averaged, with >1 min between measurements. Subjects were seated quietly for at least 5 min before BP measurements with their feet flat on the floor and arm supported at heart level. We hypothesized that 1) IMST would reduce SBP and DBP compared with sham training 2) reductions in BP would be apparent within the first week of training and 3) higher initial BP levels would be associated with larger BP reductions with IMST, but other clinical factors would not appreciably predict the efficacy of IMST.Ĭasual (resting) SBP and DBP were measured in accordance with clinical guidelines ( 6, 37, 38) using either a manual sphygmomanometer and stethoscope ( 31– 34) or automated oscillometric sphygmomanometer ( 35) placed over the brachial artery. We also evaluated BP outcomes as a function of gains in respiratory muscle strength (PI MAX). The principal purposes of this investigation were to quantify the BP-lowering effects of IMST in a larger cohort of participants, evaluate the time course of BP reductions, and identify subject characteristics that may predict the magnitude of the BP reduction in response to the intervention. Accordingly, to address these specific research gaps, we pooled data from five randomized, controlled trials performed in our laboratories at the University of Arizona and the University of Colorado Boulder that used near-identical protocols but with unique participant populations (i.e., normotensive young adults, middle-aged and older adults with above-normal BP, and adults with obstructive sleep apnea and above normal BP). Thus, current evidence suggests that high-resistance IMST has potential for public health translation ( 36).ĭespite favorable health and adherence outcomes, the small sample sizes arising from individual pilot trials performed to date both limit confidence in prior results and preclude analysis of subject characteristics that may impact effectiveness of the intervention for lowering BP. Interventions that can lower BP to recommended levels (i.e., SBP 90% of prescribed training sessions completed) has been reported in all trials to date ( 31– 35). Thus, addressing the burden of above-normal BP is an important public health goal. The number of older adults is projected to rapidly rise, predicting a dramatic increase in BP-driven CVD burden ( 4). The incidence of above-normal BP increases with age, such that 90% of adults who live to 80 years of age will develop unhealthy BP levels, even if they have normal BP at midlife ( 3). Above-normal BP is a highly prevalent health condition that affects more than 50% of adults in the United States ( 2). Above-normal blood pressure (BP), defined as having a systolic BP (SBP) ≥ 120 mmHg and/or a diastolic BP (DBP) ≥ 80 mmHg, is the primary modifiable risk factor for CVD ( 1). Given blood pressure outcomes with the intervention were only slightly altered by subject baseline characteristics (i.e., age, blood pressure medication, and health status), inspiratory muscle strength training is effective in lowering blood pressure in a broad range of adults.Ĭardiovascular diseases (CVD) are the leading cause of death in developed and developing countries. NEW & NOTEWORTHY In young-to-older adult men and women, 6 wk of high-resistance inspiratory muscle strength training lowers casual systolic and diastolic blood pressure by 9 mmHg and 4 mmHg, respectively, with initial reductions observed by week 2 of training. These compiled findings from multiple independent trials provide the strongest evidence to date that high-resistance IMST evokes clinically significant reductions in SBP and DBP, and increases in PI MAX, in adult men and women. Gains in PI MAX had a modest inverse relation with age (β = −0.20 ± 0.09 P = 0.03) and baseline PI MAX (β = −0.15 ± 0.07 P = 0.04) but not to reductions in SBP or DBP. PI MAX increased with high-resistance IMST and low-resistance sham training, with a greater increase from high-resistance IMST (+20 ± 17 vs. Greater reductions in SBP were associated with older age (β = −0.07 ± 0.03 P = 0.04) and greater reductions in DBP associated with medication-naïve BP (β = −3 ± 1 P = 0.02) and higher initial DBP (β = −0.12 ± 0.05 P = 0.04). Select subject characteristics slightly modified the impact of IMST on BP. IMST ( n = 67) reduced systolic BP (SBP) by 9 ± 6 mmHg ( P 0.05). Participants were randomized to high-resistance IMST (75% PI MAX) or low-resistance sham (15% PI MAX) training (30 breaths/day, 5–7 days/wk, 6 wk). In a retrospective analysis of five pilot trials, we assessed the BP-lowering effects of high-resistance inspiratory muscle strength training (IMST) in adults aged 18–82 years and the impact of IMST on maximal inspiratory pressure (PI MAX), a gauge of inspiratory muscle strength and independent disease risk factor. Above-normal blood pressure (BP) is a primary risk factor for cardiovascular diseases.
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