Clinical Autonomic Research

, Volume 25, Issue 2, pp 95–104 | Cite as

Time sequence of autonomic changes induced by daily slow-breathing sessions

  • Pietro Amedeo Modesti
  • Antonella Ferrari
  • Cristina Bazzini
  • Maria Boddi
Research Article



Daily sessions of slow-breathing (6 breaths/min) significantly reduced 24-h ambulatory blood pressure (ABP) in patients with mild hypertension and this effect persisted at least 6 months after the interruption of sessions. The sequence of changes induced by slow-breathing (SB) daily sessions on the modulation of ambulatory blood pressure, renal resistive index, heart rate variability (HRV), and baroreflex sensitivity (BRS) was thus investigated in a randomized, controlled clinical trial.


Thirty-seven patients (30–75 years, grade I essential hypertension), untreated with antihypertensive drugs, were randomized to daily sessions (30 min) of music-guided SB (<10 breaths/min) (intervention, n = 24) or simple relaxation (control, n = 13). Office and ambulatory blood pressure monitoring renal Doppler ultrasound, assessment of BRS (sequence method and spectral analysis), and HRV (spectral power in the high- and low-frequency bands) were performed at baseline, and after 1, 4, and 8 weeks. Mixed model analysis was conducted on derived variables given by the difference between each measurement and the baseline value within subjects.


After 1 week, the intervention enhanced the parasympathetic modulation (high-frequency power; at least p < 0.05 vs both control and baseline) and reduced renal vascular resistance (p < 0.05 for both comparisons); after 1 month, the enhancement of BRS (p < 0.05 for both comparisons at both methods) paralleled a significant reduction in 24 h ABP (p < 0.05 for all comparisons).


Repeated daily session of music-guided SB increased parasympathetic modulation and decreased renal resistive index early in the study. These changes were being followed by a positive modulation of BRS and blood pressure reduction.


Hypertension Prevention and control Complementary therapies Breathing exercises Autonomic nervous system Baroreflexes 



This study was supported by a grant from the University of Florence (progetti di ricerca d’ateneo ex 60 % 2010/2011), and Regione Toscana (PMI 2009 POR CReO FESR 2007–2013-linea d’intervento 1.1.c, D.D. n. 1942 del 10.04.2009).

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Pietro Amedeo Modesti
    • 1
  • Antonella Ferrari
    • 1
  • Cristina Bazzini
    • 1
  • Maria Boddi
    • 1
  1. 1.Department of Clinical and Experimental MedicineUniversity of FlorenceFlorenceItaly

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