Exercise has well-documented benefits for systolic blood pressure (SBP) and cardiovascular health. Whereas current guidelines advocate ~150 min moderate intensity exercise/week, our preliminary data show ~5 min/day of inspiratory muscle strength training (IMST) for 6 weeks lowers casual (resting) SBP by ~12 mmHg. This simple approach to lowering BP could be applied to almost any population however we propose to study IMST in older adults with obstructive sleep apnea (OSA). OSA is an ideal population to target because OSA prevalence is growing and because snoring and apneas result in chronic intermittent hypoxemia that drives sympathetic nervous system (SNS) hyperactivity, endothelial dysfunction and hypertension. These substantive risks for cardiovascular disease are compounded by poor adherence to the mainstay treatment continuous positive airway pressure (<50%), obesity, fatigue and a robust intolerance for exercise. Our findings in healthy young adults (n=50) show IMST-related reductions in BP are mediated by decreases in systemic vascular resistance, suggesting changes in vascular tone and function. Consistent with this hypothesis, our results from a pilot clinical trial in adults with OSA (n=24) show IMST-related reductions in plasma norepinephrine levels (PNE) and muscle sympathetic nerve activity (MSNA), both markers of SNS activity. We propose a randomized, double-blind, placebo-controlled, clinical trial to establish the efficacy of at home IMST (75% maximum inspiratory pressure, [PImax]) 5 days/week for 24 weeks vs. placebo (15%PImax) (n=61/group) for lowering SBP in adults (>50 years) with above normal BP and OSA. We hypothesize that IMST will lower SBP via reductions in SNS activity and circulating vasoconstrictor factors, improvements in vascular function, and reductions in oxidative stress/inflammation and that reductions in SBP will be sustained after IMST.
E. Fiona Bailey, PhD
Professor, BIO5 Institute
Professor, Evelyn F Mcknight Brain Institute
Professor, Speech/Language and Hearing
Dallin Tavoian, PhD
Post-doctoral Researcg Associate
Cardiovascular Research Fellow
Lupita E. Ramos Barrera
Aida Hawatmeh, MHM
Research Technician II
Josie Mazzone, MS
Graduate Research Assistant
Micaela Paulina Gamez
Undergraduate Research Assistant
College of Medicine - Tucson Clinical Trial Study a Simple Breathing Exercise for Obstructive Sleep Apnea:
A new clinical trail will assess the impact of inspiratory muscle training on blood pressure in adults with obstructive sleep apnea and hypertension.
5-minute breathing workout lowers blood pressure as much as exercise, drugs
Working out just five minutes daily via a practice described as "strength training for your breathing muscles" lowers blood pressure and improves some measures of vascular health as well as, or even more than, aerobic exercise or medication, new CU Boulder research shows.
Inspiratory muscle strength training lowers blood pressure and sympathetic activity in older adults with OSA: a randomized controlled pilot trial
Ramos-Barrera GE, DeLucia CM, Bailey EF
Daily inspiratory muscle training lowers blood pressure and vascular resistance in healthy men and women
DeLucia CM, De Asis RM, Bailey EF
Inspiratory Muscle Training Improves Sleep and Mitigates Cardiovascular Dysfunction in Obstructive Sleep Apnea
Vranish JR, Bailey EF
Daily respiratory training with large intrathoracic pressures, but not large lung volumes, lowers blood pressure in normotensive adults
Vranish JR, Bailey EF.v
Six Months of Inspiratory Muscle Training to Lower Blood Pressure and Improve Endothelial Function in Middle-Aged and Older Adults With Above-Normal Blood Pressure and Obstructive Sleep Apnea: Protocol for the CHART Clinical Trial
Tavoian, Dallin, et al.
Acute cardiovascular responses to a single bout of high intensity inspiratory muscle strength training in healthy young adults
DeLucia CM, DeBonis DR, Schwyhart SM, Bailey EF.
Time‐Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above‐Normal Blood Pressure
Craighead, Daniel H., et al.