Mindful Breathing and Biofeedback Help Manage Hypertension

Note:  The following “Wellness Journey” article is written by a client and friend, Michael LaGreca. I wanted to share his “lessons learned” and perspective on treatment of hypertension with you.

As a generally very healthy 55-year-old, it did strike me when my physician matter-of-factly pointed out during my last physical that I have hypertension. Besides me mentioning my too-often cold hands to him, I’m sure he could read it in my overall health history. My long work hours and frequent travel had left their mark. It was enough for me to process the idea of having hypertension, let alone accepting any prescriptions from my doctor (though eager to help as he was). I held off on the ‘scripts and wanted to think on this for a bit.

Yet it’s really one of the most basic things isn’t it? Effectively self-regulating ourselves. Inna Khazan, PhD, in her extremely readable book, Biofeedback and Mindfulness in Everyday Life (WM Norton and Co., 2019), discusses the fact that we each have our own optimal breathing rate (somewhere around 6 breathes/min). She’s careful to note though that most of the time, in fact, we need to have much higher breathing rates to match the situation. The idea is that we teach our bodies to optimally regulate ourselves in meeting what is facing us. Mindful, self-compassionate hearts help us to connect more deeply with our bodies, and through regular, restorative deep breathing sessions, become teachers to our “day-to-day” breathing selves.

As if I was learning it for the first time, I found it fascinating that our breathing action, mostly entirely controllable by ourselves, can contribute so much to our typically unconscious parasympathetic nervous system which, as Khazan reminds us, is responsible for relaxation and recovery. As we inhale, our conscious, sympathetic nervous system is dominant, our heart rate increasing a bit. When we exhale, our unconscious, parasympathetic nervous system is dominant, our heart rate slowing, our relaxation response expanding. One great paradox it seems is that, although our heart rate ideally settles at a lower rate, say during deep breathing sessions, the variance around that metabolic rate should be as a wide as possible, indicating optimal health. In studying Heart Rate Variability (HRV), many credible studies have correlated higher HRV to a greater level of heart health, even to the point of saying that it’s a better indicator for predicting heart disease than cholesterol level!  But coming back to breathing:  It’s been found that mindful breathing at optimal rates (i.e., 6 breathes/minute) can maximize this Heart Rate Variability. Additional biofeedback modalities using heart-beat monitoring can hone in on this loop more directly and open up an avenues for optimal heart health and many other things.

Another thing I learned was that, our tendency to overbreath (breathing out too much C02) contributes to raising the PH level of our blood, triggering other physiological reactions which look quite similar to that of a state of anxiety. Hypertension, in either case, lives there. But we can self-regulate.

On their website, http://www.mayoclinic.org, the Mayo Clinic gives positive attention to a breathing biofeedback system called Resperate. It’s one of the few of such, I believe, that are approved by the FDA. A light strap goes around the waist and the unit calibrates for the person.  It then graphically (and audibly if desired) provides breathing rate feedback during a timed period. Mindful breathing, aided by this bio-feedback device, helps me to lower into deep 20-30 minute relaxation states consistently at this point.

The benefits last well beyond these regular 20-30 minute breathing periods as well. One clear sign is that my fingers are mostly always warm again and that, in itself has been really interesting to experience.  I’ve tried not to make this too ‘salesy’, because everyone needs to find their own way towards health modalities that work for them, feel authentic, and are thus sustainable. One way or another, however, mindful breathing is a part of it. My advice is to start with breathing biofeedback using something like the Resperate system which I mentioned previously. Then perhaps move on to heart rate biofeedback work. The heart rate monitor sensor data is fed into a Heart Rate Variability calculator, usually part of the device application, and provides direct, actionable HRV feedback while the person is in a deep breathing session for instance. In any case, I would heartily recommend Dr. Inna Khazan’s books. They’re a wealth of information about understanding biofeedback and its connection to mindfulness, as well as applying biofeedback devices to modalities such as Breathing, Heart Rate Variability (again a fascinating topic in itself!), Temperature and Skin Conductance.

Inna Khazan, PhD:

  1. Biofeedback and Mindfulness in Everyday Life, (WM Norton and Company, 2019)
  2. The Clinical Handbook of Biofeedback (WileyBlackwell, 2013)

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