Mindfulness with paced breathing and lowering blood pressure
September 9, 2020
Science Daily/Florida Atlantic University
Now more than ever, Americans and people all over the world are under increased stress, which may adversely affect their health and well-being. Researchers explore the possibility that mindfulness with paced breathing reduces blood pressure. One of the most plausible mechanisms is that paced breathing stimulates the vagus nerve and parasympathetic nervous system, which reduce stress chemicals in the brain and increase vascular relaxation that may lead to lowering of blood pressure.
According to the American Stroke Association (ASA) and the American Heart Association (AHA), more than 100 million Americans have high blood pressure. Elevated blood pressure is a major avoidable cause of premature morbidity and mortality in the United States and worldwide due primarily to increased risks of stroke and heart attacks. Elevated blood pressure is the most important major and modifiable risk factor to reduce stroke. In fact, small but sustained reductions in blood pressure reduce risks of stroke and heart attacks. Therapeutic lifestyle changes of weight loss and salt reduction as well as adjunctive drug therapies are beneficial to treat and prevent high blood pressure.
Mindfulness is increasingly practiced as a technique to reduce stress through mind and body interactions. In some instances, mindfulness includes paced breathing defined as deep and diaphragmatic with slow rates typically about five to seven per minute compared with the usual rate of 12 to 14. Researchers from Florida Atlantic University's Schmidt College of Medicine and collaborators have published a paper in the journal Medical Hypotheses, exploring the possibility that mindfulness with paced breathing reduces blood pressure.
"One of the most plausible mechanisms is that paced breathing stimulates the vagus nerve and parasympathetic nervous system, which reduce stress chemicals in the brain and increase vascular relaxation that may lead to lowering of blood pressure," said Suzanne LeBlang, M.D., a neuroradiologist, second and corresponding author, and an affiliate associate professor in FAU's Schmidt College of Medicine.
The researchers believe the hypothesis they have formulated that mindfulness with paced breathing reduces blood pressure should be tested. To do so, FAU's Schmidt College of Medicine co-authors are already collaborating with their co-authors from the Marcus Neuroscience Institute, Boca Raton Regional Hospital/ Baptist Health South; and the University of Wisconsin School of Medicine and Public Health on an investigator-initiated research grant proposal to the National Institutes of Health. The initial pilot trial would include obtaining informed consent from willing and eligible subjects and assigning them at random to mindfulness either with or without paced breathing and examining whether there are sustained effects on lowering blood pressure.
"This pilot randomized trial might lead to further randomized trials of intermediate markers such as inhibition of progression of carotid intimal thickening or coronary artery atherosclerosis, and subsequently, a large scale trial to reduce stroke and heart attacks," said Charles H. Hennekens, M.D., Dr.PH, senior author, first Sir Richard Doll Professor and senior academic advisor in FAU's Schmidt College of Medicine. "Achieving sustained reductions in blood pressure of 4 to 5 millimeters of mercury decreases risk of stroke by 42 percent and heart attacks by about 17 percent; so positive findings would have important clinical and policy implications."
According to the ASA and AHA, cardiovascular disease (CVD), principally heart attacks and strokes, accounts for more than 800,000 deaths or 40 percent of total mortality in the U.S. each year and more than 17 million deaths worldwide. In the U.S., CVD is projected to remain the single leading cause of mortality and is rapidly becoming so worldwide. Stroke alone ranks fifth in all-cause mortality in the U.S., killing nearly 133,000 people annually as well as more than 11 percent of the population worldwide.
"Now more than ever, Americans and people all over the world are under increased stress, which may adversely affect their health and well-being," said Barbara Schmidt, co-author, teacher, researcher, philanthropist, bestselling author of "The Practice," as well as an adjunct instructor at FAU's Schmidt College of Medicine. "We know that mindfulness decreases stress and I am cautiously optimistic that mindfulness with paced breathing will produce sustained lowering of blood pressure."
https://www.sciencedaily.com/releases/2020/09/200909100214.htm
Stimulating the vagus nerve in the neck might help ease pain associated with PTSD
February 13, 2019
Science Daily/University of California - San Diego
In a randomized, controlled pilot trial, researchers found that participants pre-treated with noninvasive vagus nerve stimulation experienced less pain after heat stimulus than mock-treated participants.
Post-traumatic stress disorder, or PTSD, is a mental condition caused by a traumatic event. People with PTSD may experience intrusive memories, negative thoughts, anxiety and chronic pain. The condition is typically treated with a combination of psychotherapy, anti-depressants and anti-anxiety medications.
It's this connection between mental health and pain that interests Imanuel Lerman, MD, associate professor at University of California San Diego School of Medicine, Jacobs School of Engineering and Qualcomm Institute, and a pain management specialist at UC San Diego Health and Veterans Affairs San Diego Healthcare System.
Lerman especially wants to know how the emotional pain experience may be influenced by the vagus nerve, which runs down both sides of our necks from the brainstem to the abdomen. The vagus nerve also plays a critical role in maintaining heart rate, breathing rate, digestive tract movement and many other basic body functions.
In a study published February 13, 2019 in PLOS ONE, Lerman and colleagues tested noninvasive vagus nerve stimulation as a method for dampening the sensation of pain.
"It's thought that people with certain differences in how their bodies -- their autonomic and sympathetic nervous systems -- process pain may be more susceptible to PTSD," Lerman said. "And so we wanted to know if we might be able to re-write this 'mis-firing' as a means to manage pain, especially for people with PTSD." Lerman led the study with Alan N. Simmons, PhD, director of the fMRI Research Laboratory at Veterans Affairs San Diego Healthcare System and associate professor of psychiatry at UC San Diego School of Medicine.
The team used functional magnetic resonance imaging (fMRI) to get a look at the brains of 30 healthy study participants after a painful heat stimulus was applied to their legs. To determine how the body's sympathetic nervous system responds to pain, they also measured the sweat on the skin of participants before the heat was applied, and at several points as the heat increased.
Half the participants were treated with noninvasive vagus nerve stimulation for two minutes -- via electrodes placed on the neck -- approximately 10 minutes before the heat stimulus. The other half received a mock stimulation.
Lerman and colleagues report three main findings from this study. First, vagus nerve stimulation blunted peak response to heat stimulus in several areas of the brain known to be important for sensory and discriminative pain processing, as well as in emotional pain centers. The treatment also delayed the pain response in these brain regions -- pain-related brain regions were activated ten seconds later in participants pre-treated with vagus nerve stimulation than in sham-treated participants.
Second, the sweat measurements revealed that vagus nerve stimulation altered autonomic responses to painful heat stimulus. For participants pre-treated with vagus nerve stimulation, the sweat response decreased over time, in contrast to the sham-treatment group.
Third, vagus nerve stimulation dampened the usual brainstem centers critical for the fight-or-flight-type responses, which are also known to control the sweat response to pain.
"Not everyone is the same -- some people may need more vagus nerve stimulation than others to achieve the same outcomes and the necessary frequencies might change over time -- so we'll need to personalize this approach," Lerman said. "But we are hopeful and looking forward to the next steps in moving this approach toward the clinic."
Next, Lerman and colleagues will launch a Veterans Affairs Healthcare System-funded clinical trial in San Diego with military veterans, with and without PTSD. They want to determine if at-home vagus nerve stimulation can reduce emotional pain and underlying neural inflammation associated with PTSD. To learn how to participate, please call 858-552-8585.
Vagus nerve stimulation is a form of neuromodulation, an approach to pain management that also includes spinal cord and dorsal root ganglion (DRG) stimulation. The U.S. Food and Drug Administration (FDA) has approved noninvasive vagus nerve stimulator for the treatment of episodic and chronic cluster headache and acute migraine, as well as an implantable device for epilepsy. An implanted vagus nerve stimulator is now being tested in a clinical trial for the treatment of rheumatoid arthritis. Side effects of implanted vagus nerve stimulation can include hoarseness, shortness of breath and nausea.
https://www.sciencedaily.com/releases/2019/02/190213142700.htm