Capnometric feedback training decreases 24-h blood pressure in hypertensive postmenopausal women

BACKGROUND: High normal resting pCO(2) is a risk factor for salt sensitivity of blood pressure (BP) in normotensive humans and has been associated with higher resting systolic BP in postmenopausal women. To date, however, no known studies have investigated the effects of regular practice of voluntary mild hypocapnic breathing on BP in hypertensive patients. The objective of the present research was to test the hypothesis that capnometric feedback training can decrease both resting pCO(2) and 24-h BP in a series of mildly hypertensive postmenopausal women. METHODS: A small portable end tidal CO(2) (etCO(2)) monitor was constructed and equipped with software that determined the difference between the momentary etCO(2) and a pre-programmed criterion range. The monitor enabled auditory feedback for variations in CO(2) outside the criterion range. 16 mildly hypertensive postmenopausal women were individually trained to sustain small decreases in etCO(2) during six weekly sessions in the clinic and daily sessions at home. 24-h BP monitoring was conducted before and after the intervention, and in 16 prehypertensive postmenopausal women in a control group who did not engage in the capnometric training. RESULTS: Following the intervention, all 16 capnometric training participants showed decreases in resting etCO(2) (− 4.3 ± 0.4 mmHg; p < .01) while 15 showed decreases in 24-h systolic BP (− 7.6 ± 2.0 mmHg; p < .01). No significant changes in either measure was observed in the control group. In addition, nighttime (− 9.5 ± 2.6; p < .01) and daytime (− 6.7 ± 0.2 mmHg) systolic BP were both decreased following capnometric training, while no significant changes in nighttime (− 2.8 ± 2.2 mmHg; p = .11) or daytime (− 0.7 ± 1.0 mmHg; p ≤ .247) systolic BP were observed in the control group. CONCLUSIONS: These findings support the hypothesis that regular practice of mild hypocapnic breathing that decreases resting etCO(2) reliably decreases 24-h blood pressure in hypertensive postmenopausal women. The extent to which these effects persist beyond the training period or can be observed in other hypertensive subgroups remains to be investigated.